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This column is part of Globe Careers' Leadership Lab series, where executives and experts share their views and advice about leadership and management. Follow us at @Globe_Careers. Find all Leadership Lab stories at

As someone who has completed three spacewalks and logged more than 680 hours in space, there's no doubt my greatest life moments took place away from earth. The surprising part is that I learned some of my most meaningful 'on-the-ground' business lessons there too.

Being part of a team of astronauts focused on peak performance, I learned early on the importance of culture, core values, quality, safety and sustainability. Today, as president and chief executive officer of Southlake Regional Health Centre in Newmarket, Ont., I continue to keep these matters top of mind – and it's making a difference in the success of our organization.

Here are my top five business lessons learned from space that can benefit every business – large or small:

Avoid errors

In space, you live by the credo "fail ops, fail safe." When equipment fails, you must remain operational without compromising safety. In business, we talk about achieving 100 per cent success, but how do you do that when we know humans inevitably make errors? You do it by using a tight system of controls, checks and balances to prevent mistakes in the first place. When you work in a highly demanding environment such as space, you must make time-critical decisions that often come with life or death consequences. Sometimes it's impossible to reverse a wrong decision. But with a strong focus on error avoidance and mitigation, you can optimize prevention and control the consequences.

Create a sustainable culture

Creating culture is based on knowing your core values and ensuring they're memorable, relatable and clearly demonstrated by management. At NASA, culture is highly visable. I have a closet full of mission-specific shirts, each with a unique logo, worn as a reminder that all team members hold themselves accountable to the highest safety standard. That same sense of cultural pride is fostered in a business environment using catchy phrases to depict core values. At Southlake, we say: Put patients first; Give a damn; Push the envelope; Honour your commitment; and Speak up. When I started at the hospital, our hand hygiene scores were 69 per cent. Today, with more than 40,000 hand hygiene audits taking place each year, we hover between 90 and 95 per cent and that's largely because employees honour their commitments, are proud of how we're doing (they give a damn) and speak up to remind co-workers to follow protocol.

Listen to the experts

Though space commanders are ultimately responsible for missions, they know when to defer to the expertise of others. Both times I flew in space, I served as crew medical officer and took 'command' of medical problems. In business, it's important to subscribe to the same inverted pyramid model of leadership where senior executives spend less time directing and more time listening to front line workers. When a hospital team member pointed out the amount of unused consumables being discarded because they were brought into isolation rooms to treat highly contagious patients and then went untouched, we achieved significant annual savings just by listening and making changes.

Improve quality by examining errors, no matter how small

When catastrophe strikes, aviation experts commonly apply Jim Reason's Swiss Cheese Theory to examine why. His model focuses on how a series of smaller, adverse events come together to contribute to a larger event and demonstrates how harm happens when all system defences fail.

In business, we need to capture and understand those adverse events, no matter how small or inconsequential they seem, so that we can learn from them, prevent them from recurring and improve quality overall. Think of a guest staying at a hotel. The ultimate customer experience isn't about just one service, but relies on the confluence of many small things done really well over the course of a stay.

Recognize that effective leadership requires followership

In the space program, astronauts work with the National Outdoor Leadership School to learn leadership and followership skills. Followership is about speaking up and courageously contributing to the overall team environment. The first step to facilitating change within any organization is to find and influence followers who then become influencers. For leadership to be effective in peak-performing teams, there must be followership.

Applying these lessons at Southlake, we've improved our overall financial performance and achieved significant efficiencies. We also introduced a number of quality safety metrics that have improved outcomes for our patients. Each of the last three years, our hospital standardized mortality ratio (HSMR) – a patient safety indicator by which all hospitals in Canada are measured – indicates that more lives have been saved as a result of our focus on safety and quality. Today, Southlake is among one of the national leaders for HSMR.

It's not rocket science … or is it?

Dr. Dave Williams (@SouthlakeCEO) is president and CEO of Southlake Regional Health Centre (@Southlake_News) in Newmarket, Ont. Canada's first dual astronaut/aquanaut, he is a former member the Canadian Space Agency and was the first non-American to hold a senior management position within NASA.