Here’s another compendium of articles exploring blame and language in the construction of post-hoc causality explanations, or how blame effects learning and investigations. The other part covers some articles around Just Culture and restorative culture. Note: I’ve mostly focused on articles that I’ve either already summarised or that I could find a full text link… Continue reading Compendium: Blame, Just Culture & language
Tag: accidents
Human Performance Tools: Engaging Workers as the Best Defense Against Errors & Error Precursors
This article covered a more progressive view on human performance, with suggestions on some tools. Too much to cover, so just a few points. They start by saying to consider three truisms: “To err is human. Workers are fallible. Errors are inevitable (as well as predictable)”. These are fundamentals to understanding the human performance approach… Continue reading Human Performance Tools: Engaging Workers as the Best Defense Against Errors & Error Precursors
The use of weak signals in occupational safety and health: An investigation
This study explored current knowledge and use of weak signals in safety. Thanks to Clive Lloyd for sharing this a couple weeks back. As you’d expect, this sort of topic, based on accidents, is pretty replete with hindsight and outcome knowledge but is interesting nevertheless. Extracts: · They have been defined as an “…imprecise early indication… Continue reading The use of weak signals in occupational safety and health: An investigation
Boards of directors’ influences on occupational health and safety: a scoping review of evidence and best practices
This literature review evaluated the impact of boards of directors on workplace safety. 49 studies met inclusion. Way too much to cover. Background: · “There is a growing understanding that operative leadership, from line managers to senior management, plays an important role in occupational health and safety” · Leadership “do not act in a vacuum”… Continue reading Boards of directors’ influences on occupational health and safety: a scoping review of evidence and best practices
Constructions of “Human Error” (Mini-Compendium)
Here’s a bunch of linked articles (and a video) unpacking the constructs, or uses, of “human error”. (‘Keep calm’ header image source is my own, from a presentation) Welcome any additions. Shout me a coffee Link: https://safety177496371.wordpress.com/2021/08/05/searching-for-the-origins-of-the-myth-80-human-error-impact-on-maritime-safety/ Link: https://safety177496371.wordpress.com/2025/01/31/hollnagel-on-human-error-error-as-cause-process-or-outcome/ Link: https://safety177496371.wordpress.com/2024/09/05/the-emperors-new-clothes-or-whatever-happened-to-human-error/ Link: https://safety177496371.wordpress.com/2024/07/24/human-error-and-violation-of-rules-in-industrial-safety-a-systematic-literature-review/ Link: https://safety177496371.wordpress.com/2024/07/01/design-rules-based-on-analyses-of-human-error/ Link: https://safety177496371.wordpress.com/2024/06/21/understanding-human-error-in-naval-aviation-mishaps/ Link: https://safety177496371.wordpress.com/2024/05/24/state-of-science-evolving-perspectives-on-human-error/ Link: https://safety177496371.wordpress.com/2024/05/14/six-stages-to-the-new-view-of-human-error/ Link: https://safety177496371.wordpress.com/2024/04/16/human-performance-in-barrier-thinking-problems-with-human-error-post-1/ Link: https://safety177496371.wordpress.com/2024/01/18/perspectives-on-human-error-hindsight-biases-and-local-rationality/… Continue reading Constructions of “Human Error” (Mini-Compendium)
Factors affecting learning from incidents: A cross-industry review
This study systematically reviewed the research to unpack the factors that influence learning from incidents (LFI). Likely nothing new to anybody, but it is a good reference paper for tracking down specific research. Background: · Common reasons for ineffective LFI are “underreporting of incidents (Sanne, 2008), incapacity to identify latent circumstances (Jacobsson et al., 2009), the… Continue reading Factors affecting learning from incidents: A cross-industry review
The rule of three: Situation awareness in hazardous situations
“The rule of three provides a mechanism that converts the risk continuum into a dichotomy for the purposes of decision-making. It does not, however, ignore the expertise of operators … Put another way, the rule of three structures expert decision-making; it does not replace it”
How do boards of directors influence workplace safety?
What impacts do boards of directors have on workplace safety? Found this an interesting extract from a paper I summarised over the weekend (will probably post next week). It systematically explored the links between boards of directors and their influence on safety. Of the 49 included studies, they found: · “Empirical studies gave no insight into… Continue reading How do boards of directors influence workplace safety?
“Those found responsible have been sacked”: some observations on the usefulness of error
Another interesting paper co-authored by the late Richard Cook. This paper discusses the usefulness of error. It’s a larger post with a lot of quotes – I just can’t do a better or more succinct job of restating what they’ve already written. Providing background, they argue that while some see “error” as a dead-end, others… Continue reading “Those found responsible have been sacked”: some observations on the usefulness of error
How to make injury metrics suck less?
How can we make injury metrics suck less? So this came out of a conversation with somebody (thanks Jordan Vince). I’m **not** a promoter of injury measures. I think we spend FAR too much time quibbling over what are, statistically speaking, quite rare events, when we have the entire spectrum of daily work to learn… Continue reading How to make injury metrics suck less?
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