Is 'human error' ever acceptable as a cause? Hi All, first post to the forum so hopefully I don't start off on the wrong foot. I have been working in human factors for almost 15 years now, investigated/co-investigated 100s of incidents, utilised a range of methodologies for investigative and risk management purposes, and even the proud owner of
humanerror.co.nz.
However, I do not subscribe to the term human error and especially the way it is used by many organisations as a
fait accompli. I recall a recent "simple case of human error" that was quoted in the news (I get daily google feeds of news items with the term human error in them), whereby a nurse administered methadone to a baby - I found this case particularly upsetting as a father to two children - and utterly unfair on the nurse who must have been beside themselves with the awfulness of their actions. My experience of working with nurses suggest there could have been many reasons for this mistake happening and not necessarily associated with ineptitude driven by the discourse of the article I read.
I do have a lot of time for the Safety II / resilience engineering understanding of challenges to individual resiliency as it favours the idea that humans are not an erroneous liability but actually a commodity, managing the day to day challenges of the workplace. No two days are the same, each day has its challenges to our resilience to manage our day, and it is only when our ability to be resilient goes beyond its limits, do errors happen. I am sure many of you reading this may feel I am preaching to the converted - I hope so. I believe Safety II and its associated tools embraces the human factor much better than any older concepts associated with human error / swiss cheese / HFACS systems that seem to provide more aesthetic value than a true understanding of the human element in the workplace.
Happy to discuss further over coffee. Have been working closely with Erik Hollnagel (father of Safety II) for a few years now and have learnt a lot with using his FRAM methodology to increase workplace resilience and eradicate old concepts of human error. I have learnt a lot from Erik and would love the opportunity to share that learning.
Have a great day.
Karl