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SH196: They broke the rules! So...?
Manage episode 497866858 series 3516753
A tartalmat a Gareth Lock at The Human Diver biztosítja. Az összes podcast-tartalmat, beleértve az epizódokat, grafikákat és podcast-leírásokat, közvetlenül a Gareth Lock at The Human Diver vagy a podcast platform partnere tölti fel és biztosítja. Ha úgy gondolja, hogy valaki az Ön engedélye nélkül használja fel a szerzői joggal védett művét, kövesse az itt leírt folyamatot https://hu.player.fm/legal.
When diving accidents occur, the immediate response often blames rule-breaking, but reality is far more complex. Rules are designed to enhance safety, yet accidents can happen even when rules are followed—and sometimes rules are broken without incident. Diving operations occur within a web of technical, social, and cultural conditions, which can provoke deviations. This highlights the gap between “work as imagined” (rules and procedures) and “work as done” (real-world practice). Understanding why rules are broken requires looking at the system rather than focusing solely on individuals. A Just Culture, where context-rich stories can be shared without fear of punishment, helps address underlying issues and drives meaningful improvements in safety. Punishment alone rarely deters rule-breaking if systemic conditions remain unchanged.
Original blog: https://www.thehumandiver.com/blog/they-broke-the-rules
Links: Root Cause blog: https://www.thehumandiver.com/blog/the-root-cause-of-an-accident
Identifying violation-provoking conditions in a healthcare setting: https://pubmed.ncbi.nlm.nih.gov/18941971/
The Extent of Conditions: https://preaccidentpodcast.podbean.com/e/papod-399-the-extent-of-condition-episode/
Normalisation of Deviance from the Challenger launch decision: https://www.amazon.co.uk/Challenger-Launch-Decision-Technology-Deviance/dp/0226851761
Tags: English, Decision-Making, Gareth Lock, Just Culture, Normalisation of Deviance, Normalization of Deviance
220 epizódok
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