Every post-mortem I've done had:
1. timeline of events
2. impact
3. 5 whys — the details of how and why things happend
4. actionable items
I've never seen a post-mortem without actionable items.
The important part is the action items are assigned an owner and executed.
I’ve done plenty of postmortems and many meetings where we go through the motions but “leadership” does not assign and address follow-ups. Most organizations pay lip service to reliability.
Actionable items go onto the backlog. The backlog grows from the top.
As a stopgap, a manual pre-flight check is added. The number of manual pre-flight checks becomes a ridiculous overhead but it gives a clear person to blame when something goes wrong.
Do the actionable items usually get implemented?