To err is human
That is a fact. This is mainly due the way we process information in our minds. We can only cope with a certain level of information and so to help with this our minds do 1 of three things – Generalise, Distort and Delete. For example:
We grow to know that a chair is a chair despite there being lots of shapes sizes, colours etc. – this is how we generalise, we don’t have to labour in thinking about it.
We sometimes get a bad reaction from something we say to someone and don’t understand why they are offended – this is because they distort the message by reading things into it based on the beliefs and past experiences.
How often have you taken a regular car journey and arrive not having remembered some of it! when we become familiar with a situation or just expect it to be a certain way we delete information and ‘see what we expect to see’ – even if this is not how the situation is.
Imagine all this deleting, generalising and distorting happening in the field of our work? If our work processes are designed for vigilance and accepting to err is human then we can minimise the risk for potential error that may arise then we should not create too many errors. However, if it isn’t then this is a recipe for disaster and is ‘an accident waiting to happen’.
To cope with this human error factor, then we must design our work processes for Reliability.
What is Reliability?
‘Reliability depends on the lack of unwanted, unanticipated and unexplainable variance in performance’
- Eric Hollnagel, 1993 p51
‘The major determinant of reliability in an organisation is not how greatly it values reliability or safety per se over other organisational values, but rather how greatly it disvalues the mis-specification, misestimation and misunderstanding of things; All else being equal, the more things that more members of an organisation care about mis-specifying, misestimating or misunderstanding, the higher the level of reliability that organisation can hope to attain’
- Paul Schulman 1997, Diablo Canyon Power Plant
Examples of High Reliability Organisations
Nuclear power generation plants
Naval Aircraft Carriers
Chemical production plants
Air traffic control systems
Incident control teams
Wildland firefighting crews
Hospital intensive care units
Investment banks
Off-shore drilling rigs