Root Cause Analysis Blog

 

Happy Independance Day!

Posted: July 4th, 2015 in Current Events

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For those outside the USA, on the 4th of July we are off celebrating our God given freedoms that are guaranteed in the US Constitution that resulted from declaring our independence from the British crown. On July 4, 1776, the Continental Congress approved the final wording of the Declaration of Independence. That act continued the progress of the revolt that had started back in April of 1775 and resulted in the founding of the United States and the US Constitution. 

For more information about the US Constitution, see: http://www.constitutionfacts.com

See you next week!

BP to Pay $18.7 Billion for Environmental Damage Caused by the Deepwater Horizon Oil Spill

Posted: July 3rd, 2015 in Accidents, Current Events

It is the largest environmental settlement ever.

BP will pay the US Government,Alabama, Florida, Louisiana,Mississippi, and Texas $18.7 billion to compensate for environmental damage done by the Deepwater Horizon spill.

For more info, see: http://www.nytimes.com/2015/07/03/us/bp-to-pay-gulf-coast-states-18-7-billion-for-deepwater-horizon-oil-spill.html?emc=edit_th_20150703&nl=todaysheadlines&nlid=60802201&_r=0

Upcoming Public TapRooT® Course in Boston, MA

Posted: July 2nd, 2015 in Courses, Local Attractions

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Do you enjoy American history and visiting historical sites that helped make the United States what they are today? Do you also enjoy root cause analysis and investigations? Take a trip to Boston, Massachusetts with TapRooT® for a 2-Day Incident Investigation and Root Cause Analysis course and get it all in one trip. Touring the famous sites of some of the key points of the American Revolution, learning the depths of the American culture and being introduced to TapRooT® makes for one great trip.

Food:

James Hook & Co.: As if family owned restaurants weren’t already the best, try one with fresh lobster dishes straight from the sea. Enjoy!

Rino’s Place: Guy Fieri featured this delicious genuine Italian restaurant, that must mean it’s a winner!

Flour Bakery & Cafe: With four locations in the Boston area, there is no excuse not to stop. Fresh pastries, breads and gourmet coffee, what’s not to love?

Attractions:

Fenway Park: Sports lover or not, this baseball stadium is known as “America’s most beloved ball park”, don’t pass up this opportunity.

Freedom Trail: This special foundation created a route just for history buffs like you. See it all in one tour with an educated tour guide ready to share American history with you.

Samuel Adams Brewery Tour: One of America’s favorite beers brewed right here in Boston. Take a tour of the brewery and explore why it’s one of the best.

Ready to register? Click here.

TapRooT® Public Courses in Central & South America

Posted: July 2nd, 2015 in Courses

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Sao Paulo, Brazil

Upcoming TapRooT® Public Courses:

Central America: 

Monterrey, Mexico | 5-Day | August 24, 2015 (Language: Spanish)

South America: 

Sao Paulo, Brazil | 5-Day | August 17, 2015 (Language: Portuguese)

Sao Paulo, Brazil | 2-Day | September 17, 2015 (Language: Portuguese)

For more information regarding our courses around the world, click here.

Public TapRooT® Course in Chile

Posted: July 1st, 2015 in Pictures

Check out the latest Onsite course in Chile! Follow these links for more information on our Public and Onsite courses.

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Root Cause Tip: What is the Root Cause of Memory Failure While Learning?

Posted: July 1st, 2015 in Root Cause Analysis Tips

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Ever take your laptop to training to take notes? According to psychological research, (The Pen is Mightier than the Keyboard), if you want to retain what you learn during training, using a laptop to take notes is not a good idea.

The research indicates that the act of taking notes on a laptop seems to interfere with our ability to remember the information. Mueller & Oppenheimer, psychologists for the research, believe that’s because learners on laptops are mindlessly typing everything the instructor is saying.  When tested, laptop users performed similar to pen notetakers on factual questions about the notes, but significantly worse on conceptual questions.

Since we can’t take notes as fast nor capture as much information with a pen, we are required to think and actively listen for what’s most important to write down.  Thus, we store information into memory as we think about it.

One of the root causes of memory failure during learning appears to be the way we take notes.  Will this research change the way you take notes in training?  Leave your comments below.

Happy Canada Day!

Posted: July 1st, 2015 in Pictures, TapRooT® Instructor

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We are grateful for all of our Canadian TapRooT® Instructors and friends! Happy Canada Day!

TapRooT® Public Courses in Europe, Africa & Middle East

Posted: July 1st, 2015 in Courses

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Stavanger, Norway

Upcoming TapRooT® Public Courses:

Europe: 

Stavanger, Norway | 2-Day | September 9, 2015

Stavanger, Norway | 3-Day | September 9, 2015

Hamburg, Germany | 2-Day | September 14, 2015

Aberdeen, Scotland | 5-Day | September 21, 2015

Africa: 

Johannesburg, South Africa | 5-Day | August 24, 2015

Middle East: 

There are no upcoming public courses scheduled for August and September in this region. Check back frequently for updates or inquire about an onsite course.

 

Career Development: On Information Overload? Take Action!

Posted: July 1st, 2015 in Uncategorized
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Interesting headlines can lead us to good information, but they also lead us away from taking action.

I admit to being an information junkie, and list article headlines steal my attention every single day because they are tasty morsels of knowledge I can’t resist knowing.

10 Things You Didn’t Know About …

15 Things You Need to Know About …

20 Things You Should Consider About …

You get the idea!

Not to say that information is a bad thing ….
but with the Internet we are all on information overload.  What happened to simply taking action?

I love this author’s idea about implementing a “deprivation week,” disconnecting from information sources and just doing the work you know you should be doing. If you feel like you are operating less successfully because of an overwhelm of information, check out his advice to quit learning and start doing: 10 Overlooked Truths about Taking Action

 

Weekly Wisdom: Be Proactive!

Posted: June 30th, 2015 in Wisdom Quote

first aid“Safety means first aid to the uninjured.” -Unknown

 

Would you know if your corrective action resulted in an accident?

Posted: June 30th, 2015 in Accidents, Courses, Great Human Factors, Human Performance, Investigations, Performance Improvement, Root Cause Analysis Tips, Root Causes, TapRooT, Training

“Doctor… how do you know that the medicine you prescribed him fixed the problem,” the peer asked. “The patient did not come back,” said the doctor.

No matter what the industry and even if the root causes found for an issue were accurate, the medicine can be worse than the bite. Some companies have a formal Management of Change Process or a Design of Experiment Method that they use when adding new actions while on the other extreme, some use the Trial and Error Method… with a little bit of.. this is good enough and they will tell us if it doesn’t work.

You can use the formal methods listed above or it can be as simple for some risks, to just review with the right people present before implementation of an action occurs. We teach to review for unintended consequences during the creation of and after the implementation of corrective or preventative actions in our 7 Step TapRooT® Root Cause Analysis Process. This task comes with a couple of basic rules first:

1. Remove the risk/hazard or persons from the risk/hazard first if possible. After all, one does not need to train somebody to work safer or provide better tools for the task, if the task and hazard is removed completely. (We teach Safeguard Analysis to help with this step)

2. Have the right people involved throughout the creation of, implementation of and during the review of the corrective or preventative action. Identify any person who has impact on the action, owns the action or will be impacted by the change, to include process experts. Hint, it is okay to use outside sources too.

3. Never forget or lose site of why you are implementing a corrective or preventative action. In our analysis process you must identify the action or inaction (behavior of a person, equipment or process) and each behaviors’ root causes. It is these root causes that must be fixed or mitigated for, in order for the behaviors to go away or me changed. Focus is key here!

4. Plan an immediate observation to the change once it is implemented and a long term audit to ensure the change sustained.

Simple… yes? maybe? Feel free to post your examples and thoughts.

TapRooT® Public Courses in Canada

Posted: June 29th, 2015 in Courses

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Calgary, Canada

Upcoming TapRooT® Public Courses:

Calgary | 2-Day | August 18, 2015

St. John’s | 2-Day | August 25, 2015

Edmonton | 2-Day | September 21, 2015

For more information regarding our public courses around the world, click here.

Monday Accident & Lessons Learned: Broken Leg caused by Fall From Ladder Cost Company $2.4 Million

Posted: June 29th, 2015 in Accidents, Current Events

The Chicago Tribune reported “Fall from ladder nets Merrillville man $2.4 million jury verdict.”

Part of the reason that the company was found liable is that the ladder was “out of code.” It had been produced before standards for ladders were developed. 

Have any old ladders out there that need to be replaced?

Public TapRooT® Course in India

Posted: June 25th, 2015 in Courses, Local Attractions, TapRooT, Training

1280px-Marine_Drive_Kochi_Night_View_DSWOn August 3, 2015, join TapRooT® for a 5-Day Advanced Root Cause Analysis and Team Leader Training public course in Cochin, Ernakulam, India for the ONLY time in 2015. This course is filled with excellent industry training and material that is well worth the investment for you and your company.

Cochin, also referred to as Kochi or Ernakulam, is known as the Queen of the Arabian Sea due to its spice trading on the west coast. Cochin is also the second largest and highest populated city in the area making it the home of major chemical and electrical industries, the Indian Naval Headquarters and offshore refineries (pictured below).

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It’s a great trip for everyone! Bring the whole team for Root Cause Analysis Training and bring the whole family to enjoy the attractions and rich culture that Cochin, India has to offer.

A few fun attractions they have to offer:

Wonderla: From water rides to thrilling rides to kid-friendly rides, this amusement park is a fun attraction for the family.

LuLu Mall: Take a break from the heat and visit this giant mall filled with movies, shopping and food!

Folklore Museum: Step back in time with these anthropology, ethnography and architectural exhibits.

Don’t forget, this is the only time this year that you can attend TapRooT® training in this region, so register today before the seats fill up.

Want more information on the TapRooT® 5-Day course? Click here.

Ready to register and take advantage of this incredible opportunity? Click here

TapRooT® Public Course in Monterrey, Mexico

Posted: June 24th, 2015 in Courses, Pictures

Take a look at a few pictures from a recent public TapRooT® course in Monterrey, Mexico.
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Interested in attended a course? Click here. 

Interested in an onsite course for your company? Click here.

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