화학공학소재연구정보센터
Journal of Loss Prevention in The Process Industries, Vol.26, No.6, 1113-1127, 2013
Supporting organizational learning by comparing activities and outcomes of the safety-management system
The approach to support organizational learning from pro-active monitoring (activities observations) and deficiencies revealed (outcomes observations) in process-safety incident investigations is proposed. The approach builds on five main steps: i.) Implementation of the incident-investigation procedure at the company level, ii.) Monitoring of the preventive safety activities using various tools, iii.) Identification of the safety outcomes including root-cause analysis, iv.) Comparison of activities observations with outcomes observations in order to reveal latent deficiencies as well as to proof relationships, v.) New universal indicator method is proposed to enhance organizational learning from both activities and outcomes observations. The approach is demonstrated on the implementation at the anonymous SME company. This involved carrying out activities observations in terms of the SMS internal audit and the ARAMIS and the violation-motivation safety-culture questionnaire surveys. The outcomes observations consisted of the three incidents investigations using ECFA(+), 3CA and MORT methods. The approach and the case study enabled demonstration of the relationships between activities observations (preventive indicators) and outcomes observations (root causes/deficiencies indicators) and vice versa. We state that such a comparison adds to the justification of the preventive safety performance indicators. Finally, in order to ease the organizational learning from both activities and outcomes observations, universal management indicators attributes/categories are suggested to be followed and are briefly explained based on a modified REWI approach. (C) 2013 Elsevier Ltd. All rights reserved.