James Reason – RIP

Remembering James Reason

James Reason, author, professor, and developer of theories that influenced thinking on human error and safety, died in February at the age of 86. His work will be missed by all in the field of human error and performance improvement.

Swiss Cheese and More

I never got the chance to talk face-to-face with James Reason, but I followed his writing.

James Reason had his own model of errors (the Swiss Cheese Model) and his own analysis method (shown above). Some of these models were influenced by Donald Norman’s and Jens Rasmussen’s work (GEMS), and some were influenced by work at the System Safety Development Center (Barrier Analysis). Perhaps the most insightful piece of the model was the thinking behind “Latent Errors.”

My definition of a latent error is a system-based error that lies waiting to trap someone into making a mistake.

One of the “Reason Quotes” that I often referred to was this:

“… There is no one good way (of) classifying (errors),
but try and find one that can show you how to take remedial action.”

That was one of the strong points (how to take remedial action) of the TapRooT® RCA System.

Anyone wishing to contribute to a tribute to his memory should see THIS LINK.