Category: Summit

Join Us for the Quality Track for the 2018 Summit

January 25th, 2018 by

Chris Vallee put an awesome track together for professionals who are involved in quality processes. If that’s you, you don’t want to miss this informative video!

REGISTER NOW or

Learn more!

Have FUN at the 2018 Global TapRooT® Summit!

January 25th, 2018 by

We don’t want the 2018 Global TapRooT® Summit to be boring. We want you to meet smart industry leaders, learn amazing best practices, and have fun!

Learning while having fun is much more effective that trying to stay awake during boring presentations. That’s why we organize the Global TapRooT® Summit to have activities, Keynote Speakers, and sessions that are active and entertaining.

Plus we start with the Name Game and have an excellent Reception on Wednesday.

This year we will again have rock star Carl Dixon as our entertainment at the reception where you can network with the new friends and important contacts that you have established.

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Here’s Carl back in the day playing with April Wine …

And more classic rock from Carl and April Wine …

And just one more …

I think he is even better today. Don’t miss the 2018 Global TapRooT® Summit reception!

What Pre-Summit Course Should I Attend?

January 23rd, 2018 by

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That’s a tough question…

Here is more course info: http://www.taproot.com/taproot-summit/pre-summit-courses

Attending the 2018 Global TapRooT® Summit and a Pre-Summit course is a great way to learn more AND get a discount of $200 off the course.

And if you bring a team to the Summit, you can get discounts up to $600 off per person!

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CLICK HERE to REGISTER!

Ready for a road trip? Then wrap up your travel planning for the 2018 Global TapRooT® Summit in Knoxville, Tennessee!

January 18th, 2018 by

 


When some people think of Knoxville, Tennessee they often think of the regional attractions such as the Smoky Mountains and the area’s large, picturesque lakes. However, this city has plenty to offer without ever leaving town. Knoxville’s Urban Wilderness is just three miles from the Knoxville Convention Center where the 2018 Global TapRooT® Summit will be held. It includes 50 miles of natural surface for hikers, mountain bikers and trail runners. The city also has a rich musical heritage, which includes stars like Dolly Parton, the Everly Brothers and Roy Acuff. Popular music venues today include the historic Tennessee Theatre, Bijou Theatre, the Square Room and a host of clubs that present live music every night of the week. Dining options are numerous . . . you’ll find a heavy focus on farm-to-table fare during your visit downtown. In addition to hiking, biking, music, history and arts, the city has an exciting craft beer scene and the opportunity to relax with some of the country’s finest beers and people.

Have you taken the steps to a memorable road trip? It’s simple!

Step 1: REGISTER for the 2018 Global TapRooT® Summit.

Step 2: Do your travel planning and get a hotel booked.

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And don’t miss the activities the week of the Summit.

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Miranda Lambert is performing at Thompson-Boling Arena on Thursday, March 1, 2018.

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Tape Face, the Comedian, is performing at the Bijou Theatre on Sunday, February 25, 2018.

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Jonny Lang with Tony Lucca Solo is performing at the Bijou Theatre on Tuesday, February 27, 2018.

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Beth Hart is performing at the Bijou Theatre on Thursday, March 1, 2018.

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The Wizard of Oz national tour will be starring at The Tennessee Theatre on Friday, Saturday and Sunday, March 1, 2 and 3, 2018.

Why are the SMARTEST people going to the 2018 Global TapRooT® Summit?

January 17th, 2018 by

SummitHands

About three Summits ago, I had a Summit attendee come up to me and say:

Mark, it is amazing the quality of speakers and topics you put together for the Summit.
But even more amazing is the networking. The people at this Summit are some of
the smartest people working on real life performance improvement in industry!
I just wanted to tell you thanks for making this happen.

 How do we get such high quality attendees? That’s the kind of people who use TapRooT® Root Cause Analysis to stop accidents, improve quality, reduce risk, and improve equipment reliability.

If you haven’t registered for the 2018 Global TapRooT® Summit yet, GET HOT! Visit the Summit web site and get registered TODAY!

Don’t Miss the TapRooT® Family Reunion

January 17th, 2018 by

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The Global TapRooT® Summit was almost named the TapRooT® Family Reunion. Why? Because that’s the way it feels.

Friendly folks getting together to say hello and get reacquainted.

Unless you belong to a dysfunctional family, you know what I mean.

This family has a common goal. They to share best practices and learn how to achieve outstanding performance. TapRooT® Root Cause Analysis is a part of that effort. But there is so much more to learn and share at the reunion (Summit). And that’s why we sponsor the Summit and spend lavishly on speakers.

We want to provide the opportunity for our best clients to meet face to face, develop relationships, and get new ideas to make safety, quality, equipment reliability, patient and process safety, and productivity even better. And leave the Summit inspired to go back home and make performance great.

The learning that takes place is one of the reasons that we require Certified TapRooT® instructors to attend the Summit at least once every two years. We think that keeping up to date on the latest improvement ideas is that important.

So don’t miss the reunion (the Summit) and your chances to make your performance improvement efforts that much better. Register for the 2018 Global TapRooT® Summit (February 26 – March 2, Knoxville, TN) TODAY by CLICKING HERE.

Which Summit Track Should You Attend?

January 15th, 2018 by

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There is so much to new information to learn and so many best practices being shared that the hardest question you have to answer is:

“What Best Practice Track should I attend at the 2018 Global TapRooT® Summit?”

 That’s a tough question to answer. Maybe you should bring enough folks so that some attends each track?

If you have to pick just one, watch these videos and read the information at the links below to help you select the right track that will help you improve performance at your company.

Quality

http://www.taproot.com/archives/61257

Patient Safety

http://www.taproot.com/archives/61721

Human Performance

http://www.taproot.com/archives/60950

Investigator

http://www.taproot.com/archives/61241

Asset Optimization

http://www.taproot.com/archives/61327

Safety

http://www.taproot.com/archives/60790

Software

http://www.taproot.com/archives/61000

Some info about the new software …

 

TapRooT® Certified Instructor

http://www.taproot.com/archives/61023

General Discussion and Keynote Speakers

Now REGISTER! 

What Will You Learn in the Patient Safety Best Practice Track at the Summit?

January 12th, 2018 by

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Since 1994, System Improvements has included information about improving Patient Safety in the Summit. This year we have a whole best Practices Track dedicated to improving patient safety and a Keynote Speaker talking about a fatal sentinel event.

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Let’s start by telling you about Dr,. Carol Gunn, one of our Keynote Speakers. She is a medical doctor who was trained to use the TapRooT® Root Cause Analysis System before she became a doctor. While she was a doctor, her sister died in a hospital from “complications.” It turns out that those complications were a result of a medical error. She will tell the story of her sisters death and what can be learned when root cause analysis is used properly and what happens when sentinel events are covered up.

Now let’s look at what’s covered in the Patient Safety Best Practices Track:

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Improving Patient Safety – Gaining a Win from a Loss (Michel Lindsay): Michele will share the evolution and success of their system for managing patient safety incidents and the expanded role of the Quality of Care Committee (QCC) on its journey to a high reliability organization at Southlake Regional Health Centre. A serious incident can have devastating outcomes to patients, their families, and to the caregivers involved. Even errors that result in no or mild harm to the patient can be devastating and career changing for staff and physicians. We have created structures and supports for immediate and long term organizational learning and improvements from incidents while maintaining a culture of care. Learn how the process QCC role has assisted in removing the shame and blame from an incident and turned it into a powerful lever for caring, sharing and repairing. Michele will describe the investigation processes using illustrations and case studies to describe how patient safety, learning, performance and culture has been positively impacted by their approach. The presentation includes the input from the COO & SVP Operations, Director of Surgery, the Director of Risk, the Manager of Risk, the Manager of a Cardiac Clinical Program, a Physician and the Quality Specialist.

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Improving Sentinel Event Investigations (Ken Turnbull): Ken is one of the authors of the new book, Improving Patient safety with TapRooT® Root Cause Analysis (to be released somewhere around the time of the Summit) and will share some of the new ideas presented in the book.

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Using Wearables to Minimize Daily Human Errors (Kevin McManus): Look at how wearables are being used both now and in the future to help prevent errors and identify problems more effectively.

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Deep Dive Into the Procedures Basic Cause Category (Ralph Brickey): Procedures (checlists) are almost a new concept being used to improve patient safety. Learn from the TapRooT® procedures best practices including: Learn: the philosophy and practice of using procedures; different types of procedures and how they are addressed in the TapRooT® Root Cause Dictionary and the Root Cause Tree®; and two human performance tools to aid in proper procedure use

Influencing Change (Jonathon Kennedy): Change is what improving performance is all about. What is the best way to influence change? Hear what Jonathan Kennedy has to say.

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Top 7 Secrets of a Great Investigation Interview (Barb Carr): Take your interviewing skills to the next level and collect better quality and quantity of information from your investigative interviews by harnessing the power of the seven secrets.
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TapRooT® Users Share Best Practices (Linda Unger): Share best practices about root cause analysis, investigations, and performance improvement with industry leaders from around the world.

Performance Improvement Gap Analysis (Linda Unger): Evaluate where you are and where you want to go and how you will apply what you have learned at the Summit to improve performance at your facility. The goal of this session is to go back to work with a plan to improve patient safety.

That an impressive list of breakout sessions.

So are you really interested in improving patient safety? Then you should attend the 2018 Global TapRoot® Summit. Register HERE!

Why does your site need someone (or a team) at the 2018 Global TapRooT® Summit?

January 10th, 2018 by

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Since there are so many high-quality conferences and events put on each year, you really need to think about which ones you should go to. If you haven’t signed up for the 2018 Global TapRooT® Summit yet, here are four top reasons to attend.

REASONS TO ATTEND THE SUMMIT

1. SAVE MONEY

You can’t afford a major accident, a fatality, a serious quality defect, a sentinel event or an unexpected equipment failure.

The TapRooT® Summit is a unique gathering of people intent on improving performance. They share ideas across companies, disciplines, and continents. The sharing of new ideas and best practices will help you develop ideas to stop accidents, fatalities, quality issues, sentinel events, and equipment failures.

What you may not have thought of is how much money this could save your company. Do you know the costs of human errors that occurred at your site? What were your workman’s comp costs? How much does unexpected downtime and lost production cost your site? What were the costs of legal issues due to mistakes and the resulting lawsuits? You will be far ahead financially if you stop just ONE major issue.

2. GET A PROMOTION

What will happen to your career is you are seen as an essential problem solver that leads the sites improvement efforts?

But where will you get the skills and ideas to lead improvement at your site? That’s easy. Attend the 2018 Global TapRooT® Summit.

When we plan the Summit we take the lessons we learn from teaching root cause analysis around the world and build sessions that we know will help solve frequently occurring issues that we have observed at courses. You will be surprised how many people face issues similar to the ones that you face and how there are people who have figured out how to improve performance and stop those problems. Don’t reinvent the wheel. Attend the Summit and learn from the success of others.

3. GET FIRED UP!

Improving performance requires constant attention. Working hard to constantly improve performance can wear you down. Where do you get the motivation to continually challenge the status quo? Attend the TapRooT® Summit!

Most people we talk to before the Summit say that they are attending to learn new skills and get new ideas and best practices to help their site improve performance. And after the Summit they agree that they learned valuable information well worth the time and expense of attended. But they are surprised that they got an unexpected benefit that was even more valuable. They left the Summit FIRED UP to go back to work and make things happen.

Why is motivation so valuable? Because an unmotivated person is unlikely to have the stamina to see an improvement effort through to completion. They get started but they don’t get things done.

We understand motivation and making improvements happen and that’s why we know that motivation is important. That’s why we build in events to motivate you throughout the Summit. Attend the 2018 Global TapRooT® Summit and go back to work CHARGED UP to make improvement happen.

4. HAVE FUN

What? How can fun be an important reason to attend the TapRooT® Summit? We have learned that people learn more, retain more, and bring more and better ideas back to work from the Summit if they have fun learning and sharing.

After all, who says that work and learning have to be dull and boring? We have discovered how to make the Summit an activity that you will find valuable and ENJOYABLE every time you attend.

ONE MORE IDEA…

Have you ever noticed how an effective team accomplishes much more than a single motivated individual?

That’s why we recommend that a site truly interested in achieving excellence send an improvement team to the TapRooT® Summit.

A team can spread out across the various sessions (there are tracks with various topics to pick from). Someone might attend the Safety Track while someone else attends the Quality Track, while someone else attends the Human Factors Track, while someone else attends the Asset Optimization Track. See the schedules for the various tracks by CLICKING HERE.

GUARANTEE

We know that you will find the 2018 Global TapRooT® Summit a valuable experience. We know that you will have a great return on your investment of time and money. And we provide you with this guarantee:

Attend the Summit and go back to work and use what you’ve learned. If you don’t get at least 10 times the return on your investment, simply return the Summit materials and we’ll refund the entire Summit fee.

So don’t wait. REGISTER TODAY!

Want to see what people who attend the Summit have to say after they attend? Here’s a video I made a few years ago and it sure is a blast from the past that still applies today…

Sorry, we won’t be having golf at this Summit (the first week in March in Tennessee just doesn’t work) but we will have a great reception and a lot of sharing.

4 Steps to Playing like a Champion in 2018

January 8th, 2018 by


Ever wonder what your life would feel like if you had the knowledge to live life at the top of your game? Champions know how to compete, but they are not born that way. Every champion has to first learn how to qualify for the game before they even get a chance to compete for the win.

So, how do you qualify to play?

First

Begin today by forming a mental picture of where you want to be. If you can form a strong mental picture and rehearse it, your brain will find a way to get you there. Write it down.  Read it daily.

Second

Expect setbacks and move past them. Let them be lessons learned that propel you forward not anchors that weigh you down. A champion is an ordinary individual who persists through obstacles. Are expectations causing you stress? Don’t put the high expectations of others in a negative light.  Expectations are really support… a belief that you can accomplish a goal.

Third

Stay focused on your mental picture of success and support yourself with positive affirmations. If you are not telling yourself that you are capable of success every single day, there is no way you are going to experience it. If you are waiting for someone else to believe in you, they are probably waiting for you to believe in yourself. Stay positive.

Fourth

Strive for improvement. You will experience wins practicing these steps but regardless of your achievements, operate under the goal of self-improvement. So, practice these steps to qualify to play, and then join us at the 2018 Global TapRooT® Summit to continue improving! Boaz Rauchwerger is our special keynote speaker on Wednesday, February 28 at 12:30 p.m., presenting “Play Like a Champion Every Day.” After his keynote, he will be presenting “Improve People Skills and Become More Productive” in a best practice session from 1:30 pm to 2:30 pm on the Alternative Sessions Track.

Boaz Rauchwerger is Speaker of the Year for Vistage International, the world’s largest organization of CEO’s. He is the founder and president of Boaz Power Corp., a Los Angeles-based high performance consulting firm. He is also an internationally-known professional business speaker for major corporations such as American Airlines, Xerox, and Toyota.

Previously, Boaz was a newspaper publisher, owned his own advertising agency and has produced corporate films as well as a network television show. He is the author of “How to Create Exceptional Outcomes – Become the CEO of a Very Successful Life.” Boaz holds a degree in journalism, public relations and advertising from the University of Tulsa.

Join us for his game-changing presentations and live your life like a champion in 2018!

Register today!

Learn more.

Root Cause Tip: Causal Factor Development

January 4th, 2018 by

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Human Error?

 

Hi, everyone.

I thought I’d do a quick discussion on some ideas to help you when developing Causal Factors on your SnapCharT®.

Let me start out by stressing the importance of using the definition of a Causal Factor (CF) when you are looking at your SnapCharT®. Remember, a Causal Factor is a mistake, error, or failure that, if corrected would have prevented the incident, or mitigated it’s consequences.  The most important part of the definition are the first few words:  mistake, error, or (equipment) failure.  As you are looking for CFs, you should be looking for human error or mistakes that led directly to the incident.  Remember, we aren’t blaming anyone.  However, it is important to realize that almost all incidents are “caused” by someone not doing what they were supposed to do, or doing something they shouldn’t.  This isn’t blame; this is just a recognition that humans make mistakes, and our root cause analysis must identify these mistakes in order to find the root causes of those mistakes.

With this definition in mind, let’s talk about what is NOT a CF.  Here are some examples:

  • “The operator did not follow the procedure.”  While this may seem like a CF, this did not lead directly to the incident.  We should ask ourselves, “What mistake was made because someone did not follow the procedure?”  Maybe, the operator did not open the correct valve.  Ah, that sounds like a mistake that, if it had not occurred, I probably would not have had the incident.  Therefore, “Operator did not open valve VO-1” is probably the CF.  Not following the procedure is just a problem that will go under this CF and describe the actual error.
  • “Pre-job brief did not cover pinch points.”  Again, we should ask ourselves, “What mistake was made because we did not cover pinch points in our pre-job brief?”  Maybe the answer is, “The iron worker put his hand on the end of the moving I-beam.”  Again, this is the mistake that led directly to the incident.  The pre-job brief will be a piece of information that describes why the iron worker put his hand in the pinch point.
  • “It was snowing outside.”  I see this type of problem mis-identified as a CF quite often.  Remember, a CF is a mistake, error, or equipment failure.  “Snowing” is not a mistake; it is just a fact.  The mistake that was made because it was snowing (“The employee slipped on the sidewalk”) might be the CF in this case, again with the snowy conditions listed under that CF as a relevant piece of data.

Hopefully, this makes it a little easier to identify what is and is not a CF.  Ask yourself, “Is my Causal Factor a mistake, and did that mistake lead directly to the incident?”  If not, you can then identify what actually lead to the incident.  This is your CF.

Want to learn more? Attend our 2-day Advanced Causal Factor Development course 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!

Resolve to Improve!

January 2nd, 2018 by

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On New Year’s Eve, did you make a resolution? According to the data company, iQuanti, here were the top seven resolutions made:

  1. Get healthy.
  2. Get organized.
  3. Live life to the fullest.
  4. Learn new hobbies.
  5. Spend less/save more.
  6. Travel.
  7. Read more.

Are you surprised by any of the above? Nothing earth shattering there.  Outside personal improvements, there is a way to truly make a difference in your own life as well as the lives of others. The one resolution not on the top seven list that you shouldn’t overlook is a work-related resolution.

Here are some work-related resolutions to consider…

  • Eliminate the blame environment when someone makes a mistake.
  • Stop problems from happening over and over again.
  • Save time and get better results when you perform an incident investigation.
  • Learn best practices to make your workplace safer and more productive.
  • Become better at your job by applying state-of-the-art root cause analysis.

How do you do these things?

TapRooT®

Start by attending TapRooT® Training. See our upcoming courses here:

 http://www.taproot.com/store/Courses/

Then make sure that you are at the 2018 Global TapRooT® Summit to learn best practices from around the world. That’s the best place to learn best practices from industry leaders from around the world. The Summit is in Knoxville, TN, on February 26 – March 2. See the Summit schedule here:

http://www.taproot.com/taproot-summit/summit-schedule

And register here:

http://www.taproot.com/taproot-summit/register-for-summit

The knowledge you will gain will help you make 2018 the best year ever.

2018 Global TapRooT® Summit Updates!

December 19th, 2017 by

There’s been LOTS of exciting news posted lately about the upcoming 2018 Global TapRooT® Summit, so I thought I’d organize it all into one post and help you catch up.

There are NINE Best Practice Tracks you can choose from for your Summit experience (February 28 – March 2):

  1. Human Factors
  2. Investigator
  3. Quality
  4. Safety
  5. Software
  6. TapRooT® Instructor Recertification
  7. Alternative Sessions (More info to come in January)
  8. Asset Optimization
  9. Patient Safety (More info to come in January)

There are TEN 2-day Pre-Summit Courses for you to choose from (February 26 – 27)

  1. TapRooT® Root Cause Analysis Training (Course description)
  2. Equifactor® Equipment Troubleshooting and Root Cause Analysis (Course description)
  3. Advanced Causal Factor Development Course (Course description)
  4. Advanced Trending Techniques (Recent update! | Course description)
  5. TapRooT® Analyzing and Fixing Safety Culture Issues (Recent update! | Course description)
  6. Risk Management – Best Practices & Risk-Based Thinking (Recent update! | Course description)
  7. Getting the Most from Your TapRooT® VI Software (Recent update!Course description)
  8. TapRooT® for Audits (Recent update! | Course description)
  9. TapRooT® Evidence Collection and Interviewing Techniques to Sharpen Investigation Skills (Recent update! | Course description)
  10. Understanding and Stopping Human Error (Recent update! | Course description)

Make plans to attend the Reception with Carl Dixon.

And don’t forget to check out the recently updated Hotel & Travel page for ideas about:

  • where to stay.
  • how to get around Knoxville once you arrive (“Transportation Tips”).
  • what’s happening around town that you may be interested in during your free time.

And CLICK HERE to view our informative short Summit videos.

REGISTER NOW.

Sign up now for the February 2018 Global TapRooT® Summit Quality Track

December 19th, 2017 by

 

Need a jumpstart on your Quality Management System’s improvements to better utilize your company’s product realization? Sign up for the Quality Track during the Global TapRooT® Summit, Knoxville, Tennessee, February 26 – March 2, 2018

Improve Your Resource Usage Management by attending:

Mark Paradies (the creator of TapRooT®)

How to Replace 5 Whys with TapRooT® for Better Results

People argue that 5-Whys is a “good enough” root cause analysis tool. They say it’s simple to ask “why” five times and that people in the field can “understand it.” Well, the time has come to put that argument to bed… 5-Whys is inadequate. It has fundamental flaws that make it inadequate. This session will demonstrate how replacing 5-Whys with TapRooT® provides better results.

 

Kevin McManus– Great Systems!

Stop Daily Goofs for Good

This session has a proactive, process-based focus, and promotes the use of systematic improvements to prevent human error and improve cognitive ergonomics on the job.

Using Wearables to Minimize Daily Human Errors

Look at how wearables are being used both now and in the future to help prevent errors and identify problems more effectively.

 

Barb Carr – System Improvements, Inc.

Top 7 Secrets of a Great Investigation Interview

Take your interviewing skills to the next level and collect better quality and quantity of information from your investigative interviews by harnessing the power of the seven secrets.

 

Improve Your Management Responsibility by attending:

 John Boyle

Making Audits an Integral Part of a Proactive Improvement Program –

This session has a proactive, process-based focus, and promotes the use of systematic improvements to prevent human error and improve cognitive ergonomics on the job. Kevin McManus

 Jonathan Kennedy

Influencing Change

Nothing happens without change. Nothing happens without support of change. Learn techniques to increase the ability to change with full management support.

 

Improve Your Analysis and Improvements by attending:

Christopher Vallee – System Improvements, Inc.

What is a Trend and How Can You Find Trends in the TapRooT® Data?

You have invested in TapRooT® and have root cause data, but do you know what the data tells you? Do you know if what you are measuring has changed for the good or the bad? Do you know how to access your trend-able data in your VI Software? Learn what to look for, what needs to be acted on and how to access the data on VI Software.

Performance Improvement Gap Analysis

Put together everything that you learned this week in your Summit Tracks and from your peers, then develop your action plan to hit the ground running.

REGISTER NOW or

Learn more!

Are you interested in improving human performance? Try this four step plan!

December 19th, 2017 by

Plan4

Is discipline the main way you “fix” human error problems?

Are you frustrated because people make the same kind of mistakes over and over again?

Have you tried “standard” techniques for improving human performance and found that they just don’t get the job done long term (they have an impact short term but not long term)?

Is management grasping for solutions to human error issues?

Would you like to learn best practices from industry human performance experts?

Try this four step plan:

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1. Attend a 5-Day TapRooT® Advanced Root Cause Analysis Course.

The TapRoot® System is made to reactively and proactively help you solve human performance issues. It has built in human factors expert systems that guide you to the root causes of human errors and help you develop effective fixes. The 5-Day TapRooT® Course is the best way to learn the system and get started fixing human performance issues.

See the upcoming course schedule here: http://www.taproot.com/store/5-Day-Courses/

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2. Attend the Understanding and Stopping Human Error Course

At this two day class, Dr. Joel Haight, a human factors and safety improvement expert and industrial engineering professor at the University of Pittsburg (where he is the Director of the Safety Engineering Program) shares the reasons why people make mistakes and what you can do to understand the problems and fix them.

Joel is an expert TapRooT® User having extensive experience apply TapRooT® to fix human factors problems at a Chevron refinery and in the oil field in Kazakhstan. He is also an expert in applying other human performance analysis and improvement techniques. He brings this knowledge to the 2-Day Understanding and Stopping Human Error Course.

It is best if you have already attended at least a 2-Day TapRooT® Course prior to attending this course. See the course description here: http://www.taproot.com/taproot-summit/pre-summit-courses#HumanError

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3. Attend the Human Factors Track at the 2018 Global TapRooT® Summit

Once a year we put together a track at the Global TapRooT® Summit that is designed to share best practices and the latest state-of-the-art techniques to improve human performance. That’s what you get at the Human Factor Track at the Summit. What are the sessions at the 2018 Global TapRooT® Summit?

  • TapRooT® Users Share Best Practices – This is a workshop designed to promote the sharing of investigation, root cause analysis, and human performance best practices from TapRooT® Users from around the world. Every year I attend this session and get new ideas that I share with others to help improve performance. Many say this is the best session at the Summit because they get such great ideas and develop new, helpful contacts from many different industries.
  • Top 5 Reasons for Human Error and How to Stop Them – Mark Paradies, President of System Improvements and a human factors expert, shares his deep knowledge of the top five reasons that he see’s for people making “human errors.” For each of these he shares his best ideas to stop the problems in their tracks.
  • Stop Daily Goofs for Good – Kevin McManus, a TapRooT® Instructor and performance improvement expert, shares systematic improvement ideas s to prevent human error and improve cognitive ergonomics on the job.
  • Using Wearables to Minimize Daily Human Errors – Using “wearables” is a technological approach to error prevention. Find out more about how it is being used and may be applied even more effectively in the future.
  • Alarm Management, Signal Detection Theory, and Decision Making – Are people at your facility overwhelmed by alarms? Do the become complacent because of nuisance alarms? Dr. Joel Haight, Director of the University of Pittsburg Safety Engineering Program will discuss control system decisions, decision execution, alarm management, signal detection theory, and decision making theory and how it could be critical in an emergency situation.
  • The Psychology of Failing Fixes – Why do your fixes fail to prevent human error? That’s what this session is all about!
  • What is a Trend and How Can You Find Trends in the TapRooT® Data? – looking for trends in human error data is an important activity to identify generic human factors problems and take the first step to major human performance improvements. Now for the bad news. Most people really don’t understand trending. Find out what you need to know and how to put trending to work in your improvement program.
  • Performance Improvement Gap Analysis – This is the session where you put everything together. Where does your program have holes? How can you apply what you have learned to fill those holes? What are others doing to solve similar problems? Put your plan together so you are ready to hit the ground running and make improvements happen when you get back to work.

And the Best Practice Sessions outlined above are only a start. You will also see five great Keynote Speakers:

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Mike Williams will share his experience surviving the Deepwater Horizon explosion.

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Dr. Carol Gunn will share the story of the her sisters unnecessary death in a hospital and patient safety improvement.

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Inky Johnson will share his experience with a debilitating football injury and how it changed his life and helps him inspire excellence in others.

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Mark Paradies will help you get the most out of your application of TapRooT®.

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Vincent Ivan Phipps will teach yo to amplify your leadership skills and communication ability.

We know that the Summit will provide you with new ideas and the inspiration to implement them.

Start

4. Get started! Analyze your human performance issues and make improvements happen!

Just Do It! get back to work and implement what you have learned. Need more help? We can provide training at your site to get more people trained in using TapRooT® so that you have help making change happen.

Don’t wait! Get your four step plan started! Register for the courses and Summit today!

5 Reasons Why You Should Attend the Pre-Summit Course: Getting the Most from Your TapRooT® VI Software

December 19th, 2017 by

 

  1. Learn to create your own Custom Tab and Custom Fields. Creating custom tabs and fields is a very powerful feature in the software and this course will go into great detail on how to customize these for your business needs.
  2. Learn to create your own Custom Reports and Report Templates. The TapRooT® VI software does not assume to know exactly what reports you want to see and share with your team members. This course will teach you how to build reports that contain specifically what you want and how to create and share the same templates with other users.
  3. Learn to use the redesigned Optional Techniques. Do you know that the software contains tools and techniques that can help you build better SnapCharT®s and more thoroughly investigate your incidents? This course will show you how to use Safeguard Analysis, Change Analysis, Equifactor® and CHAP.
  4. Learn the Administrative functions available to give your users more options. This course will go into great detail on the new administrative features including Notifications, Maintenance Mode and Custom Equifactor®.
  5. Learn how to use the Trending features to understand where opportunities exist in your business. The new dashboard is customizable and offers hundreds of options to look at root cause, location and classification trends. You will also learn to export custom data to create additional custom reports.

Come join us February 26th and 27th before the Global TapRooT® Summit to get the most from your TapRooT® VI Software!

CLICK HERE to register today.

Sign up now for the Investigator Best Practices 2018 Summit Track

December 18th, 2017 by

The 2018 TapRooT® Summit will be in Knoxville, TN February 28 – March 2, with unique and valuable Pre-summit courses on February 26 and 27. Make plans to attend, and sign up early since this will be a blockbuster!

As the coordinator for the Investigator Best Practices Track, I’d like to introduce the speakers and best practice sessions.

How to Replace 5 Whys with TapRooT® for Better Results – Mark Paradies (the founder of TapRooT®)
This session will demonstrate how replacing 5-Whys with TapRooT® provides better results. It is a misconception that 5-Whys is “good enough” for root cause analysis. It has fundamental flaws, not least of which is that it introduces investigator bias. TapRooT® will yield better results also in complex, but also in smaller investigations.

Improving Safety Culture through measuring and grading investigations – Jack Frost (VP Matrix Service, contractor to energy, power and manufacturing)
Continuous improvement is important not just in production but also with the HSEQ efforts. In this session Jack Frost will share how a disciplined approach to incident investigations over three years has improved performance more than 40%, and improved the safety culture in an organization. Central to the approach has been a focus on engineering controls, quality assurance of investigations, and use of KPIs for personal accountability and rewards.

Making sense of complex investigations– Pat Fortune (team lead for EH&S major projects at Suncor Energy)
Pat is an “investigator’s investigator” with dozens of years of experience. He will warn us not to go down the wrong track with investigations, not take shortcuts but be disciplined and use the expertise built into the Root Cause Tree®

Best practices for sharing lessons learned – Pat Fortune
This session focuses on Pat’s take on “the learning organization”, that does investigations of incidents and near misses but also broadly communicates results internally. You will greatly benefit from making this approach part of your company DNA.

The psychology of failing fixes – Kevin McManus (Author and trainer with 35 years experience with Engineering, Training, and as a Plant Manager and Director of Quality)
This will be a top session on understanding the psychology behind insufficient fixes. Learn how blaming individuals and mis-identifying systemic root causes can lead to failing corrective actions

Top 7 secrets of a great investigation interview – Barbara Carr (TapRooT® trainer and co- author of the new book “Evidence Collection and Interviewing Techniques to Sharpen Investigation Skills”)
There are certain techniques and approaches that are proven to work well when doing investigative interviews. Come learn how to collect better quality and quantity of information from people you talk to.

Deep Dive into the Procedures Basic Cause Category – Dr. Ralph Brickey (TapRooT® trainer with a 28 year background in nuclear power maintenance, training and program management)

An investigator looking at an incident may find that performance would have improved if a well-written procedure was used correctly. This Basic Cause category deals with instances where a procedure was not followed, was wrong, or followed incorrectly. Learn what a good procedure looks like, and what pitfalls exist with obsolete or poorly written ones. Ralph will make sure this is a lively and interactive session, as he “is curious about almost everything and interested in the rest.”

Participants in this eminent track will of course also have opportunity to hear the different keynote addresses. Feel free to contact me with questions, and register today!

Gift yourself! (Santa has your back)

December 13th, 2017 by

Do you have the feeling that you have the ability to do more in your career in 2018 but are unsure of how to get going? Why not think about giving a gift to yourself?

Click here to learn more.

TapRooT® for Audits Pre-Summit Course at the Global TapRooT® Summit

December 13th, 2017 by

“An Ounce of Prevention is Worth a Pound of Cure.”
Ben Franklin

Around the world, professionals and companies have sought to find a better way to perform investigations on problems and losses. Many of the smartest people and leading companies use TapRooT®.

The TapRooT® Root Cause Analysis System is a robust, flexible system for analyzing and fixing problems. The complete system can be used to analyze and fix simple or complex accidents, difficult quality problems, hospital sentinel events, and other issues that require a complete understanding of what happened and the development of effective corrective actions. However, wouldn’t it be better if you never had to do investigations in the first place? Of course, and that is why auditing is so important.

Many companies do perform audits. Unfortunately, in some cases, this work does not yield improvements. Why? There are many reasons, but the primary reason is lack of good root cause analysis. A company can actually be very good at finding problems, but not be effective at FIXING problems.

Beyond auditing, proactive improvement can take many forms, and when effective, becomes an overall mindset and can put an organization on the path to excellence. If that is the case, why are more companies not proactive? Here are just a few reasons:

• Time (perceived at least)
• They don’t have a reason to (not enough pain)
• They do not have the buy-in (management and employee support)
• Procrastination (human nature!)
• They don’t know how (this is where TapRooT® comes in!)

TapRooT®, when used with auditing and proactive improvement programs, can help lead to organizational excellence and reduce the number of investigations required.

To help you in your performance improvement efforts, we created a course entitled “TapRooT® for Audits,” which will be a Pre-summit course at the Global TapRooT® Summit. Why should you attend?

Top 5 Reasons to attend TapRooT® for Audits:
1. You did an audit and found the same thing you did last year!
2. You have used TapRooT® for investigations but never used it for audits.
3. You are an auditor, not an investigator.
4. You are a good investigator, but want to become a better auditor.
5. You want to help your company improve, show your value to the company, and build your expertise level.

If any of these 5 reasons apply to you, please attend our course, TapRooT® for Audits, at the Global TapRooT® Summit, February 26-27, in Knoxville, TN. To register for the course (and the summit on February 28-March 2), click HERE

Are you on Santa’s “Naughty” or “Nice” List for investigative interviewing?

December 12th, 2017 by

 

 

I’m really excited to share the “Top 7 Secrets of a Great Investigation Interview” during Global TapRooT® Summit Week, February 26 – March 2, 2018 in Knoxville, Tennessee. Meanwhile, in the spirit of the season, I want to share some interviewing tips to keep you on Santa’s “nice” list!

.

Santa’s Nice List Santa’s Naughty List
.

Explain to the worker that you want to
interview him/her to find the root causes of
the problem so you can fix them.

.

Explain to the worker that you want to
interview him/her to find out who is responsible
for the mistake because they deserve to be fired.

.

Ask the worker open ended questions.
“Tell me about… ” and then listen
to their narrative without
interruption
.

.

Interrupt the worker whenever you think of a
question or comment he or she may find accusatory,
like, “Mark, isn’t it true that you disregarded company
procedure? Why did you intentionally do that?”
That will pressure him/her to spill the beans!

.

Tell the worker that you will share information
with only those who need to know.

.

Promise total and complete confidentiality. You know
you can’t, but they’ll tell you more if you do.

.

Let the worker know you’ll take notes during
the interview and that you will review them
together upon the conclusion of the interview
to make sure you understood everything
correctly.

Don’t take any notes. You already know
what happened – you’ve seen it a million times.

.

What do you think? What best practices do you use for investigative interviewing? What practices do you think lands an investigator on the “naughty” list?

Ten Indicators that your Company may have a Safety Culture Problem

December 11th, 2017 by


What puzzle pieces do you need to put in place to improve your safety culture?

A safety culture is difficult to measure, but there are some indicators that alert us to problems.

  1. There is no visible commitment from leadership.
  2. When there are competing priorities, safety comes in second.
  3. Workers feel uncomfortable reporting safety issues to their supervisors.
  4. Safety is viewed as more of a cost than an investment.
  5. Injuries and illnesses are sometimes swept under the rug.
  6. Safety issues are dealt with in an untimely and inefficient manner.
  7. Workers do not have the power or resources to find and fix problems as they see them.
  8. Managers are never seen on the shop floor with the workers.
  9. Safety is not part of the everyday conversation.
  10. Workers are blamed for accidents.

Do any of these sound familiar? If you identify problems like those listed above, you can improve your facility’s safety culture. We’re excited to welcome Brian A. Tink and Brian W. Tink back to the Global TapRooT® Summit to share their popular 2-day Pre-Summit course, “TapRooT® Analyzing and Fixing Safety Culture Issues.”

Click here to learn more about this course.

Register now for the 2-day course only (Febuary 26 and 27)

Register now for the 3-day Global TapRooT® Summit and this 2-day course (February 26 – March 2)

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Fortunately, I already had a plan. I had previously used TapRooT to improve investigations…

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