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"So we just completed our detailed root cause analysis…." "It took us several weeks to complete and lots of effort, but we can now most definitively say that the root cause was categorically linked to "human error". If this sounds like any of your own recent detailed incident analysis conclusions, then it's likely you've just used up significant effort and resources without getting much in return. Simply stated, if your root cause conclusions point toward human behavior, you're likely no further forward in either understanding the real causes of your unplanned event or in establishing an effective corrective action. That's because it's hard to prevent reoccurrence for something as broad and ill-defined as human behavior.
doi: 10.2118/168327-MS
SPE-168327-MS
SPE International Conference on Health, Safety, and Environment
bad apple, coalface, consequence, corrective action, develop corrective action, effective corrective action, fixing human error, human behavior, human error, new thinking, Petroleum Engineer, probability, procedure, relation, senior management, serious unplanned event, Supervisor, unplanned event, Upstream Oil & Gas