Is There a Direct Correlation Between Reliability & Safety? “Assumption 1: Safety is increased by increasing system or component reliability. If components or systems do not fail, then accidents will not occur. (p. 7) This assumption is one of the most pervasive in engineering and other fields. The problem is that it is not true. Safety is a system property, not…
What Happened? As many of you know, I have been encouraging my LI contacts for years to take me up on my offer to review any pictures they have of failed parts, and we would try and provide them some preliminary feedback. Well, someone finally took us op on the offer and we wanted to share what was learned (we…
Shallow Cause Analysis vs. Root Cause Analysis In this original post, A Mechanic’s Story: Basic Component Fatigue, we took a detailed journey through the physical side of a shaft failure RCA. We stopped at the physical side of that failure, parallel misalignment. However, stopping at the component level of failure does not constitute a credible and thorough RCA. Actually stopping at…
Grade Your RCA Effort and Print Out Your Private Report Card… Abstract: If you had to give a grade to your current Root Cause Analysis (RCA) initiative, what would it be? How would you come to that conclusion (grade)? The paradox many face with such initiatives is drawing the distinction between compliance and actual effectiveness. What would our RCA grade be based on? In this…
The Need to be a “Little Bit Bold & Outrageous” the man who taught us how This phrase ‘a little bit bold & outrageous’ was constantly used by my father, Charles J. Latino early in his Reliability career. Charles founded and led one of the first corporate, global Reliability Engineering R&D groups in the U.S. for a company called Allied…
The Pro’s and Con’s of Using Pre-Existing Logic in Root Cause Analysis (RCA) By Robert J. Latino, CEO, Reliability Center, Inc. Abstract: There has been an ongoing debate for decades as to whether or not the use of pre-existing logic for conducting Root Cause Analyses helps or hinders the analysis results. Does the use of such pre-existing logic expand the thinking…
In order to know if all RCA is the same, we first have to define ‘What is RCA?’ On the surface, this seems quite simple, but unfortunately, it is quite complex. When I train or present speeches around the world, I often poll my audiences about how they define ‘RCA’. The fact is I will get as many answers, as I have people…
What is ‘Reliability Engineering’? I have been very involved recently with ongoing LI discussions with respected and noted experts in the Safety community, revolving around the perceptions those in Safety have of Reliability, and vice-versa. In Safety today, there are ‘new’ approaches emerging being lead by noted Safety researchers like Sidney Dekker, Erik Hollnagel and Todd Conklin. Such ‘new’ approaches…
“Preventing process accidents requires vigilance. The passing of time without a process accident is not necessarily an indication that all is well and may contribute to a dangerous and growing sense of complacency. When people lose an appreciation of how their safety systems were intended to work, safety systems and controls can deteriorate, lessons can be forgotten, and hazards and deviations from safe…
Much has been written about James Reason’s original Swiss Cheese Model described in his book Managing the Risks of Organizational Accidents. Figure 1 is a basic representation of this model. Many today consider this model to be obsolete because of the evolving complexity of systems due to emerging technologies. Therefore, the linearity of failure expressed in this original model, is not as…
Is System’s Thinking Critical to Root Cause Analysis’s (RCA) Success? Put another way, can RCA be successful without the incorporation of system’s thinking? What prompted this question was that according to Drs. Leveson and Dekker in their 2014 paper Get To The Root of Accidents, systems thinking is not currently utilized in the application of RCA. In this paper they cite:…
Why Can’t Learning Teams (LT) and RCA Teams be Friends? A Little History About How I Came Across Learning Teams. A little over three years ago I was asked to speak at a conference that was entitled, Human Performance, Root Cause and Trending or HPRCT (great conference BTW and I encourage you to attend). This was a different world for me as I…