Human and organizational factors in the achievment of high reliability
1. High reliability organizations (HRO’s)
• Nuclear power stations, commercial aviation, nuclear
submarines, air traffic control
• Potentially hazardous, highly complex systems
Katharine Parkes Design and manufacture of complex equipment
School of Psychology, UWA for which failure is expensive and/or hazardous
• Deepwater subsea equipment, space
exploration, satellite deployment
• Also, medical equipment, software
design, electronics, automobile engineering.
8 June 2009 Engineers Australia / SPE
“Reliability is the probability that a Organizational culture
device, system, or process will perform its
prescribed duty without failure for a given Organizational structure
time when operated correctly in a specified Organizational l
O i i l learning
i
environment”
Capability of companies to meet
reliability requirements (CMM models)
Reliability-oriented HR policies
“The Organizational culture is shaped by the
beliefs, values, attitudes, assumptions, norms, an
d behaviours, which are widely shared throughout philosophy, values, skills and leadership
the organization, and are expressed through qualities of the top management personnel.
rules, structures, decision-making processes, and To build and support a high reliability
reward mechanisms”
culture, managers need to -
, g
• Culture defines how an organization operates • develop a clear vision and provide a coherent sense
internally, and how it adapts and interacts with of direction.
customers, suppliers, regulatory bodies, and other • make a strong and consistent commitment to
external organizations reliability, and ensure adequate resources
• Strong vs. weak cultures • identify and communicate reliability goals
• Defensive vs. constructive cultural styles throughout the company and its suppliers in a way
that engages and inspires employees
1
2. Face-to-face
• High levels of communication foster trust and
good working relationships, the sharing of Video conference
information, and the opportunity to develop new Telephone Decreasing
skills. E-mail
richness
• Constraints on communication: remote sites; Letter
language barriers; engineers as ‘smart people
who don’t talk’ Memo
• The means of communication influences its Numerical computer printout
effectiveness . . .
The right information must be conveyed to the right person
at the right time, to communicate all necessary implications
and consequences without overloading the recipient
• Encourage and reward reporting of
errors; treat errors as learning • In the organization as a whole, high
opportunities; avoid a ‘blame’ culture. levels of alertness and vigilance are
directed at identifying possible
problems and errors, and using
• Fear of a blame culture and possible experience to anticipate future
financial penalties may affect the honesty
and transparency of feedback through the problems.
supply chain (Roberts, Strutt et al, 2001)
Reliability Management Framework
1. Leadership and direction
Refers to the way responsibility and authority is • Setting goals and objectives
distributed within the organization: the number • Corporate Project Processes
of hierarchical levels, reporting lines, and how 2. Consistency
work tasks are allocated among employees.
• Vertical alignment of goals/ processes
• Allocation of goals and requirements
Better company performance is associated with:
3. Coherence
• Fewer layers in the organizational hierarchy • Common processes and practices
• Decentralizing decisions to the lowest possible level • Alignment of goals across disciplines
• Allowing authority to flow to those with relevant
expertise 4. Feedback
• How the organization learns, and
• Frequent and open communication within and across communicates its experience in
work groups projects and operations
Strutt and Brookes (2007)
2
3. Capturing individual knowledge (e.g. lessons
“The way firms build, supplement, and learned, root cause analyses)
organize knowledge and routines around ◦ Systematically storing and organizing knowledge
their activities and within their cultures, and ◦ Regularly updating records
adapt and develop organizational efficiency Transferring knowledge
by improving the skills of their workforce” ◦ Information needs to be widely disseminated
y
◦ Readily accessible to potential users; ‘user-friendly’
• Organizational learning depends on sharing ◦ Shared among individuals and groups
knowledge and experience Mobilizing knowledge; integrating information
• Facilitated by a ‘constructive’ organizational from different sources
culture which places high value on participation ◦ to create new knowledge, and to solve problems
and co-operation ◦ to prevent the recurrence of past errors
Provide a means of assessing the level of
maturity of the practices within organizations
that contribute to reliability, safety, and
effective risk management.
CMM models have been applied in software
development, electronics, offshore oil/gas
industry, subsea engineering, maintenance
activities, marine construction, and water
services.
(Garvin et al. 2008)
Level Maturity Description Characterized as
Lack of written procedures. No real Ad hoc,
1 Uncontrolled understanding of reliability or how solely reactive
Optimized 5 Proactive to achieve it.
Can consistently repeat what it has
2 Repeatable done before, but does not address Prescriptive
Managed 4 or control reliability
Understands reliability and the
3 Defined factors that influence it. Written
it Measured,
Measured
design procedures. Limited open-loop
Defined 3 feedback of lessons from failures.
Can meet reliability targets;
4 Managed products are adapted and reliability Single-loop
improved in response to feedback learning
Repeatable 2 from observed failures.
‘Best practice’. Uses experience and Adaptive
5 Optimized testing not only to correct product processes,
Ad hoc 1 Reactive problems but also to change the way
it operates.
double-loop
learning
3
4. Mean capability scores of subsea supplier companies
on 13 CMM dimensions (Williams et al, 2003)
Setting and allocating
reliability requirements
Research and development in 1
risk and reliability 4 Risk and reliability analysis
13 2 in design. Setting reliability
requirements
3
4
Education and training in risk 12 3 Reliability assurance
and reliability 2 Reliability Training and
3
improvements development
1 2
Feedback and Verification, validation and
organizational learning
g g
11 4 bench-marking g
0 1
Verification and
0 Reliability analysis Customer
validation
Reliability improvement and
risk reduction in design
10 5 Project risk management.
Management of change 9 6 Failure data tracking
Reliability setting in design Reliability testing
and life-cycle transitions
and development and analysis
8 7
Failure reporting, tracking
Supply chain management.
and analysis. Supply chain
management
Subsea equipment suppliers were at a level of 2.2 – 2.75 (c.f. aeronautical Tiku et al (2007)
and automotive industry, 4 – 4.5)
Setting reliability Implement policies that serve to create a stable
requirements
4
workforce, and reinforce and support employee
Reliability Training and engagement and commitment (e.g. provision of
3
improvements development training, good pay, job security)
2
1
Verification and Supplier Develop selection procedures that successfully
Reliability analysis
identify, recruit, and promote people whose
0
validation
Customer
personal characteristics predispose them to
conscientious, vigilant and consistent
performance.
Failure data tracking
Reliability testing
and analysis
Supply chain
management
Tiku et al (2007)
Ensure that all communications reinforce some
aspect of reliability Individual characteristics that promote team
Reward reliability over and above productivity or work, positive interaction, co-
efficiency operation, communication, sharing of information, and
learning among employees
Create clear lines of responsibility; instil
accountability
t bilit • e g Emotional stability, extraversion and emotional
e.g. stability extraversion,
intelligence
Select and promote people on the basis of their
adherence to organizational values ‣ Diligence: conscientious, purposeful, attentive, and
Facilitate development, provide training vigilant behaviour
Encourage employment security; reduce turnover Ability to respond effectively to unexpected problems
and events, and to anticipate possible future difficulties
4
5. Leadership and a strong commitment to
Reliability-enhancing reliability from senior managers
HR strategies An organizational culture that encourages
frequent and open communication
throughout the company and its supply chain
Reliability oriented
Reliability-oriented
Devolving d i i
D l i decision-making t l
ki to lowest possible
t ibl
employee behaviours
levels
‘Trying
conditions’ Positive error management culture
Organizational Encouraging organizational learning
reliability Use of CMM models to assess capability
Implementing reliability-oriented HR policies
Ericksen & Dyer (2005)
Obstacles to communication caused by hierarchy and consequent power that
managers wielded over engineers, stifling their input to critical decisions . .
Cultural traits and organizational practices detrimental to safety were
allowed to develop, including reliance on past success as a substitute for
sound engineering practices; organizational barriers that prevented effective
Melinda Hodkiewitz, School of communication of critical safety information and stifled professional
differences of opinion;
Dave Morrison, School of Psychology A flawed decision-making process – managers tended to solve problems
John Cordery, UWA Business School internally not forwarding them to all hierarchical levels
The evolution of an informal chain of command of decision-making thatg
operated outside the organization’s rules
‘NASA’s organizational culture had as much to do with this accident (the
Gledden Trust, UWA Columbia disaster) as foam did’
. . . The hierarchical, protocol-oriented management culture that failed to
decentralize and defer to engineering expertise after the foam hit.
Cultural belief that the problems were not a threat to flight safety – a belief
reinforced by the safe return of each mission. Flying with these flaws became
normal and acceptable, not deviant.
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