[SystemSafety] Hazard analysis and The Vinci Massacre

[Les Chambers]

It's easy to be wise after the event (when it's too late). But, if that was
Iraqi I doubt that special forces would have just walked down the street in
clear view of a window in a building populated by the enemy. Clearly in this
case the police didn't believe that surveillance prior to the raid was
warranted. The old acorn of, "it'll never happen" is one of the deadliest
assumptions you can make in hazard analysis. And after the event you kick
yourself for not being paranoid enough and pushing hard enough. 

But this was not my point in offering this piece of theatre.

I am all for using the various hazard analysis techniques and processes that
have been developed over time by functional safety professionals. But often
they get so involved that normal people can't understand what you're talking
about.

Overall, I'd call implementing them step two in hazard analysis sessions.

Step one is creating the emotional environment conducive to people engaging
in the process. In my experience the fertile ground for hazard
identification is the operational experience of those who work with the
systems of interest 8 to 12 hours a day, day and night, mostly without
professional supervision. These people are almost never professional
analysts. Nor are they excellent at expressing themselves. In short they may
lack formal education but are smart and dependable. Universally they believe
more than they can prove and they know more than they can tell. 

I'm constantly in search of ways of getting people who know to actually
speak up and not be intimidated by professional hazard analysts who walk in
the door with no operational experience but massive checklists and
methodologies that look impressive on paper but ignore these simple facts.
Too often I have experienced people who have never done, telling people who
do, how to do.

So the objective of this eight minute scene is to convey with drama:

1. this is a serious process

2. getting it wrong has consequences, personal consequences

3. we are all in this together

4. all our opinions are valuable

5. even if it's a hunch and you can't prove it

6. even if its gut feel

7. speak up we're listening

 

I can't stress these issues too much. I have worked with people who have got
it wrong and been responsible for fatalities. Probably what triggered my
interest in this video was the last minute of the scene, the image of Rachel
McAdams surrounded by dead bodies, smoke and carnage, bent over,
hyperventilating, mouthing every explicative she can think of ... It
reminded me of a guy I met in California 1976. You could see all that in his
eyes. The thing was, his incident had occurred 10 years before.

 

Cheers

Les

From: paul cleary [mailto:clearmeist at hotmail.com] 
Sent: Wednesday, January 13, 2016 3:22 PM
To: Les Chambers
Cc: systemsafety at lists.techfak.uni-bielefeld.de
Subject: Re: [SystemSafety] Hazard analysis and The Vinci Massacre

 

Hi,

 

Not sure how they could have anticipated and identified those hazards, ahead
of time.. 

 

Can I ask, are you familiar with using Nodes and Guidewords as a means to
conduct a structured HAZID session.

 

Or would you approach HAZID without constraints, and leave nodes/guidewords
for HAZOP only?  

 

Regards 

Paul Cleary  BSc, MSc, CEng, EUR ING

M + <tel:+44%20(0)7860%20861979> 44(0)7464722444

 


On Jan 13, 2016, at 4:08 AM, Les Chambers <les at chambers.com.au> wrote:

Hi 

Watching the HBO series: True Detectives (season 2, episode 4), it struck me
that the following eight minute scene would be an excellent warmup for a
hazard analysis session. 

It depicts a day that starts well but just doesn't pan out the way our
heroes planned.

 

Refer: https://www.youtube.com/watch?v=Roi-mL1eUM0

 

Pay particular attention to the last minute, beautifully dramatised as only
Hollywood can.

And ask yourself, do you ever want to be in that situation because you
didn't put enough time into figuring out what could go wrong and what you
could do about it?

 

Cheers

Les

 

-------------------------------------------------
Les Chambers
Director
Chambers & Associates Pty Ltd
www.chambers.com.au

Blog: www.systemsengineeringblog.com
<http://www.systemsengineeringblog.com/> 

Twitter: @ChambersLes <http://www.twitter.com/chambersles> 
M: 0412 648 992
Intl M: +61 412 648 992
Ph: +61 7 3870 4199
Fax: +61 7 3870 4220
les at chambers.com.au
-------------------------------------------------

 

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