November 30, 2011 | Mark Paradies

Root Cause Analysis Tip: Common Accident Investigation Errors

Trevor Kletz

Trevor Kletz, Professor at Loughborough University and safety guru from the UK, recently published an article titled: “Some Common Errors in Accident Investigations” in the Safety and Reliability Society Journal.

Four of the eight common errors he listed are:

  1. They quote human error as the cause.
  2. They blame individuals though many people have opportunities to prevent most accidents.
  3. They do not realize that [corrective] actions are the most important part of a report.
  4. The worst error: they think of a possible cause and then look for evidence that supports it.

Why do I bring up this article and these four errors here?

First, because I think that investigators could learn a lot from Trevor’s insights.

But second, because TapRooT® was developed to help prevent these four errors (and help with some of the ones not listed above too). Here’s how…

First, the TapRooT® Root Cause Tree® was developed to lead investigators past the common cause of human error to the real, fixable causes of human error.

Second, TapRooT®’s SnapCharT® diagram helps people see that there is not just one person to blame for an accident. It’s remarkable to see the investigation focus change from blame to understanding.

Third, the TapRooT® Corrective Action Helper® puts emphasis on developing effective corrective actions then the TapRooT® Software automatically includes the actions in the investigation report.

Finally, the TapRooT® System avoids the common cause-and-effect related error of jumping to conclusions by trying to prove a cause. Instead, TapRooT® starts with trying to understand what happened before de¬fining causal factors and then determining their root causes.

By design, TapRooT® helps beat common accident investigation errors.

Isn’t it time you tried TapRooT®?

See our public root cause analysis courses at:

Root Cause Analysis
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