In health care, a post-mortem might be required after a patient has died, to try and establish why, and sometimes when and how, the patient died. Many projects are likely to fail, with reasons including the lack of tools to facilitate change, and failure to consider the organizational and environmental situation a change project faces. When projects or initiatives fail, clinicians often carry out a 'post-mortem', trying to understand the factors that contributed to the failure, with the aim of learning lessons and not repeating the same mistakes. This article discusses the management technique known as the 'pre-mortem', with application of tools and strategies to help mitigate the risks of a change leading to failure.