What does the collapse of sub-prime lending have in common with a broken jackscrew in an airliner s tailplane? Or the oil spill disaster in the Gulf of Mexico with the burn-up of Space Shuttle Columbia? These were systems that drifted into failure. While pursuing success in a dynamic, complex environment with limited resources and multiple goal conflicts, a succession of small, everyday decisions eventually produced breakdowns on a massive scale. We have trouble grasping the complexity and normality that gives rise to such large events. We hunt for broken parts, fixable properties, people we...
What does the collapse of sub-prime lending have in common with a broken jackscrew in an airliner s tailplane? Or the oil spill disaster in the Gulf o...
Human error is cited over and over as a cause of incidents and accidents. The result is a widespread perception of a 'human error problem', and solutions are thought to lie in changing the people or their role in the system. For example, we should reduce the human role with more automation, or regiment human behavior by stricter monitoring, rules or procedures. But in practice, things have proved not to be this simple. The label 'human error' is prejudicial and hides much more than it reveals about how a system functions or malfunctions. This book takes you behind the human error label....
Human error is cited over and over as a cause of incidents and accidents. The result is a widespread perception of a 'human error problem', and soluti...
Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge. Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors perspective, Patient Safety: A Human Factors Approach delineates a method that can enlighten and clarify this discourse as well as put us on a better path to correcting the issues.
People often think, understandably, that...
Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to pat...
How do people cope with having "caused" a terrible accident? How do they cope when they survive and have to live with the consequences ever after? We tend to blame and forget professionals who cause incidents and accidents, but they are victims too. They are second victims whose experiences of an incident or adverse event can be as traumatic as that of the first victims . Yet information on second victimhood and its relationship to safety, about what is known and what organizations might need to do, is difficult to find.
Thoroughly exploring an emerging topic with great relevance to...
How do people cope with having "caused" a terrible accident? How do they cope when they survive and have to live with the consequences ever after? ...
When faced with a human error problem, you may be tempted to ask 'Why didn t these people watch out better?' Or, 'How can I get my people more engaged in safety?' You might think you can solve your safety problems by telling your people to be more careful, by reprimanding the miscreants, by issuing a new rule or procedure and demanding compliance. These are all expressions of 'The Bad Apple Theory' where you believe your system is basically safe if it were not for those few unreliable people in it. Building on its successful predecessors, the third edition of The Field Guide to Understanding...
When faced with a human error problem, you may be tempted to ask 'Why didn t these people watch out better?' Or, 'How can I get my people more engaged...
First published in 1999, this volume examined how increasing cockpit automation in commercial fleets across the world has had a profound impact on the cognitive work that is carried out on the flight deck. Pilots have largely been transformed into supervisory controllers, managing a suite of human and automated resources. Operational and training requirements have changed, and the potential for human error and system breakdown has shifted. This compelling book critically examines how airlines, regulators, educators and manufacturers cope with these and other consequences of advanced aircraft...
First published in 1999, this volume examined how increasing cockpit automation in commercial fleets across the world has had a profound impact on the...
