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Also known as: postmortem, incident review, retrospective, RCA

Post-Mortem

ConceptualOperationsFrameworks

Definition

Post-Mortem: A post-mortem is a structured analysis conducted after an incident or project to understand what happened, why it happened, and how to prevent recurrence. Blameless post-mortems focus on systemic improvements rather than individual fault. The goal is organizational learning, not punishment.

Example Usage

β€œOur post-mortem for the 4-hour outage identified three contributing factors and resulted in five systemic improvements, including better monitoring.”

Common Misconceptions

Post-mortems find who to blame. Blameless culture focuses on systems and processes, not individuals.
Only major incidents need post-mortems. Near-misses and smaller issues often reveal the same systemic problems.
Writing the doc is enough. Post-mortems need follow-through on action items; track completion.

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