What is a Postmortem?
Postmortem, told as a story about a meeting that writes down what happened instead of hunting for who's to blame.
Right after the incident, the hunt for who's at fault begins.Everyone jumps straight to 'who pressed that button?!'
Blame makes people hide their mistakes.And then the same incident happens again.
Without blame — just writing down what happened.Not who's to blame — just the facts, and what to fix.
Timeline, root cause, and action items — all written down together.It starts with what happened, minute by minute.
Just saying 'no blame' out loud isn't enough.It has to actually become the culture.
Postmortem = after an incident, gathering without blaming anyone to write down what happened and how it'll be fixed.
A document written under a blameless culture, recording an incident's timeline, root cause, and action items, then sharing it. Instead of blaming a person's mistake, it asks why the system failed to catch it — so the same incident doesn't repeat.
When grown-ups say it
- Postmortem
- The blameless record written after an incident. It only keeps what actually happened.
- Blameless culture
- An attitude of fixing the system, not the person. It has to be a real culture, not just words.
- Timeline reconstruction
- What happened, minute by minute, in order. It's the first thing written down.
- Root cause
- The answer to why it wasn't caught. It looks for the cause, not just the symptom.
- Action items
- The to-dos for what changes next. It also says who does it, and by when.
- Shared documentation
- Writing it so other teams can read it too. It helps other teams avoid the same incident.
- Incident commander
- The one who held the baton during the incident. Makes sure the postmortem actually happens. → the one holding the baton
- Playbook improvement
- Adding what was learned here into the notebook. It means fixing it faster next time. → the mechanic's notebook