KACHARAGADLA

Open now? Open later? As the debate rages about restarting economies, one critical element is absent from the discussion. The predictor of our success or failure will have less to do with when businesses open their doors and more to do with how often people open their mouths. Decades of research suggest that the heart of a high-reliability culture is immediate peer accountability. A few years ago, John Noseworthy, CEO of the Mayo Clinic in Rochester, Minnesota, proudly told me about a nurse who confronted him when he forgot to use hand sanitizer as he exited an elevator. He said, in effect, “If everyone in our system will speak up to forgetful colleagues, no matter their level or position, we can avoid most incidents of preventable harm.” And he was right. And yet, in late April, at the peak of the Covid-19 pandemic, Vice President Mike Pence entered the Mayo Clinic to learn about their research efforts. During his tour, provided by Mayo leaders who all wore masks, Pence proceeded bare