Human error is normal. Human error is part of the way we learn. It is almost impossible to remove human error from any system. Therefore, 'Human error' should not be the conclusion of an investigation. If it is, then we are not likely to improve the situation for the future. Depending on the outcome of the error or errors, the impact can be minor or it can be fatal, the problem is we don't necessarily know the scale of the issue until after the event.
In the last blog I covered the basic concept of a Just Culture and why it is essential to have this if we are to improving safety. We need to be able to talk about the errors or violations (at risk behaviours) that occur, and the reasons why it made sense to us at the time if we are to improve performance and safety, and reduce the likelihood of the same adverse event happening again. In this blog I am going to talk about 'human error' and the differences that exist within this overly-simple classification. The next...
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