PAPod 587 - Start in the Black: How Sleep Debt Impacts Safety

Hosts Todd and Brent discuss an upcoming restorative workshop centered on RaDonda Vought's account of the Emory Hospital event. The episode highlights how normal performance variability can combine into serious failures, the value of storytelling, and the importance of learning and building resilience across complex systems. The workshop in Santa Fe (March 31–April 1) invites healthcare and high‑risk industry professionals to move from “what” happened to “how” to apply lessons in practice. For more information or to register, contact [email protected].

Host Todd Conklin interviews fatigue expert Mark Rosekind, PhD about his path from sleep research to roles at NASA, the NTSB, and NHTSA, and how sleep science applies across transportation and safety-critical work. Key takeaways: think of sleep like a bank account (sleep debt), "start in the black" before major schedule changes, the benefits of strategic naps, and systemic ways organizations can reduce fatigue to improve performance, health, and safety.

Todd Conklin discusses VUCA (Volatility, Uncertainty, Complexity, Adaptation) and argues that innovation and safety improve when organizations embrace uncertainty and gather more diverse information and perspectives. He mixes personal travel and Olympics anecdotes, touches on aviation and healthcare examples, and invites listeners to a hands-on workshop to explore these ideas further.

In this clip from the Pre‑Accident Investigation Podcast and Punk Rock Safety, Todd joins Ron, Ben, and David to debate why safety innovation is stalling, where new ideas are coming from, and who’s pushing practice forward. They explore barriers like regulatory pressure, the pull of “normal,” and the difference between improving safety and redesigning work. Using examples from pediatric intensive care and other domains, the conversation highlights pockets of progress, the danger of idea corruption, and the need to embrace experimentation, rethink systems, and find the next generation of thinkers to advance safety practice.

This episode tells the real-life story of how the Society for Patient Safety and a network of children’s hospitals used learning teams, proactive safety huddles, and simulations to reduce unplanned extubations in neonatal ICUs — cutting rates by 60% and preventing thousands of deaths. It covers the data, the frontline-led solutions, the narrowing of racial disparities, and an invitation to a small conference in Santa Fe to learn and share improvement practices.

This episode previews a small workshop in Santa Fe where Todd Conklin, Ann Lyren, and guest ReDonda Vaught will explore a tragic patient safety case. They frame accidents as the unexpected combination of normal performance variability and discuss how to learn from such incidents. Listeners will hear about the meeting goals (March 31–April 1), opportunities to chart the event, and practical tactics for organizations to identify and respond to accumulating risks, with cross-industry lessons and a focus on improving safety culture.

Todd Conklin breaks down why accountability is an act of clarity, not blame or discipline, and why leaders and workers share responsibility for operational safety. He highlights the need to set roles before incidents occur, contrasts accountability with performance management, and announces a case-study workshop about Redonda’s Vanderbilt story in Santa Fe (March 31–April 1).

Todd Conklin explores why its so difficult to measure events that never happen and how traditional safety metrics can mislead organizations. He argues for focusing on metrics that validate safeguards and create desired outcomes rather than only counting accidents. The episode also touches on automation risks, the limits of frequency-based measures, and the need for better leading indicators and verification practices to keep systems safe even when nothing appears to go wrong.

Todd Conklin opens 2026 reflecting on why how we begin interactions and jobs matters more than we often realize. He uses stories from travel, aviation, and workplace examples to show that the start of an encounter often predicts its outcome. Conklin urges listeners to choose kindness, psychological safety, and deliberate planning—start the job when the right controls are in place—rather than beginning from hate, division, or aggression. He links these opening choices to organizational resilience, safety, and reliability. The episode is a New Year’s call to focus on how we start conversations and work: start safe, be kind, and build cultures that help people succeed in difficult and high-risk environments.

In this episode Todd Conklin reflects on entering 2026 by urging listeners to focus on how we begin interactions—at work and in life. He explains how starting encounters from a place of respect, psychological safety, and proper planning increases the chances of ending safely and builds stronger, more resilient organizations. Practical takeaways include prioritizing pre-job readiness, shifting from compliance to capacity, and choosing kindness over division to improve culture, safety, and outcomes.