Docstoc

Microsoft PowerPoint - 14 Megan Brown

Document Sample
Microsoft PowerPoint - 14 Megan Brown Powered By Docstoc
					 Managing Risks Through
 Training and Competence
 Management
 Megan Brown
 Principal Human Factors Consultant

 8th Nov 2007




Intermodal Conference
LLOYD’S REGISTER AISA
Overview


•   Introduction
•   Definitions
•   Historical approaches
•   Risk-based training needs analysis
•   Risk-based competence assurance
•   Why risk manage competence?
•   Risk of getting it wrong
•   Conclusions




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
 Competence….. that’s the training department’s
 problem…… isn’t it?

 •   Recent incidents, such as Texas City and Buncefield, show that safety critical
     organisations are still struggling with how to assure themselves that they are
     managing organisational and human risks
 •   Staff / contractor competence are often cited as key risk controls




Safety culture      Design of         Process control      Operator          Mechanical
                    equipment             system         monitoring and      protection
                                                            action            systems

 •   A Competence Risk Management Process provides a way of measuring,
     monitoring and improving the human safeguards put in place


Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Definitions


• Risk management
   • “the application of systems, process and activities for the
      identification, understanding and control of hazards to prevent
      loss” (adapted from CCPS)
• Competence
   • “the ability of personnel to perform tasks according to
      expectations” (CCPS)
   • Implies appropriate qualifications, training, technical and non-
      technical skills, knowledge, understanding, behaviour and
      attitudes




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Historical approaches to training and competence
management

• Evolutional
   • No planned, systematic approach
   • Reactive – to fix a problem, often after an incident
• Common misconceptions
   • Competence management is only about training
   • Competence is related to technical skills alone
• Reliance on operational personnel to develop training programmes
  and material can lead to:
   • Gaps and surpluses
   • Disappointing training material
   • Disconnected from risk management controls




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Risk-based training needs analysis (RBTNA)


• Increasing realisation that a risk control that relies on correct human
  action is a weak control, particularly if the person is not competent to
  undertake the action
• Recommendations from Waterfall Inquiry, 2005, established the need
  for risk-based approach to TNA
• RBTNA recognises the contribution of day-to-day activities to the
  overall safety of the organisation
• The risk-based approach prioritises the tasks in a role related to the
  risk associated with ‘getting it wrong’




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
RBNTA Process
               Analysis


                                               Identify and record the tasks performed in the role
                          1. Task Analysis



                                               For each task, identify the technical skills, non
                                                                                           -
                                               technical skills (behavioural markers) and
                          2. Task Elements
                                               underpinning knowledge requirements


               Prioritisation



                                               For each task, determine the Difficulty (D),
                           3. DIF Analysis     Importance (I) and Frequency (F) that the task is
                                               performed


                                                For each task, assign a Priority score, from 1 to 5
                                                                                         –
                          4. Priority Rating    using the DIF algorithm



               Decision Making


                                                         -
                                               Make risk-based and informed decisions about
                                5. Decision    training and competence management
                                Workshop




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
RBTNA spreadsheet


• G:\Rail\SydArea\U_User Folders\Megan\Projects\railcorp\9623 -
  RMC RBTNA\IRO\RMC RBTNA Level B (IRO).xls




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Risk-based competence assurance


• Challenge is to extend the RBTNA approach beyond training needs
  analysis and into competence assurance




                                                                    Knowledge
                                                                    Knowledge
                                                    Ongoing
                                                    Ongoing
  Selection &
  Selection &           Initial
                         Initial    Competence
                                    Competence                      Management
                                                                    Management
                                                    Competence
                                                    Competence
  Recruitment
  Recruitment           Training
                         Training   Assessment
                                    Assessment                      &
                                                                    &
                                                    Maintenance
                                                    Maintenance     Retirement
                                                                    Retirement




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
RBCA Outputs

                                                                         Design of training:
                   RBCA =                 Contributes to    - initial training curriculum for role entry
             Baseline profile of Job,
                                                           - refresher training / ongoing development
            Tasks and Task Priorities
                                                           - training programmes/ learning pathways




                                                           Design of recruitment and selection process



                                                                Design of position descriptions

                                              …
                         Can also contribute to
                                                                     Design of procedures



                                                                Design of job and team structure



                                                           Design of competence assessment process:
                                                                     - assessment checklist
                                                                   - assessment programme




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Corporate Framework


• The competence risk management process should be fully integrated
  into the (process) safety management system
• It links organisational and human performance with safety
  management by defining and measuring the safety critical aspects of
  culture and tasks as risk controls
• It enables the strength and adequacy of these controls to be
  understood, evaluated and managed




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
RBCA as a risk management tool



                Strengthen Organisational Culture & Reduce
                        Error Producing Conditions




                                                                                                                       Detection and Recovery
                                                                                                                        Strengthen Resilience
                                                                          Increase Competence
  Systemic /                                                                                       Human Error /
                                                               Active                                                                           Unwanted
   Latent                                                                                       Procedural Violation
                                                             Conditions                                                                         Outcomes
  Conditions




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Outcomes


• The aspects of organisational culture that are identified as risk
  controls are strengthened
• The organisation is able to demonstrate a robust and defensible
  process for competence assurance
• A framework for reducing human error and improving procedural
  compliance is put in place
• Interventions implemented should lead to improved human reliability
  and reduced LTIs




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
When competency fails…..
•   Flixborough 1974, cyclohexane release              28 fatalities, 86 injuries
      • Operators not trained in hazard identification
      • Not supervised by qualified engineer

•   Seveso, 1976, dioxin release                                 Multiple illness
     • Set point on bursting disc on reactor vessel set too high
     • Operators failed to follow shutdown procedures (weekend holiday)

•   Three Mile Island, 1979, nuclear meltdown          Halted nuclear industry expansion in US
      • Inadequate abnormal process operations training
      • Maintenance staff left 2 block valves in closed position

•   Bhopal, 1984, release of methyl isocyanate        Est. 8000 fatalities, 300,000 injuries
     • 50% to 75% of skilled engineers had left prior to the incident

•   Longford, 1998, major fire                           2 fatalities
      • Poor alarm system design
      • Qualified engineers removed from site




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
Conclusions


• Organisations need to be confident that their personnel are equipped
  with the skills, knowledge and attributes required to perform their
  tasks safely
• Organisations need to train their personnel such that they reduce the
  likelihood and consequences of human error to ALARP
• Using a risk-based approach to training and competence
  management can aid organisations to strengthen their people-related
  risk controls
• However, people will still make mistakes!
• RBCA can help to reduce the frequency of errors and severity of the
  consequences




Intermodal Conference 2008
LLOYD’S REGISTER ASIA
   Thank you …

              questions?

 For more information, please
 contact:

 Megan Brown                    The Lloyd’s Register Group
 Principal Consultant           works to enhance safety and
                                approve assets and systems at
                                sea, on land and in the air –
 T +61 (0)2 8299 4100           because life matters.
 F +61 (0)415 680 975
 E megan.brown@lr.org


Intermodal Conference 2008
LLOYD’S REGISTER ASIA

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:5
posted:4/17/2010
language:English
pages:16
Description: Microsoft PowerPoint - 14 Megan Brown