Safety and Human Error in Engineering Systems

Safety and Human Error in Engineering Systems
Author: B.S. Dhillon
Publisher: CRC Press
Total Pages: 262
Release: 2012-07-05
Genre: Technology & Engineering
ISBN: 146650692X

In an approach that combines coverage of safety and human error into a single volume, Safety and Human Error in Engineering Systems eliminates the need to consult many different and diverse sources for those who need information about both topics. The book begins with an introduction to aspects of safety and human error and a discussion of mathematical concepts that builds understanding of the material presented in subsequent chapters. The author describes the methods that can be used to perform safety and human error analysis in engineering systems and includes examples, along with their solutions, as well as problems to test reader comprehension. He presents a total of ten methods considered useful for performing safety and human error analysis in engineering systems. The book also covers safety and human error transportation systems, medical systems, and mining equipment as well as robots and software. Nowadays, engineering systems are an important element of the world economy as each year billions of dollars are spent to develop, manufacture, and operate various types of engineering systems around the globe. A rise in accidental deaths has put the spotlight on the role human error plays in the safety and failure of these systems. Written by an expert in various aspects of healthcare, engineering management, design, reliability, safety, and quality, this book provides tools and techniques for improving engineering systems with respect to human error and safety.

To Err Is Human

To Err Is Human
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 312
Release: 2000-03-01
Genre: Medical
ISBN: 0309068371

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Engineering a Safer World

Engineering a Safer World
Author: Nancy G. Leveson
Publisher: MIT Press
Total Pages: 555
Release: 2012-01-13
Genre: Science
ISBN: 0262297302

A new approach to safety, based on systems thinking, that is more effective, less costly, and easier to use than current techniques. Engineering has experienced a technological revolution, but the basic engineering techniques applied in safety and reliability engineering, created in a simpler, analog world, have changed very little over the years. In this groundbreaking book, Nancy Leveson proposes a new approach to safety—more suited to today's complex, sociotechnical, software-intensive world—based on modern systems thinking and systems theory. Revisiting and updating ideas pioneered by 1950s aerospace engineers in their System Safety concept, and testing her new model extensively on real-world examples, Leveson has created a new approach to safety that is more effective, less expensive, and easier to use than current techniques. Arguing that traditional models of causality are inadequate, Leveson presents a new, extended model of causation (Systems-Theoretic Accident Model and Processes, or STAMP), then shows how the new model can be used to create techniques for system safety engineering, including accident analysis, hazard analysis, system design, safety in operations, and management of safety-critical systems. She applies the new techniques to real-world events including the friendly-fire loss of a U.S. Blackhawk helicopter in the first Gulf War; the Vioxx recall; the U.S. Navy SUBSAFE program; and the bacterial contamination of a public water supply in a Canadian town. Leveson's approach is relevant even beyond safety engineering, offering techniques for “reengineering” any large sociotechnical system to improve safety and manage risk.

Guidelines for Preventing Human Error in Process Safety

Guidelines for Preventing Human Error in Process Safety
Author: CCPS (Center for Chemical Process Safety)
Publisher: John Wiley & Sons
Total Pages: 416
Release: 2010-08-13
Genre: Technology & Engineering
ISBN: 0470925086

Almost all the major accident investigations--Texas City, Piper Alpha, the Phillips 66 explosion, Feyzin, Mexico City--show human error as the principal cause, either in design, operations, maintenance, or the management of safety. This book provides practical advice that can substantially reduce human error at all levels. In eight chapters--packed with case studies and examples of simple and advanced techniques for new and existing systems--the book challenges the assumption that human error is "unavoidable." Instead, it suggests a systems perspective. This view sees error as a consequence of a mismatch between human capabilities and demands and inappropriate organizational culture. This makes error a manageable factor and, therefore, avoidable.

Ten Questions About Human Error

Ten Questions About Human Error
Author: Sidney Dekker
Publisher: CRC Press
Total Pages: 233
Release: 2004-12-27
Genre: Technology & Engineering
ISBN: 1410612066

Ten Questions About Human Error asks the type of questions frequently posed in incident and accident investigations, people's own practice, managerial and organizational settings, policymaking, classrooms, Crew Resource Management Training, and error research. It is one installment in a larger transformation that has begun to identify both deep-rooted constraints and new leverage points of views of human factors and system safety. The ten questions about human error are not just questions about human error as a phenomenon, but also about human factors and system safety as disciplines, and where they stand today. In asking these questions and sketching the answers to them, this book attempts to show where current thinking is limited--where vocabulary, models, ideas, and notions are constraining progress. This volume looks critically at the answers human factors would typically provide and compares/contrasts them with current research insights. Each chapter provides directions for new ideas and models that could perhaps better cope with the complexity of the problems facing human error today. As such, this book can be used as a supplement for a variety of human factors courses.

The Field Guide to Human Error Investigations

The Field Guide to Human Error Investigations
Author: Sidney Dekker
Publisher: Routledge
Total Pages: 137
Release: 2017-11-01
Genre: Social Science
ISBN: 1351786032

This title was first published in 2002: This field guide assesses two views of human error - the old view, in which human error becomes the cause of an incident or accident, or the new view, in which human error is merely a symptom of deeper trouble within the system. The two parts of this guide concentrate on each view, leading towards an appreciation of the new view, in which human error is the starting point of an investigation, rather than its conclusion. The second part of this guide focuses on the circumstances which unfold around people, which causes their assessments and actions to change accordingly. It shows how to "reverse engineer" human error, which, like any other componant, needs to be put back together in a mishap investigation.

A Human Error Approach to Aviation Accident Analysis

A Human Error Approach to Aviation Accident Analysis
Author: Douglas A. Wiegmann
Publisher: Routledge
Total Pages: 174
Release: 2017-12-22
Genre: Technology & Engineering
ISBN: 1351962353

Human error is implicated in nearly all aviation accidents, yet most investigation and prevention programs are not designed around any theoretical framework of human error. Appropriate for all levels of expertise, the book provides the knowledge and tools required to conduct a human error analysis of accidents, regardless of operational setting (i.e. military, commercial, or general aviation). The book contains a complete description of the Human Factors Analysis and Classification System (HFACS), which incorporates James Reason's model of latent and active failures as a foundation. Widely disseminated among military and civilian organizations, HFACS encompasses all aspects of human error, including the conditions of operators and elements of supervisory and organizational failure. It attracts a very broad readership. Specifically, the book serves as the main textbook for a course in aviation accident investigation taught by one of the authors at the University of Illinois. This book will also be used in courses designed for military safety officers and flight surgeons in the U.S. Navy, Army and the Canadian Defense Force, who currently utilize the HFACS system during aviation accident investigations. Additionally, the book has been incorporated into the popular workshop on accident analysis and prevention provided by the authors at several professional conferences world-wide. The book is also targeted for students attending Embry-Riddle Aeronautical University which has satellite campuses throughout the world and offers a course in human factors accident investigation for many of its majors. In addition, the book will be incorporated into courses offered by Transportation Safety International and the Southern California Safety Institute. Finally, this book serves as an excellent reference guide for many safety professionals and investigators already in the field.

Behind Human Error

Behind Human Error
Author: David Woods
Publisher: CRC Press
Total Pages: 495
Release: 2017-09-18
Genre: Technology & Engineering
ISBN: 1317175530

Human error is cited over and over as a cause of incidents and accidents. The result is a widespread perception of a 'human error problem', and solutions are thought to lie in changing the people or their role in the system. For example, we should reduce the human role with more automation, or regiment human behavior by stricter monitoring, rules or procedures. But in practice, things have proved not to be this simple. The label 'human error' is prejudicial and hides much more than it reveals about how a system functions or malfunctions. This book takes you behind the human error label. Divided into five parts, it begins by summarising the most significant research results. Part 2 explores how systems thinking has radically changed our understanding of how accidents occur. Part 3 explains the role of cognitive system factors - bringing knowledge to bear, changing mindset as situations and priorities change, and managing goal conflicts - in operating safely at the sharp end of systems. Part 4 studies how the clumsy use of computer technology can increase the potential for erroneous actions and assessments in many different fields of practice. And Part 5 tells how the hindsight bias always enters into attributions of error, so that what we label human error actually is the result of a social and psychological judgment process by stakeholders in the system in question to focus on only a facet of a set of interacting contributors. If you think you have a human error problem, recognize that the label itself is no explanation and no guide to countermeasures. The potential for constructive change, for progress on safety, lies behind the human error label.

Space Safety and Human Performance

Space Safety and Human Performance
Author: Barbara G. Kanki
Publisher: Butterworth-Heinemann
Total Pages: 946
Release: 2017-11-10
Genre: Technology & Engineering
ISBN: 0081018703

Space Safety and Human Performance provides a comprehensive reference for engineers and technical managers within aerospace and high technology companies, space agencies, operators, and consulting firms. The book draws upon the expertise of the world's leading experts in the field and focuses primarily on humans in spaceflight, but also covers operators of control centers on the ground and behavior aspects of complex organizations, thus addressing the entire spectrum of space actors. During spaceflight, human performance can be deeply affected by physical, psychological and psychosocial stressors. Strict selection, intensive training and adequate operational rules are used to fight performance degradation and prepare individuals and teams to effectively manage systems failures and challenging emergencies. The book is endorsed by the International Association for the Advancement of Space Safety (IAASS). - 2019 PROSE Awards - Winner: Category: Engineering and Technology: Association of American Publishers - Provides information on critical aspects of human performance in space missions - Addresses the issue of human performance, from physical and psychosocial stressors that can degrade performance, to selection and training principles and techniques to enhance performance - Brings together essential material on: cognition and human error; advanced analysis methods such as human reliability analysis; environmental challenges and human performance in space missions; critical human factors and man/machine interfaces in space systems design; crew selection and training; and organizational behavior and safety culture - Includes an endorsement by the International Association for the Advancement of Space Safety (IAASS)

Safety-I and Safety-II

Safety-I and Safety-II
Author: Erik Hollnagel
Publisher: CRC Press
Total Pages: 158
Release: 2018-04-17
Genre: Technology & Engineering
ISBN: 1317059794

Safety has traditionally been defined as a condition where the number of adverse outcomes was as low as possible (Safety-I). From a Safety-I perspective, the purpose of safety management is to make sure that the number of accidents and incidents is kept as low as possible, or as low as is reasonably practicable. This means that safety management must start from the manifestations of the absence of safety and that - paradoxically - safety is measured by counting the number of cases where it fails rather than by the number of cases where it succeeds. This unavoidably leads to a reactive approach based on responding to what goes wrong or what is identified as a risk - as something that could go wrong. Focusing on what goes right, rather than on what goes wrong, changes the definition of safety from ’avoiding that something goes wrong’ to ’ensuring that everything goes right’. More precisely, Safety-II is the ability to succeed under varying conditions, so that the number of intended and acceptable outcomes is as high as possible. From a Safety-II perspective, the purpose of safety management is to ensure that as much as possible goes right, in the sense that everyday work achieves its objectives. This means that safety is managed by what it achieves (successes, things that go right), and that likewise it is measured by counting the number of cases where things go right. In order to do this, safety management cannot only be reactive, it must also be proactive. But it must be proactive with regard to how actions succeed, to everyday acceptable performance, rather than with regard to how they can fail, as traditional risk analysis does. This book analyses and explains the principles behind both approaches and uses this to consider the past and future of safety management practices. The analysis makes use of common examples and cases from domains such as aviation, nuclear power production, process management and health care. The final chapters explain the theoret