MANUAL HANDLING & ERGONOMICS
KEY PRINCIPLES IN MANAGING HUMAN FAILURE:
• Human failure is normal and predictable. It can be identified and managed.
• Industry should tackle error reduction in a structured and proactive way, with as much rigour as the technical aspects of safety. Managing human failure should be integral to the safety management system.
• A poorly designed activity might be prone to a combination of errors and more than one solution may be necessary.
• Involve workers in design of tasks and procedures.
• Risk assessments should identify where human failure can occur in safety critical tasks, the performance influencing factors which might make it more likely, and the control measures necessary to prevent it.
• Incident Investigations should seek to identify why individuals have failed rather than stopping at ‘operator error’.
new and unexpected, or because they have not be properly trained (or both).
Often in such circumstances, people fall back on remembered rules from similar situations which may not be correct. Training based on good procedures is the key to avoiding mistakes.
Violations (non-compliances, circumventions, shortcuts and work- arounds) differ from the above in that they are intentional but usually well- meaning failures where the person deliberately does not carry out the procedure correctly. They are rarely malicious and usually result from an intention to get the job done as efficiently as possible.
These types of failures often occur where the equipment or task has been poorly designed and/or maintained. Mistakes resulting from poor training are often mistaken for violations. Understanding that violations are occurring and the reason for them is necessary if effective means for avoiding them are to be introduced. Peer pressure, unworkable rules and incomplete understanding can give rise to violations. HSG48 provides further information.
There are several ways to manage violations, including designing violations out, taking steps to
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increase their detection, ensuring that rules and procedures are relevant/practical and explaining the rationale behind certain rules. Involving the workforce in drawing up rules increases their acceptance. Getting to the root cause of any violation is the key to understanding and hence preventing the violation.
COMMON FAILURES There is more to managing human failure in complex systems than simply considering the actions of individual operators. However, there is obvious merit in managing the performance of the personnel who play an important role in preventing and controlling risks, as long as the context in which this behaviour occurs is also considered.
When assessing the role of people in carrying out a task, be careful that you do not do any of the following:
• Treat operators as if they are superhuman, able to intervene heroically in emergencies.
• Assume that an operator will always be present, detect a problem and immediately take appropriate action.
• Assume that people will always follow procedures.
• Rely on operators being well- trained, when it is not clear how the training provided relates to accident prevention or control.
• Rely on training to effectively tackle slips/lapses.
• State that operators are highly motivated and thus not prone to unintentional failures or deliberate violations.
• Ignore the human component completely and failing to discuss human performance at all in risk assessments.
• Inappropriately apply techniques, such as detailing every task on site and therefore losing sight of targeting resources where they will be most effective.
• In quantitative risk assessment, provide precise probabilities of human failure (usually indicating very low chance of failure) without documenting assumptions/data sources.
In order to effectively tackle human error companies should consider whether any of the above applies to how their organisation manages human factors.
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