Oops! Why Things Go Wrong: Understanding and Controlling Error, by Niall Downey

‘I am thirty miles south of London’s Gatwick Airport, the world’s busiest single-runway airport, when one of the seven Flight Control computers in my Airbus A320 aircraft fails . . . ’

So begins this pioneering book by Niall Downey – a cardio-thoracic surgeon who retrained to become a commercial airline pilot – where he uses his expertise in medicine and aviation to explore the critical issue of managing human error. With further examples from business, politics, sport, technology, education and other fields, Downey makes a powerful case that by following some clear guidelines any organisation can greatly reduce the incidence and impact of making serious mistakes.

While acknowledging that in our fast-paced world getting things wrong is impossible to avoid completely, Downey offers a strategy based on current best practice that can make a massive difference. He concludes with an aviation-style Safety Management System that can be hugely helpful in preventing avoidable catastrophes from occurring.

An acknowledged expert in error management, Niall Downey advises governments, major corporations and the health industry on how to develop a systemic approach to controlling for human imperfection. Arguing that prevention is far preferable to denying responsibility after the fact, he gave an influential TEDx talk outlining how healthcare could use aviation's experience to reduce tragic outcomes and improve patient safety.

‘Niall Downey is perhaps the only person in the world who could write this important new book . . . an owner's manual on how to work, live and play safer by knowing how and why errors happen.’ – Dr Brian Goldman, Mount Sinai Hospital, Toronto, and author of The Secret Language of Doctors

About the Author

Capt. Niall Downey FRCSI attended St. Columb’s College in Derry and qualified as a doctor from Trinity College, Dublin. After twelve years of medical training, Niall decided to change course and retrained as an airline pilot with Aer Lingus, initially combining aviation with medicine by working as an Accident & Emergency doctor before focusing full-time on aviation. He currently operates on Aer Lingus’ Airbus A330 fleet flying on their transatlantic network. Niall provides courses and speaks at major conferences on the topic of error management, in particular how it relates to the healthcare industry. He lives with his family in Newry in Northern Ireland.

More Praise for Oops! Why Things Go Wrong

‘Oops! Why Things Go Wrong is essential reading for every person who wants to improve their leadership and teamwork skills, be resilient and survive crises. Downey’s unique knowledge from years of experience commanding commercial airline cockpits and surgeries puts you into the Captain’s seat to maximise safety, quality and save lives.’ – Captain Richard de Crespigny, Retired Airbus A380 Captain at Qantas author of QF32

‘Niall takes the reader on a fascinating journey through a condition we all suffer from – human error. From sport and surgery to aviation and agriculture, this book details both the unfortunate and the catastrophic, why error happens and, most importantly, what we can do about it’ – Mark Gallagher, author of The Business of Winning: Strategic Success from the Formula One Track to the Boardroom

‘Human connections are essential to delivering person-centred care and sometimes the care environment, culture or the way we do things creates harm. In healthcare this can be catastrophic. This book provides safety critical insights and methods to help eliminate avoidable harm. A must read for healthcare teams.’ – Professor Charlotte McArdle, Deputy Chief Nursing Officer NHS England

‘I’ve made mistakes, every doctor will make mistakes, but how can we limit them? Niall Downey’s unique perspective as both pilot and doctor has enabled him to apply the lessons learned by the airline industry to modern medicine. This book should be mandatory reading for everyone with an interest in healthcare, i.e. everyone.’– Dr Liam Farrell, author of Are You the F**king Doctor?

‘Trainee to Captain ... from inside the chest with hands on the heart, to inside the cockpit with hands on the side-stick, Niall Downey offers unique insights into mitigation of errors and human factors. We need this in healthcare now.’ – Professor David J. O’Regan , Retired Consultant Cardio-Thoracic Surgeon

‘In this book, Niall Downey takes a look at error through multiple lenses: from aviation to sport, justice to politics. As a surgeon-turned-pilot, Downey has skin in the game and he casts his net wide to find answers for why things go wrong. – Dr Steven Shorrock, Chartered Human Factors Specialist, Editor in Chief of Hindsight magazine, Honorary Clinical Tutor at the University of Edinburgh

‘Niall’s perspective in this new book is just what the doctor ordered! His insight on what we need to do to radically transform how we all react to human error is urgently needed in healthcare systems across the world.’ – Ariana Longley BS, MPH, Technical Consultant, World Health Organisation, Geneva

‘Captain Niall Downey originally qualified in medicine, training in cardiothoracic surgery, before deciding to change career for commercial aviation. In this great new book, Niall shares his unique expertise and insight from both professions to help healthcare colleagues learn how to reduce their chance of medical error.’ – Professor Peter Brennan, Consultant Oral & Maxillo-Facial Surgeon

‘We so often sleepwalk through life, assuming the systems around us work for the best. Being attentive to human error not only wakes us from that stupor, but makes us realise the ways we can be attentive to our own mistakes. As relevant to big business, industry and elite sport as it is to the individual, error management and how to be alert to it is an important conversation to be had in all walks of life. Niall’s vast experience makes him the perfect person to write this book.’ – Orla Chennaoui, journalist and Lead Presenter for Eurosport’s cycling coverage

‘Niall has spent his entire career studying human error, initially as a surgeon in training and in the last number of years as an airline captain. It is critical that such knowledge and training is adopted in the health service to reduce the risk and impact of error and to ensure that a just culture exists to prevent problems in the future. This book is a vital part of the armoury required.’ – Professor Mark A. Taylor, Consultant General and Hepato-Biliary Surgeon

‘I have known Niall for many decades, as a medical student in Trinity ... a potential Olympic cyclist, a Surgical Registrar and a pilot. He has always ... been an excellent researcher with great integrity which is reflected in his book Oops! Why Things Go Wrong. I recommend that everyone should read this book.’ – Fellow Emeritus Professor Moira O’Brien, Retired Professor of Anatomy, Trinity College, Dublin, Founding Fellow of the RCPI/RCSI Faculty of Sport & Exercise Medicine

‘Infused with hard-won wisdom, Captain Downey has a flair for dazzling scene-setting and an arsenal of startling facts. If you care deeply about making your systems safe and seek to design long-term reliability, then put this book on your required reading list. I greatly appreciate this no-nonsense guide to mitigating against errors and speaking the truth to power about designing safer systems.’ – Professor Paul Barach MD, Former Editor BMJ, Critical Care Specialist