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Human Performance (HP) acknowledges the inevitability of human fallibility, often influenced by work systems.
HP is an applied science that helps us identify where we have opportunities to set people up for success and how we can build error-tolerant systems that limit or catch human error.
The Principles of HP
People are an organisation’s most important resources in managing safety, there is an expectation for them to use the correct systems to perform their work safely, and for the organisation to recognise:
- People make mistakes
- Mistakes often result from well-meaning behaviours intended to get the job done
- Underlying conditions often contribute to error-prone situations
- Understanding the ‘how’ and the ‘why’ mistakes occur can help us prevent them
- We can predict, and then prevent or manage most error-prone situations
- A leader’s response to mistakes directly impacts the culture of both learning and accountability
- Leaders, first line Leaders and workers come together to create an engaged, collaborative team
What would it look like if we adopted HP Principles?
A paradigm shift in thinking about operational integrity
Old/Current View
- Asks who is responsible for the outcome
- Sees human error as the cause of trouble
- Suggests that human error is random, unreliable behaviour
- Suggests that human error is an acceptable conclusion of an investigation
- Says what people failed to do and what they should have done to prevent the outcome
New View
- Asks what is responsible for the outcome
- Sees human error as a symptom of trouble inside a system
- Human error is systematically connected to features of people’s tools, tasks and operating environment
- Human error is only the starting point for further investigation
- Helps us find out how peoples’ actions made sense at the time given the circumstances that surrounded them
- Allows the organization to learn from both success and error
Our programs empower and enable effective decision-making at all levels by providing new knowledge and techniques linked directly to an organization’s safety and risk management tools and systems, delivering positive transformational change.
What does Great look like?
Sustainment of Human Performance is foundational, and leaders should know What Great Looks Like.
Leadership & communication
- All Leaders demonstrate behaviors supportive of HP Principles (e.g.: build fluency, effectively apply concepts, respond appropriately when events / errors occur, etc.)
- HP language & terminology are used in correct context in meetings, toolbox discussions, communications, sharing’s to reinforce linkages between HP concepts and existing tools.
- HP Champions are identified to assist in guiding training and sustainment efforts.
- Leaders respond in a positive and supportive manner when team member(s) “Speak Up” about and stop work when a trigger is encountered
Design
- Leaders and Process owners ( e.g. Maintenance, Engineering, Safety) engage end users to redesign facilities and systems so it easier for end users to do it right than get it wrong.
- Design learnings are being developed and communicated back to the design team(s) to drive improvement.
- Leaders consider HP concepts when reviewing and approving changes to project scope that involve addition or deletion of facilities and/or equipment.
Pre-task briefings
- HP concepts are used during pre-task discussions with team members as applicable to the current work.
- Error Prone Situations: Identify the factors associated & mitigations to manage EPSs.
- Hold Points: Discuss Hold Point(s) to be used during execution immediately prior to an unrecoverable step(s)
- Triggers: Pre-define and discuss Triggers to STOP work
- Safeguard Verification: Verify safeguards are in place and effective before commencing work.
- Share Learnings: Connect applicable learnings from events, observations, and After-Action Reviews back to field activities to support continuous improvement.
Higher Consequence Work
- Critical Task Execution: Ongoing use of the Critical Task Execution process for higher consequence work in a manner consistent with HP Principles.
- Planning: Identify targeted work with potential for serious injury or fatality and incorporate LSRA safeguard verification into processes/procedures.
- Safety Critical Task Analysis: Use Safety Critical Task Analysis on all High Consequence Work to identify vulnerabilities and implement additional safeguards.
- Safeguard Verification: Ongoing verification that safeguards are in place and effective before starting work.
Learn
- Operational Learning: Ongoing use of Operational Learning techniques (e.g.: After Action Reviews, structured task observations, etc.) for work consistent with HP Principles.
- How Work Gets Done – Identifying variations from job standards where the team member is potentially exposed to higher risk than expected.
- Difficult Work – Asking team members if there is anything that makes it difficult to perform the work according to job plan/steps.