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Systems Failures (How can systems be made more fail safe? (Hierarchy of…
Systems Failures
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If systems were operated the way they are supposed to be, would accidents happen?
System failure, or end user failure?
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Automation - reduces human error, but can be infiltrated or sabotaged
Without eliminating the human system, the other functional systems should be robust and function in a manner to allow for the human system errors to be buffered
Ultimately, people are the biggest variable factor
All systems have a human element, either in the design or operation
Is accident prevention systematic, or witchcraft?
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Technology has been a cause of accidents, as humans believe there is no hazard and fail to react accordingly
balance between procedure, training and the system are important and must be tested and reviewed regularly
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ALARP
What is ALARP, and who should make that decision?
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System failure can be easy to find in hindsight, but more difficult in foresight
Making the systems more fail safe would involve making the design and or device inherently respond or react in a way that would cause no or minimal harm to the people and the machine itself. The system can fail, but when it does, it will do so in a safe manner.
We need to differentiate between organisational systems, and mechanical or operational systems