Solving safety problems centers around two key strategies:
Eliminating or reducing the surface causes. It's important to eliminate or at least reduce the inappropriate employee thoughts, unsafe behaviors, and hazardous workplace conditions that directly cause or contribute to the accident.
Employee thoughts, behaviors, and workplace conditions represent the most direct observable and measurable indicators of the effectiveness of the safety management system. If safety management system design or performance is flawed, the most direct internal effect on employees is the change that occurs in what they think. Thoughts, then, affect what employees believe, and belief affects how they feel and behave in the workplace.
The most common external effect of safety management system design or performance is employee behavior. Behaviors are, therefore, the most direct observable effect (leading indicator) of safety management system effectiveness. Inappropriate or unsafe employee behaviors, then, result in hazardous workplace conditions.
To improve employee thoughts and behaviors, and workplace conditions, conduct employee surveys, employee interviews, observations, and workplace inspections to improve the safety management system root causes.
Eliminating or reducing the root cause problems. As you already know, root causes are safety management system weaknesses. To most effectively eliminate or reduce surface causes, you must dig up and treat their root causes. To treat root causes you need to design, develop and deploy a healthy safety management system. Improving safety management system policies, programs, plans, processes, and procedures (the 5-Ps) will positively affect what employees think and how they behave in the workplace.
Ultimately, it all boils down to what employees think: change what they think and they'll change how they behave.
It's the System!
It's very important that management take action to correct OHSMS problems to reduce the risk of injuries and illnesses in the workplace. Most accidents, by far, are caused by inappropriate or unsafe employee thoughts/behaviors. Problems with the physical work environment can also cause injury or illness. Unsafe behaviors indicate that the nature of the problem may reflect employee/manager personal behaviors and performance that increases the probability of injury or illness. Tools that we have previously discussed in the course to identify and understand hazardous conditions and unsafe work procedures include:
Root cause problems include corporate behavior and performance that lead to increased probability of injury or illness. Unsafe corporate behavior and performance is reflected in poor management vision, attitude, decision-making, and policy direction regarding workplace safety and health. Tools to help identify and understand the root-cause problems associated with surface causes include:
To better understand the problem you are trying to solve, you need to answer some very basic questions.
Is there REALLY a problem?
One technique used in conducting root cause analysis when hazards are identified or when incidents/accidents occur is called Cause-Effect Analysis. For every effect there is a cause. Starting with the accident, we analyze each event leading up to the accident to identify "effects." Then we attempt to uncover the cause for each event.
Every "effect" is the result of a "cause". It's important to understand that each effect is, at the same time, the cause for another effect. A single effect by itself can generate a completely new cause-effect branch. Click on the image to the right. It represents only one branch of many possible branches.
As you can see, the first set of questions get at the surface cause(s) related to an actual or potential accident. Once we know what directly caused the injury or illness, we begin to ask why to arrive at root causes. Each time a why question is asked, a deeper root cause is uncovered.
One of the primary tools in cause-effect analysis is the Fishbone Diagram or Cause and Effect Diagram. Basically, it's just a mind map using a different form. The diagram illustrates this. The "Effect" describes the problem. Possible causes are listed under one of several categories that you determine. Generally, these categories might be people, materials, equipment, environment, methods, or procedures.
Mind Mapping, originated by Tony Buzan, is nothing more than "instantaneous non-linear cognitive deduction utilizing spatial forms in a two-dimensional plane." (huh?) Seriously, mind mapping is merely drawing circles and lines to help you quickly think about and categorize ideas, problems, concepts, subjects, and just about anything else. Mind mapping is successful because it takes advantage of the brain's natural ability to categorize ideas in a rapid, but rather unorganized manner.
Look at the mind map below. At the center we write the problem. Then, try to think of the factors that are more obvious causes for the problem. (This works best by letting your subconscious do the work while you watch TV or work on another project) Next, take a look at each factor listed and ask why that particular cause exists. After a while (minutes to hours) you will build a diagram similar in form (but not content) to the one below.
Using this technique, you will be able to take any topic, project, or problem and quickly determine related categories, processes, procedures, etc. Once the mind map is complete, it is merely a matter of reorganizing the information into the more common outline format.
You are probably familiar with this problem solving technique. Brainstorming can be used by individuals or groups quite successfully to quickly develop a list of possible solutions to problems. There are six basic and unalterable rules to the group process of brainstorming that set it apart from other problem-solving procedures. They are:
Mindmelding is just another way to gather a large number of ideas by taking advantage of the creative minds of many people. Here's the process:
Using these techniques to conduct cause analysis will help you uncover those root causes that contributed to an incident or accident. If you improve the system as a result of your analysis, long term benefits will result. You are now saving or making money for your organization...safety's bottom line.
Well, I think it's about time for your MODULE QUIZ, don't you?
Before beginning this quiz, we highly recommend you review the module material. This quiz is designed to allow you to self-check your comprehension of the module content, but only focuses on key concepts and ideas.
Read each question carefully. Select the best answer, even if more than one answer seems possible. When done, click on the "Get Quiz Answers" button. If you do not answer all the questions, you will receive an error message.