Human Error containment strategies – Safety Engineering (SAFTENG)

To contain and control human error, one must first understand its nature. There are basic concepts associated with the nature of human error: the origins of errors can be fundamentally different, and the consequences of similar errors can also be significantly different. While some errors are due to carelessness, negligence, or poor judgment, others may be induced by poorly d signed equipment or may result from a person’s normal reaction to a particular situation. The latter kind of error is likely to be repeated, and its occurrence can be anticipated.

If we want to find actual solutions for the problems human errors cause, we often need large organizational and systemic changes. Another way is to build error tolerance into the system—limiting the consequences of errors when they do occur. This involves adopting a broad organizational approach to error management rather than focusing solely on the
individuals making errors. Here are some suggested strategies from the Human Factors and Error Management training manual (2010)…

(Link provided to SAFTENG members)

ERROR CONTAINMENT	SAMPLE STRATEGIES
Formalize acknowledgment that errors are “normal”	Policy signed by the CEO stating the importance of reporting errors Safety investigation procedures acknowledging differences between intentional and unintentional errors
Conduct regular systemic analysis to identify common errors and build stronger defenses	Periodic staff discussion groups to identify errors and ways to manage them Task analysis to identify error potential and effectiveness of current controls
Identify the risk of potential errors through normal operations behavioral observation programs.	Independent peer-on-peer confidential observation program Safety mentoring and coaching program to identify task-specific potential errors
Identify potential single-point failures (high risk) and build stronger defenses	Road testing of procedures to identify ease of comprehension before roll-out Ensure critical job roles have a backup to avoid over-reliance on individuals
Include the concept of shared mental models in team-based training initiatives	Focus on good operational examples of situational awareness and threat and error management in recurrent crew resource management (CRM) training Focus on good examples of error capture at shift handover at regular toolbox talks Use shift handover as an opportunity for team problem solving, where the incoming shift, with fresh eyes, may help resolve any issues that have occurred during the outgoing shift

Source: Human Factors and Error Management training manual (1998)

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