The Hallmark of an Organization with a Great Safety Culture is how it Responds to Incidents
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The Hallmark of an Organization with a Great Safety Culture is how it Responds to Incidents
April 28, 2017
My last blog highlighted a recent incident in Asia called 'Scaffold or Gallows ?'
Within days of that incident my close friend and JMJ Partner, Steve Lang, sent this photo and brief anecdote from a large operating and construction site in India:
“This young man works in the Punjab, Northern India and sends his earnings home to his family in a small village, hundreds of miles away. Two days ago he was removed from site for a “violation” - not wearing his safety glasses.
JMJ suggested that perhaps there was a bigger opportunity here. Rather than just reinforcing the rules, what might provide a better overall outcome?
After much discussion, the site management brought him back and gave him an option in lieu of dismissal. He was offered a role as a Safety Glasses Ambassador. He was surprised and he accepted the new role immediately.
As part of this new role, JMJ arranged for him to meet another worker on the same site, who had suffered a terrible eye injury three months before. As a result of his injury, the worker permanently lost 70% of his eyesight. It was an emotional exchange and one neither man will forget.
Many companies are implementing Just Culture and Consequence Management frameworks. They are doing so to promote fairness, proportionality and transparency on their sites and factory floors, in response to incidents. This is a positive step. They are seeking to instill accountability, so workers and supervisors pay heed to their work and decisions. At the same time these companies are also trying to avoid fear. They hope that a rational model, implemented transparently, will offset the negative consequences of punishment and discipline. Unfortunately, I believe most of these efforts are failing in this latter regard.
The Consequence Models I’ve seen are virtually 100% disciplinary, corrective and retributive. Even though they are rationally applied, this doesn’t move the organization forward. I have yet to see a model that is as focused on learning, as it is on retribution.
The site in India chose to forego retribution to achieve learning. Although the incident is a simple one and the offense perhaps ‘easy to forgive’, I think it is instructional.
Organizations implementing Consequence Models may want to consider driving three objectives, not just one: Accountability, restoring loss or harm and then perhaps most important, learning.
I think this site in India chose a way to meet all three objectives.
First, accountability. The model, most companies, have is seeking to reinforce and instill accountability. “Let’s send a message to everyone that this site’s management means business.” Unfortunately, this message translates as punishment for mistakes and fear ensues. Discipline, additional competence training etc., are the consequences typically applied in this approach.
Restoring harm or loss from an incident? I don’t see that objective in the models. Justice in the models is the sole province of the management team, who are not exactly impartial. Reporting is formal, cumbersome and has legal ramifications in most places. As a result incident reporting is typically guarded, at best. Plain-speaking disclosure of an error or culpability is rarely seen. The benefits that can come from genuine disclosure, forgiveness and restoration of the prior social code or accountability, are rarely seen in the workplace.
Sharing learning may be one of the hardest areas to address for companies seeking to improve safety. Incident investigations have improved and typically include lots of credible recommendations, but are they truly adding to organizational learning? Companies have on-line systems, shared networks and more, but most companies are still frustrated by the lack of learning.
JMJ suggested that perhaps there was a bigger opportunity here. Rather than just reinforcing the rules, what might provide a better overall outcome?
What if the emphasis was to be placed on teaching instead of learning? I regularly recall and draw on lessons I learned from great teachers I had 20, 30, or 40 years earlier. I remember each one, his or her approach, the relationship each had with students, the passion for their topics, the stories they told and how they inspired me. How much teaching goes on at your site?
Please take a look at this man’s photo again. I want him on my site. I bet you’d want him on yours. His accountability is greater than it was, the commitment to safe practices is restored at the site and learning is happening.
Let’s stop sending people home who make mistakes. Instead let’s restore their accountability, and maybe even move them to the forefront of our safety efforts. Let’s consider letting go of retribution in service of achieving larger objectives.
In HSE, let’s go beyond static models and complicated processes to lead safety, not just manage it.
My appreciation to the managers and leaders of this site for being willing to listen and consider new approaches, and for restoring this man’s livelihood and future. My thanks and admiration also to Steve Lang and Paul O’Keeffe of JMJ.
Readers: I welcome comments and your examples where consequence management has been implemented in forward-looking ways. Other readers will welcome those, too.
