Category: Equipment/Equifactor®

When is a leak in a nuclear reactor minor?

September 20th, 2018 by

NewImage

I saw an interesting article in the Military News yesterday. The headline read:

Navy: ‘Minor’ moisture leak in nuclear plant prompts sub’s return to Groton base

This caused me to think of several things…

First, if a ship has to return to port, the leakage was not minor.

Second, I’m glad they returned to port for repairs. Much better than having the leak progress into an accident.

Third, why did we hear about this?

The article doesn’t give many details about the problem and the Navy spokesperson downplayed the significance by calling coming back into port for a leak:

…not uncommon, and ensures the ship is maintained at a high state of readiness.

I guess I was in the Navy a long time ago when things like that were uncommon.

In fact, back then if something like this happened, there would not have been a press release. The ship would have gone ito port, been fixed, and gone back out to sea.

Los Angeles class subs are getting old (USS Pittsburgh is over 30 years old) and I hope the Nuclear Navy really is maintaining the high state of readiness that they are known for.

How is your maintenance program? Need help troubleshooting equipment problems? Consider having an TapRooT®/Equifactor® Course at your site. Contact us by clicking here.

TapRooT® Around the World: 3-Day Equifactor® in Bogota, Colombia

September 5th, 2018 by

Here’s a glimpse into a recent 3-Day Equifactor® course in Bogota, Colombia, taught by TapRooT® Instructors Hernando Godoy and Piedad Colmenares. We really appreciate Diana Munevar for sharing these pictures that show teamwork, the TapRooT® learning experience, and a great time in the process!

The 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Failure Analysis Course is designed to help investigators troubleshoot equipment problems to get the information they need to find and fix the root causes of equipment-related failures. These tools can be used by equipment troubleshooting experts, maintenance and equipment reliability specialists, or other investigators who don’t have an extensive understanding of equipment engineering.

Through TapRooT® Training with our exceptional instructors, students learn to find and fix the root causes of incidents, accidents, quality problems, precursor events, operational errors, hospital sentinel events, and many other types of problems. Take a course taught by one of our expert TapRooT® instructors and you will understand how to troubleshoot and identify the root cause of any issue and/or incident.

Put yourself in the picture by becoming trained in troubleshooting and identifying root causes of issues and incidents. Register today for a TapRooT® course and gain advantage, experience, and expertise from our professional instructors. Here are some of our upcoming courses:

Denver, Colorado, September 18, 2018: 2-Day TapRooT® Root Cause Analysis Training

Calgary, Canada, September 24, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Amsterdam, The Netherlands, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Atlanta, Georgia, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Bogota, Colombia, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Bogota, Colombia, September 26, 2018: 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Analysis Course

Manchester, United Kingdom, October 1, 2018: 2-Day TapRooT® Root Cause Analysis Training

Aberdeen, Scotland, October 08, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Knoxville, Tennessee, October 15, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Kuala Lumpur, Malaysia, October 17, 2018: 2-Day TapRooT® Root Cause Analysis Training

Edmonton, Alberta, Canada, October 18, 2018: Special 2-Day Equifactor® Equipment Troubleshooting and Root Cause Analysis Course

Bogota, Colombia, October 22, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Seattle, Washington, October 24, 2018: 2-Day TapRooT® Root Cause Analysis Training

Albuquerque, New Mexico, October 29, 2018: 2-Day TapRooT® Root Cause Analysis Training

Orlando, Florida, November 8, 2018: 2-Day TapRooT® Root Cause Analysis Training

Johannesburg, South Africa, November 19, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Bogota, Colombia, November 21, 2018: 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Analysis Course

We are global to meet your needs. If you need other times or locations, please see our full selection of courses.

If you would like for us to teach a course at your workplace, please reach out here to discuss what we can do for you, or call us at 865.539.2139.

TapRooT® Around the World: Equifactor® Equipment Troubleshooting in Bogota, Colombia

August 28th, 2018 by

Take a look into the recent 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Analysis Course in Bogota, Colombia, taught by TapRooT® and Equifactor® Instructors Hernando Godoy Garzón and Piedad Colmenares.

Using Equifactor®, you can learn a more efficient, effective method to solve equipment failure and performance problems. Equifactor® integrates troubleshooting techniques and the TapRooT® Root Cause Analysis System to identify real root causes and implement lasting fixes faster and with more reliability. One single-user license of TapRooT® Root Cause Analysis software is included in this course.

The Equifactor® 3-day courses are designed for Maintenance, Reliability and Safety professionals who want a proven method of analyzing equipment problems and failures when conducting root cause failure analysis.

Many thanks to Hernando for sharing these pictures of action and insights into the great interactive learning during the course!

Put yourself in the picture by becoming trained in troubleshooting and identifying root causes of issues and incidents. Register today for a TapRooT® course and gain advantage, experience, and expertise from our professional instructors. Here are some of our upcoming courses:

Newcastle, Australia, September 12, 2018: 2-Day TapRooT® Root Cause Analysis Training

Denver, Colorado, September 18, 2018: 2-Day TapRooT® Root Cause Analysis Training

Calgary, Canada, September 24, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Amsterdam, The Netherlands, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Atlanta, Georgia, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Bogota, Colombia, September 26, 2018: 2-Day TapRooT® Root Cause Analysis Training

Bogota, Colombia, September 26, 2018: 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Analysis Course

Manchester, United Kingdom, October 1, 2018: 2-Day TapRooT® Root Cause Analysis Training

Aberdeen, Scotland, October 08, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Knoxville, Tennessee, October 15, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Kuala Lumpur, Malaysia, October 17, 2018: 2-Day TapRooT® Root Cause Analysis Training

Edmonton, Alberta, Canada, October 18, 2018: Special 2-Day Equifactor® Equipment Troubleshooting and Root Cause Analysis Course

Bogota, Colombia, October 22, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Seattle, Washington, October 24, 2018: 2-Day TapRooT® Root Cause Analysis Training

Albuquerque, New Mexico, October 29, 2018: 2-Day TapRooT® Root Cause Analysis Training

Orlando, Florida, November 8, 2018: 2-Day TapRooT® Root Cause Analysis Training

Johannesburg, South Africa, November 19, 2018: 5-Day TapRooT® Advanced Root Cause Analysis Team Leader Training Course

Bogota, Colombia, November 21, 2018: 3-Day TapRooT®/Equifactor® Equipment Troubleshooting & Root Cause Analysis Course

We are global to meet your needs. If you need other times or locations, please see our full selection of courses.

If you would like for us to teach a course at your workplace, please reach out here to discuss what we can do for you, or call us at 865.539.2139.

Is “Wear and Tear” an Acceptable Equipment Root Cause?

August 27th, 2018 by

In 2016, the Bureau of Safety and Environmental Enforcement (BSEE) expanded the SafeOCS reporting system to require the submission of off-shore well control equipment failure reports. The first annual report has been released that includes the first full year of reporting. Here is a summary of the findings.

A few of the findings include:

  • 1,129 BOP equipment component failures
    • 18 of 25 active operators in the GoM
    • 45 of 59 active rigs
  • 84% were on non-operating rigs
  • 49% were external leaks
  • 24% were internal leaks
  • “Wear and tear” was the root cause listed in nearly 54% of the incidents

Is “wear and tear” an acceptable root cause? I don’t have the data for this particular set of reports, but I have found, in general, that this root cause is often selected at the maintenance technician level. It is in a drop-down box in the CMS system, and it is an easy selection to make. It doesn’t require much research, and management accepts this as a “normal” failure mode.

Unfortunately, having something as ambiguous as “wear and tear” makes it almost impossible to adequately analyze equipment failures for trends.  The definition of this “root cause” is either too broad or not defined at all. It is an easy selection, requiring very little follow-up action by either the maintenance or the reliability departments. There is no way to understand why the part actually failed.

World class maintenance departments have put severe limitations on when “wear and tear” can be selected as a root cause. In fact, some organizations have removed this selection completely, forcing the maintenance department to determine the actual physical cause of the failure. For deep ocean leaks, this root cause could probably be broken up into multiple actual physical causes:

  • Improper assembly of the component
  • Inadequate pre-use testing
  • Inadequate inspection prior to use
  • Wrong component installed
  • Infrequent inspections during use
  • Improper design analysis

There are many possible causes that will give your company a much better understanding of the physical cause of a failure. If you find that a large percentage of your equipment failures are being categorized under a single failure mode, you have several possible problems:

  • Your categorization is poor. That category is too broad.
  • Your review of the results not able to catch the misuse of the CMS. If you are allowing everyone to pick a single category, you are missing the opportunity to catch problems.
  • Your review of the results is not triggering adequate repairs. If you actually DO have a large percentage of failures in a particular failure mode, you should be performing a root cause analysis to understand and correct the causes of this frequent failure mode.

Take a look at your CMS input screens. Are you allowing the selection of a useless “root cause”?  Why is this category there in the first place? What management reviews are in place that will catch this type of problem?

Don’t make this section of your CMS a paperwork exercise. Make sure you are getting useful information that allows you to catch and correct the real physical causes of your equipment failures.  Then, once the physical cause is determined, don’t forget to complete your investigation to find the human performance problems that lead to these failures.

Fatal Helicopter Crash in Pigeon Forge, TN Blamed on Faulty Fuel Pump

August 23rd, 2018 by

In April of 2016, a sightseeing helicopter crashed while on a tour of Pigeon Forge, TN, killing the four passengers and the pilot. Several problems were noted, including an old-design fuel system that allowed a fire after the crash. This was noted early in the investigation. Here is the news report:  LINK

After further inspection, it was found that the physical cause of the crash was a failure of the fuel pump, causing the engine to lose power. The pump drive shaft splines were severely worn, preventing the pump from operating and supplying fuel to the engine. The engine quit prior to the crash.

There are still some questions about why the fuel pump failed. The excessive wear on the fuel pump drive splines were most likely due to a lack of lubricant, which may have leaked out through an improper seal. The wrong seal was noted, but it is not obvious when this wrong part was installed, or even if this was a contributor to the failure.

It’s a pretty good read. Here is the actual NTSB report: LINK

Ever have trouble with root cause analysis during batch production with impurities?

July 6th, 2018 by

We received the question below in our TapRooT® Root Cause Analysis Users & Friends Group on LinkedIn, please join the discussion with your experiences and best practices.

How would one do a SnapCharT® for intermittent product quality issues that span weeks/months?

The only way to detect the product impurity is to use the product. Even so, the impurity seems random in the same batch or lot, at different weeks or months, with different upstream raw material suppliers, with different personnel. Past root cause analysis was not systematic enough to find the rc. Fixes did not solve.

Monday Accident & Lessons Learned: Why is Right of Way Maintenance Important?

June 18th, 2018 by

Here is another example of why right of way maintenance is important for utility transmission and distribution departments …

Wildfires

An article on hazardex reported that the California Department of Forestry and Fire Protection (Cal Fire) said in a press release that 12 of the wildfires that raged across California’s wine country were due to tree branches touching PG&E power lines.

Eight of the 12 fires have been referred to county District Attorney’s offices for potential criminal prosecution for alleged violations of California laws.

The fires last October killed 44 people, burned more than 245,000 acres, and cost at least $9.4 billion dollars of insured losses. PG&E has informed it’s shareholders that it could be liable costs in excess of the $800 million in insurance coverage that it has for wildfires.

PG&E is lobbying state legislators for relief because they are attributing the fires to climate change and say they should not be held liable for the damage.

What lessons can you learn from this?

Sometimes the cost of delayed maintenance is much higher than the cost of performing the maintenance.

Can you tell which maintenance is safety critical?

Do you know the risks associated with your deferred maintenance?

Things to think about.

Newest Aircraft Carrier Breaks Down During Sea Trials

May 8th, 2018 by

USS Ford underway for sea trials …

An article in Popular Mechanics said the the USS Ford had to return early from sea trials because of an overheating thrust bearing on one of the four main engines. Bloomberg reported that:

“inspection of the parts involved in the January 2018 incident revealed improperly machined gears at GE’s facility in Lynn, Massachusetts as the ‘root cause.'”

Is “improperly machined gears” a root cause? That would be a Causal Factor and the start of a root cause analysis in the TapRooT® System. And why wasn’t the “improper” machining detected prior to installation and sea trials?

Here is some footage of sea trials (including a brief glimpse of one main shaft turning).

Mechanical Seal Efficiency – Potential for huge savings

March 20th, 2018 by

 

 

 

 

 

 

 

 

Here’s a great article by AESSEAL about potential energy savings by selecting the correct mechanical seal flush plan. It’s a pretty interesting read, and possibly an eye-opener for a company with many mechanical seals, especially in high-temperature processes.

 

Equifactor® Troubleshooting and FMEA

March 12th, 2018 by

equifactor, repair, FMEA

 

 

 

 

 

 

 

 

For those of you that have met me, you know that I am a huge fan of proactive improvement processes. Why wait until something bad happens to fix your issues? Wouldn’t it be nice if we could fix problems before we have an incident that actually hurts someone, or damages our equipment?  I’ve spoken numerous times about using TapRooT® proactively for HSEQ problems, but I wanted to give you a tool to help you with your proactive equipment troubleshooting.

Design and process engineers are usually familiar with Failure Modes and Effects Analysis, or FMEA.  This is a generic tool that can be used to look at a piece of equipment or a process, identify what can go wrong, and determine more stringent controls should be put in place to prevent that failure.  There are actually quite a few ways to do this, but most FMEA’s are all based on a fairly standard format.  For this discussion, I’m going to focus on equipment failures.  Generally, the system walks you through several distinct steps:

  1. Identify the piece of equipment you wish to analyze.
  2. Look at all realistic potential failure modes that can occur with that equipment.
  3. Assign a Severity, Occurrence, and Detectability score to each failure
  4. Multiply these scores together to calculate a Risk Priority Number (RPN).
  5. Determine the controls that are currently in place to prevent this issue.
  6. Decide if additional controls are required, based on the RPN.

Now, looking at these steps, it occurs to me that many of these steps are somewhat subjective.  For example on a scale of 1-10, what is the Severity of the failure?  Most companies have put a matrix in place to help quantify these numbers and make it easier to come up with consistent results.  This guidance is really important if you want to have any kind of meaningful, systematic way of determining that RPN.  While not perfect, these matrices do a pretty good job of keeping everyone focused and getting consistent answers.

However, the one step that is still VERY subjective is step #2.  Somehow, you need to come up with a list of all the potential failure modes that your piece of equipment can experience.  This is the very basis of the entire analysis, and it is probably the most difficult.  Imagine telling your maintenance manager or design engineer, “Tell me all the ways this compressor can fail.”  While I’m sure your team is pretty sharp, this is a daunting task.  Ideally, they will need to list every possible failure mode to ensure we don’t miss anything.  Imagine how many “unknown unknowns” are floating around in our FMEA’s!

Wouldn’t it be nice if there were some compendium of possible failures that we could use to initially populate our FMEA list?  This is where I would recommend pulling up your Equifactor® tables.  Take a look at (for example) the Centrifugal Compressor troubleshooting tables.  Just in this category alone, we have nearly 50 possible failure modes, spread across 7 symptoms.  Imagine if you could start your FMEA with all of these items.  You’d be well on your way to conducting a detailed FMEA on your centrifugal compressors, with the ability to add a few more failure modes that may be unique to your situation.

We normally think about Equifactor® as a reactive troubleshooting tool.  While it excels in that mode, try using the Equifactor® tables more proactively.  Use those tables as the baseline for your FMEA, and limit the number of unknown issues that may be lurking in your equipment.

 

Keeping Your Equipment Reliability Team Sharp

March 7th, 2018 by

study, read, reliability, troubleshoot

 

 

 

 

 

 

 

We have just completed our annual Global TapRooT® Summit, and we all walked away with some terrific ideas to bring back to our companies. Many people think the Summit is only for our customers to improve their processes, but I ALWAYS come away with new ideas for myself.

Heinz Bloch was one of our speakers this year.  He had 2 excellent sessions on how equipment reliability is tied directly to your company’s bottom line.  As always, he had some great insights into how a company can integrate reliability techniques into their business model for real, measurable savings.

One of his observations is that, as technology progresses, it is imperative that your reliability and maintenance team  keep up-to-date on the current best practices and technologies.  It is too easy to assume your excellent reliability and maintenance engineers will just magically remain top-notch.  His suggestion (almost a demand!) was to ensure we give our team the time and motivation to actually READ about their craft.  Your team should be allocating some amount of time EVERY DAY to reading professional journals and articles to see what is happening outside their own company boundaries.

  • Are you using the very best lubricant?
  • What new bearing materials are available for your applications?
  • How much can we save by investing in slightly more expensive, but much more efficient technology?
  • What are our competitors using for condition-based maintenance?

As managers, we should be giving our team both the time and the incentive to read these journals and articles.  Trust me, your competition is doing this; don’t be left behind!

‘Equipment Failure’ is the cause?

February 22nd, 2018 by
Fire, equipment. failure

Drone view of tank farm fire Photo: West Fargo Fire Department

 

 

 

 

 

 

 

On Sunday, there was a diesel fuel oil fire at a tank farm in West Fargo, ND. About 1200 barrels of diesel leaked from the tank.  The fire appears to have burned for about 9 hours or so.  They had help from fire dapartments from the local airport and local railway company, and drone support from the National Guard.  There were evacuations of nearby residents.  Soil remediation is in progress, and operations at the facility have resumed.  Read more about the story here.

The fire chief said it looks like there was a failure of the piping and pumping system for the tank. He said that the owners of the tank are investigating. However, one item caught my attention. He said, “In the world of petroleum fires, it wasn’t very big at all. It might not get a full investigation.”

This is a troublesome statement.  Since it wasn’t a big, major fire, and no one was seriously hurt, it doesn’t warrent an investigation.  However, just think of all the terrific lessons learned that could be discovered and learned from.  How major a fire must it be in order to get a “full investigation?”

I often see people minimize issues that were just “equipment failures.”  There isn’t anyone to blame, no bad people to fire, it was just bad equipment.  We’ll just chalk this one up to “equipment failure” and move on.  In this case, that mindset can cause people to ignore the entire accident, and that determining it was equipment failure is as deep as we need to go.

Don’t get caught in this trap.  While I’m sure the tank owner is going to go deeper, I encourage the response teams to do their own root cause analyses to determine if their response was adequate, if notifications correct, if they had reliable lines of communications with external aganecies, etc.  It’s a great opportunity to improve, even if it was only “equipment failure,” and even if you are “only” the response team.

Tips on Preventing Vibration in Rotating Equipment

February 13th, 2018 by

Pump

Improper installation of rotating equipment, either for the first time or after maintenance, can quickly lead to excessive vibration and premature failure. Here are some tips on the proper use of shims and alignment equipment.

Root Cause Analysis Tip: Do you perform an incident investigation like you watch the news?

January 31st, 2018 by

If you are like me, you flip channels to see how each news station or news website reports the same issue of interest. Heck, I even look at how different countries discuss the same issue of interest. Take the “Deep Water Horizon Spill of 2010” or was it the “BP Oil Spill of 2010” or was it the “Gulf of Mexico Oil Spill of 2010”? It depends on where you were or what you watched when it was reported. At the end of the day we all often develop Bias Criteria of Trust… often without any true ability to determine which perspective is closer to the truth.

Now there are fancier terms of bias from confirmation bias to hindsight bias, but let’s take a look at some of our news source Bias Criteria of Trust.


So here is the question to stop and ask….. do you do the same thing when you start an investigation, perform root cause analysis or troubleshoot equipment? It is very easy to say YES! We tend to trust interviews and reports using the same criteria above before we actually have the evidence. We also tend to not trust interviews and reports purely because of who and where they came from, without evidence as well!

Knowing this…..

Stop the urge to not trust or to overly trust. Go Out And Look (GOAL) and collect the evidence.

Got your interest? Want to learn more? Feel free to contact me or any of our TapRooT® Instructors at info@taproot.com or call 865.539.2139.

Where Do You Get Ideas To Improve Root Cause Analysis?

4 Signs You Need to Improve Your Investigations

Equipment Troubleshooting in the Future

January 5th, 2018 by

Equipment Troubleshooting in the Future
By Natalie Tabler and Ken Reed

If you haven’t read the article by Udo Gollub on the Fourth Industrial Revolution, take some time to open this link. This article can actually be found at many links on the internet, so attribution is not 100% certain, but Mr. Gollub appears to be the probable author.

The article is interesting. It discusses a viewpoint that, in the current stage of our technological development, disruptive technologies are able to very quickly change our everyday technological expectations into “yesterday’s news.” What we consider normal today can be quickly overtaken and supplanted by new technology and paradigms. While this is an interesting viewpoint, one of the things I don’t see discussed is one of the most common problems with automating our society: equipment failure. If our world will largely depend on software controlling machinery, then we need to take a long hard look at avoiding failure not only in the manufacturing process, but also in the software development process.

The industrial revolution that brought us from an agricultural society to an industrial one also brought numerous problems along with the benefits. Changing how the work is done (computerization vs. manual labor) does not change human nature. The rush to be first to come out with a product (whether it be new software or a physical product) will remain inherent in the business equation, and with it the danger of not adequately testing, or overly optimistic expectations of benefit and refusal to admit weaknesses.

If we are talking about gaming software – no big deal. So, getting to the next level of The Legend of Zelda – Breath of the Wind had some glitches; that can be changed with the next update. But what if we are talking about self-driving cars or medical diagnostic equipment? With no human interaction with the machine (or software running it) the results could be catastrophic. And what about companies tempted to cut some corners in order to bolster profits (remember the Ford Pinto, Takata airbags, and the thousands of other recalls that cost lives)? Even ethical companies can produce defective products because of lack of knowledge or foresight. Imagine if there were little or no controls in production or end use.

Additionally, as the systems get more complex, the probability of unexpected or unrecognized error modes will also increase at a rapid rate. The Air France Flight 447 crash is a great example of this.

So what can be done to minimize these errors that will undoubtedly occur? There are really 2 options:

1. Preventative, proactive analysis safety and equipment failure prevention training will be essential as these new technologies evolve. This must also be extended to software development, since it will be the driving force in new technologies production. If you wonder how much failure prevention training is being used in this industry, just count the number of updates your computer and phone software sends out each year. And yes, failure prevention should include vigilance on security breaches. A firm understanding of human error, especially in the software and equipment design phase, is essential to understanding why an error might be introduced, and what systems we will need in place to catch or mitigate the consequences of these errors.  This obviously requires effective root cause analysis early in the process.

2. The second option is to fully analyze the results of any errors after they crop up. Since failures are harder to detect as stated in #1, it becomes even more critical that, when an error does cause a problem, we dig deep enough to fix the root cause of the failure. It will not be enough to say, “Yes, that line of code caused this issue. Corrective action: Update the line of code.” We must look more deeply into how we allowed the errant line of code to exist, and then do a rigorous generic cause analysis to see of we have this same issue elsewhere in our system.

With the potential for rapidly-evolving hardware and software systems causing errors, it will be incumbent on companies to have rigorous, effective failure analysis to prevent or minimize the effects of these errors.

Want to learn more about equipment troubleshooting? Attend our Special 2-Day Equifactor® Equipment Troubleshooting and Root Cause Analysis training February 26 and 27, 2018 in Knoxville, Tennessee and plan to stay for the 2018 Global TapRooT® Summit, February 28 to March 2, 2018.

Asset Optimization Track at the Summit – Are you in?

January 2nd, 2018 by

If you are a typical procrastinator, you probably haven’t signed up for the Global TapRooT® Summit yet. Well, it’s now 2018, and procrastination is over! Don’t miss the chance to get in on one of the best opportunities to improve your company.

I wanted to give you a little more information about one of the most exciting tracks at the Summit: the Asset Optimization Track (doesn’t that sound so much better than “Equipment Fixing Track”?) We’ll be providing some great sessions to get your reliability and maintenance processes moving in the right direction in 2018. Besides the Summit Keynote addresses common to all tracks, here are a few of the sessions that make the Asset Optimization track right for you:

  • Multiple Failures Without Learning:  Tired of repeat failures?  Chris Vallee will give you some examples of why the “break it – Fix it” mentality is no longer the way to go.
  • Improved maintenance Troubleshooting using Equifactor®:  I’ll be leading a session on how Equifactor® Equipment Troubleshooting module of the TapRooT® VI software service works, including some of the new features available in the software.  For some reason, I think this is the best session of all!
  • The Business End of Equipment Reliability:  OK, maybe my session is NOT the best!  Heinz Bloch will be with us again this year, giving us his unique insight into the business case behind reliably operating your equipment.
  • The Psychology of Failing Fixes:  Kevin McManus will be sharing his unique view on how root cause analysis is the key to a truly reliable operation.  Don’t miss the opportunity to soak up some of Kevin’s enthusiasm!

We’re going to have a great Summit this year, in our hometown for the first time ever.  Please plan on signing up for the Summit.  Don’t tell yourself, “Oh, yeah, I need to do that sometime.”  The time is now; the Summit is next month! REGISTER NOW for the Asset Optimization Track!

The Georgia State Public Services Commission Demands Root Cause Analysis of Atlanta Airport Blackout

December 21st, 2017 by

ATL

Read about the story in The Atlanta Journal-Constitution: http://www.ajc.com/news/georgia-regulators-demand-answers-about-atlanta-airport-blackout/nDwICT5QFrUyXOvFnZbroM/

It’s hard to believe there wasn’t a redundant transmission line and transformers to such a vital resource.

Root Cause Tip: Equipment difficulty… did the equipment break or wear out?

August 28th, 2017 by

Teaching TapRooT® Root Cause Analysis and Equifactor® for the last 10 years, I often get this question…

“The tool/component broke while we were using it. Why can’t we just select Equipment Difficulty on the TapRooT® Root Cause Tree®?”

Simple, you have to pass the test below first

NOTE: If the failure was caused by:

  – improper operation;

  – improper maintenance;

  – installation errors;

  – failure to perform scheduled preventive maintenance;

  – programming errors;

  – use for a purpose far beyond the intention of the design; or

  – a design that causes a human performance difficulty

then the failure is NOT an Equipment Difficulty, but rather the failure is a Human Performance Difficulty

Trust me! If a tool, piece of equipment or product breaks, you know the manufacturer, vendor and supplier are going to push back to see if it was used properly and meets the warranty. Shouldn’t you ask first? We say yes!

During my 18 years in aviation in fuel systems troubleshooting and executive jet assembly, we used to have a phrase…

“Our mechanics or assemblers that grew up on the farm are our best and worst mechanics. They can get anything mechanical to work.”

Now there are signs that tools might not be the right ones for the job or that the job was not designed with good Human Engineering in mind. First test… look into the toolboxes in the field.

✔Are the tools modified
✔Are the tools old and worn
✔Are there tools from home

Okay, so tools are easier to see being misused, like a screw driver being used as a scraper or a pry bar, but what about equipment/components being used like a…

✔ Compressor
✔ Switch
✔ Valve
✔ Bottle

Now we must dig a little deeper in our TapRooT® Root Cause and Equifactor® Analysis. We start by mapping out our SnapCharT® (Sequence of Events with supporting Conditions) using system schematics to ensure we know what occurred with the equipment, people and system being operated. A knowledgeable system operator can elaborate on events and conditions such as:

✔ Energized open, mechanically closed
✔ Dynamic or static energy
✔ System work arounds and deficiencies

Why you may ask is this knowledge vital? If an operator knows how the light turns on when you flip a light switch on, then when system does fail, it is easier to start and understand the SnapCharT®.

To pass the first two tests while facilitating TapRooT® Root Cause Analysis, whether for a low to moderate level issue or a major incident, bring along that knowledgeable operator or engineer that can answer the following…

improper operation;
improper maintenance;
installation errors;
failure to perform scheduled preventive maintenance;
programming errors;
use for a purpose far beyond the intention of the design; or
a design that causes a human performance difficulty

Good luck and be safe! Please get rid of those unsafe tools and processes.

LEARN MORE in our 2-day TapRooT® Root Cause Analysis Training.

Enhance Your Equifactor® Skills in Houston

October 20th, 2016 by

Equipment problems can be difficult, but fixing them is vital for safety in the workplace and efficiency in production. Where do you start? Find the root cause of the failure. But how? Come to a TapRooT® Equifactor® public course to learn how to find that root cause, develop effective solutions and implement them successfully. Our systematic process is reliable, and your equipment should be, too.

Well, good news! TapRooT® is offering this course in Houston on November 3. You can learn how to optimize your equipment and enjoy a city with a big personality. Houston lives up to the western character that many assume they’ll find, but that’s not all it is. You’ll find cuisine of all kinds, sophisticated downtown shops and industrial powerhouses of all kinds. Visit and see for yourself!

Join TapRooT® in Houston for this local public course.

Inquire about an Equifactor® onsite course for your company.

Equipment Reliability: What Happens as Pumps Wear Out?

October 11th, 2016 by

Equipment reliability - Pump wear

When we are faced with the prospect of installing a new pump, we have to take a look at several factors to decide what the best course of action will be. For example, we have to look at:
– Fit for purpose
– Initial cost
– Life-cycle maintenance costs
– Electrical efficiency
– Ease of maintenance
– etc.

An additional consideration is how the characteristics of the pump vary over time.  It is fairly straight forward to calculate flow rates and pressures using the specs of a new pump.  However, how do these specs vary over time?  As the pump wears, how will the characteristics of the pump change, and how will this affect the overall fitness of the pump for the service environment?

Here is a nice article that describes how pump nameplate characteristics will change as the pump wears, and what to expect as the components wear.

Equipment Failure: Mechanical Seal Basics

October 3rd, 2016 by

Mechanical seal

 

Modern pump systems are moving more and more away from traditional pump packing, and more towards mechanical seals.  There are many advantages to using a mechanical seal instead of pump packing.  However, using these seals brings along some additional potential problems.

Before we can look at these additional issues, we first need to make sure we understand exactly what we mean by a “mechanical seal.”  Here is a quick refresher on how these seals work.  Next week, we’ll look a little more deeply into the advantages and disadvantages of these systems.

Equipment Failure: Crane Gearbox Failure

September 30th, 2016 by

Equipment Failure - Broken Gear

While performing a lift using a tower crane, a failure of the gearbox cause about 1.000 lbs of hook and rigging gear to fall to the ground, narrowly missing workers in the area. Here is the report.

The investigation revealed several issues, most relating to proper inspections of the gearboxes to identify defective gears.  While again this appears to be a straight equipment failure, we would also want to know:

  • How did the deficient gear end up in the gearbox (it was the wrong material)?
  • Are we looking for repeat failures (this had happened before)?
  • How close were the workers in the vicinity?
  • What was the preventative maintenance plan for this gearbox?  Was it required be the vendor?

Lots of other directions a good investigation will lead you.

 

Equipment Failure? Delta Airlines “Computer” Failure

September 6th, 2016 by

equipment failure 2

Last month, Delta Airlines experienced an equipment failure that caused their reservation system to shut down, Media reports indicate close to 2,000 flights were canceled. This is only a few weeks after Southwest Airlines experienced a similar computer failure, causing numerous flight delays and cancellations.

Reports continue to indicate that this was an equipment failure, due to a small fire in a power supply in there server room.  Here is their description:

“Monday morning (August 8) an uninterrupted power source switch experienced a small fire which resulted in a massive failure at Delta’s Technology Command Center. This caused the power control module to malfunction, sending a surge to a transformer outside of Delta, resulting in the loss of power. The power was stabilized and power was restored quickly. But when this happened, critical systems and network equipment didn’t switch over to backups. Around 300 of about 7,000 data center components were discovered to not have been configured appropriately to avail backup power. In addition to restoring Delta’s systems to normal operations, Delta teams this week have been working to ensure reliable redundancies of electrical power as well as network connectivity and applications are in place.”

Keep in mind that the “uninterrupted power supply switch” is actually known as an “uninterruptible” power supply (UPS).  This normally swaps you over to another power source if your primary source fails.  You may have a simple UPS on your computer systems at the office, providing battery backup while power is restored.  In Delta’s case, their UPS system attempted to switch over, but configuration issues prevented a significant number of their devices from actually shifting over.

Additionally, other reports indicate that the reservation system is an extremely antiquated system, linked into other airlines’ (also extremely antiquated) systems.  They have all patched together and upgraded their individuals systems to the point that it is almost impossible to upgrade; it really requires a complete replacement, which would be EXTREMELY difficult and expensive to replace while still being used for current reservations.

So while this is discussed by the airlines as an equipment failure, I think there are more than likely multiple causal factors, of which only one (the initiating problem) was a burned up component.  Without knowing the details, we can see several Causal Factors:

  • A UPS caught fire
  • This small fire caused a large surge and widespread power loss
  • Other equipment was not properly configured to shift to backup power
  • There is no backup in the event of a loss of the primary reservation system
  • The reservation computer system has not been upgraded to modern standards

I always question when a failure is classed as “equipment failure.”  Unless the equipment failure is an allowed event (Tolerable Failure), it is much more likely that humans were much more involved in the failure, with the broken equipment as only a result.

Optimize Your Equipment Reliability with an Equifactor® Course!

September 1st, 2016 by

gears

Equipment problems can be difficult, but fixing them is vital for safety in the workplace and efficiency in production. Where do you start? Find the root cause of the failure. But how? Come to a TapRooT® Equifactor® public course to learn how to find that root cause, develop effective solutions and implement them successfully. Our systematic process is reliable, and your equipment should be, too.

Knoxville is not only the home of the Tennessee Vols but also headquarters of Tennessee Valley Authority and lifestyle media company, Scripps Network. This large city right in the heart of Appalachia is surrounded by the Great Smoky Mountains giving you an astounding view anywhere you go, especially in the Autumn.

Take a trip to Knoxville and join TapRooT® for this local public course.

Food: 

Stock and Barrel: This rustic, fun restaurant offers the best burgers in the area. Voted by locals.

Calhoun’s on the River: Enjoy eating with a great view? Calhoun’s serves great barbecue right on the Tennessee River.

Litton’s: A Knoxville favorite! One of the best hometown restaurants serving homestyle burgers, fries and dessert with friendly service.

Attractions: 

Market Square: Full of restaurants, bars and boutiques, there’s no better place to enjoy a night out in Knoxville.

Maple Hall Bowling Alley: The trendiest bowling alley you’ve ever seen that is located underground. It doesn’t get much cooler than that.

World’s Fair Park: Located next to University of Tennessee’s campus, this famous park was built for the 1984 World’s Fair. Fun area for the kids!

Old City: This area of Knoxville has been brought back to life and is better than ever. Located near Market Square, you can get a feel for all Knoxville has to offer in one place.

Ready to register for this Knoxville Equifactor® course? Click Here

WANTED: New Equifactor® Equipment Troubleshooting Tables

August 29th, 2016 by

equipment troubleshooting table

We’re pretty excited about the new TapRooT® VI software service that we released this year. It has some terrific features that are a definite upgrade to the older Version 5 software.

As part of the conversion over to TapRooT® VI, we did an in-depth review of the Equifactor® equipment troubleshooting tables. We found we were able to streamline those tables to make them even easier to use. We dropped some redundant items, standardized some of the terminology, and generally mde them easier to use. Additionally, TapRooT® VI allows you to take the items from the Equifactor® table and drop them right onto your SnapCharT®. It’s a feature we’ve been asked about for quite a while, and the TapRooT® VI architecture finally let us add this enhancement.

I am currently looking for new ideas for tables you would be interested in seeing added to Equifactor®. What general categories of equipment would you like to see developed and added to the system? Some we might be able to do; some aren’t really very conducive to putting into a table format. For example, I was asked to develop tables to troubleshoot PLC problems. While this would be great, there are unfortunately hundreds of different models and types of PLC’s out there, and a simple set of tables would be really tough to do.

Another idea was for hydraulic system troubleshooting. Again, this might be to broad a category. However, I am researching the possibility of doing more specific tables on things like hydraulic cylinders and motors. These might be specific and generic enough that we can put together a useful set of tables.

So what would you like to see? Let me know, and I’ll be happy to take a look.

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