Trial and error is a sloppy way to investigate and/or manage

We have a very public example of what I call trial and error investigating and/or managing. When we have a problem and don’t know the cause, we try something, and if it doesn’t work, we’ll try something else. We keep trying until we find something that fits. It can be a very exciting way to manage as we’ll never really know what we’ll be doing next.

On June 12, Air India Flight 171 crashed on takeoff, killing 260 people. The aircraft was a Boeing 787-8 Dreamliner. Dreamliners were first introduced to commercial service in 2011. This is the first crash ever of this plane, which has had an incredibly good safety record.

Almost immediately, before anyone knew what the cause could be, Boeing stock took a terrible hit.

Poor videos of the takeoff were immediately analyzed. Licensed pilots said it looked like the flaps weren’t properly set and the landing gear were not retracted after takeoff. It was a warm humid day, the plane was fully loaded, and they felt all these combined factors caused the crash. A properly functioning 787 should have been able to climb despite those factors.

On closer analysis of the videos, they noticed the RAT (ram air turbine) had deployed. This emergency generator deploys automatically when a plane loses electrical and/or hydraulic power to keep critical functions operating. All of a sudden, the flaps and the landing gear were no longer candidates.

Additionally, it was known the plane had experienced electrical problems for some time. On the previous flight, the air conditioning and cabin lights had stopped working. So, a massive electrical power failure was thought to be the cause.

As time went on, different pilots had different theories. These were licensed pilots, including some who actually fly 787s. Who could know more?

The black boxes and cockpit voice recorders were recovered and analyzed in India, rather than in the U.S. This, of course, raised suspicions as to what they were trying to hide as lack of maintenance seemed to be a possible cause.

In any case, a preliminary report was released, and it claimed the plane lost power when the fuel control switches were moved to the closed position shortly after takeoff. The cockpit voice recorder revealed one pilot asking the other why he shut it off. The other one said he didn’t. The switches were restored to the run position, but the plane crashed immediately after.

Of course, that news changed everything.

Back in the late ‘80’s, I had done some work for Boeing in Seattle. I got friendly with several of their VPs. As a former pilot, I was welcomed into their brotherhood, so to speak. Like them, I understood that when a plane gets into trouble, you can’t pull over to the side of the sky and call AAA to tow it to an airport.

One of the VPs was Brian Wygle, and he was in charge of all flight operations. They do a fair amount of flight testing on the planes before delivering them.

Brian was also in charge of the investigative teams deployed to crash sites to determine what went wrong when a Boeing plane goes down. When he talked about this part of his job, he became visibly emotional. It was obvious these guys never wanted any of their planes to go down.

What made these investigations especially disconcerting was the leaking of data by workers at the sites. Every time something was found, the news leaked, and it went viral. Unfortunately, those early finds often had nothing to do with the crash. Even so, reputations were damaged, and careers ruined on erroneous information.

It’s a complicated endeavor, and it often takes a year or so to figure out what really happened. By then, the horror of the crash has cooled, and the real news is no longer newsworthy. It appears in a small article somewhere, never undoing the damage done by the erroneous information that got headlines.

You may not be in the aviation industry, but the same thing happens in our companies when we take corrective action without understanding the real causes. The media may not know of it, and the damage may not be as universal, but it’s still damaging, nonetheless.

Transparency is important, but it can be highly detrimental until we have the real verifiable facts.

Ronald J. Bourque, a consultant and speaker from Salem, has had engagements throughout the United States, Europe and Asia. He can be reached at 603-898-1871 or RonBourque3@gmail.com.