Could it be that Root Cause Analysis (and 5 Why’s) are designed to create simplistic stories of ‘human error’?
𝗖𝗼𝘂𝗹𝗱 𝗶𝘁 𝗯𝗲 𝘁𝗵𝗮𝘁 𝗥𝗼𝗼𝘁 𝗖𝗮𝘂𝘀𝗲 𝗔𝗻𝗮𝗹𝘆𝘀𝗶𝘀 (𝗮𝗻𝗱 𝟱 𝗪𝗵𝘆’𝘀) 𝗮𝗿𝗲 𝗱𝗲𝘀𝗶𝗴𝗻𝗲𝗱 𝘁𝗼 𝗰𝗿𝗲𝗮𝘁𝗲 𝘀𝗶𝗺𝗽𝗹𝗶𝘀𝘁𝗶𝗰 𝘀𝘁𝗼𝗿𝗶𝗲𝘀 𝗼𝗳 ‘𝗵𝘂𝗺𝗮𝗻 𝗲𝗿𝗿𝗼𝗿’? Here’s a mock interview between a seasoned investigator and a seafarer about an enclosed space entry incident. 𝘞𝘩𝘺 𝘥𝘪𝘥 𝘺𝘰𝘶 𝘯𝘰𝘵 𝘧𝘰𝘭𝘭𝘰𝘸 𝘵𝘩𝘦 𝘦𝘯𝘤𝘭𝘰𝘴𝘦𝘥 𝘴𝘱𝘢𝘤𝘦 𝘦𝘯𝘵𝘳𝘺 𝘤𝘩𝘦𝘤𝘬𝘴?Because I did not have sufficient time to go through […]