The identification and measurement of safety management systems : towards a behavioural response approach

Master Thesis


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University of Cape Town

This thesis presents a model for identifying, measuring and managing the risks of hazardous technologies. This paper is not targeted at any one domain, but identifies specific principles of safety management applicable to mining, manufacturing, maritime and aerospace industries. Further, the application of a principled and comprehensive programme intends to provide an effective safety culture for general industry. The model addresses safety management at three levels - senior, middle and supervisory - with the aim of identifying latent conditions and active errors in terms of accident causation. The author intends to show that human error is a consequence, not a cause, and that is shaped and provoked by upstream workplace and organisational factors. Only by understanding the context that caused the error can we hope to limit its recurrence. The thesis rejects the popular notion that "human error" is implicated in roughly eighty percent of all major accidents, and proposes that lack of guidelines at the managerial levels of organisations is responsible. This hypothesis was tested and proven at Koeberg Nuclear Power Station by the process of assigning programme elements with steering mechanisms to managers to facilitate evaluation of programme effectiveness. This programme was designed to locate, identify and track errors due to the existence of latent conditions and active failures in operational processes. Human error is thus conceptualised as a symptom. The validity of this approach was established by both qualitative and quantitative assessments. Evaluation of questionnaires clearly indicated the effectiveness of steering controls assigned to the three management levels. It confirmed that specific safety programme elements need to be assigned to managerial levels to facilitate effective behavioural response at the operational level. Significantly, the programme elements utilised provided three essential management functions to the organisation: the human, engineering and organisational management models. Scientific opinion has recognised the need to incorporate these models into management procedures. But current safety management programmes conceptually exclude the above models for lack of appropriate steering mechanisms. The author concludes therefore that the model implemented provides a practicable framework for safety management in general industry. Stressed is the function of error identification and containment in a framework of continuous evaluation of process safety.