Blog Authors: Paul Gantt, CSP and Ron Gantt, CSP, ARM
Those low frequency, high severity events that we talked about in our recent video really place a lot of pressure on organizations to rethink the way they define “workplace safety.” After all, if you measure safety by the absence of an event that doesn’t happen very often, that means you’re looking for trouble. If something that normally doesn’t happen very often doesn’t happen on a given day, how can we say with confidence that our safety management system was working? Perhaps we just got lucky (or didn’t get unlucky) that day. This is one of the dangers of using lagging indicators (i.e. injury rates, experience modification rates, etc.) to measure safety performance. Certainly lagging indicators have a place in a program to measure safety performance, but if they are all that your organization is measuring you may be misleading yourself.
Perhaps a case study will be useful to illustrate this. BP is an organization that isn’t high on many people’s list of “good safety management systems.” After all, in the last seven years, BP has been involved in two horrifically catastrophic events, killing 34 people in the two incidents alone and one considered the worst environmental disaster in US history. Of course, I’m referring to the Texas City Refinery explosion in 2005 and the Deepwater Horizon explosion in 2010. Interestingly, in both cases, using only lagging indicators one would have concluded before both explosions that effective safety management systems were in place. In both cases the incidents rates were very low and were decreasing.
So what happened? Well, both events were very complex in both their physical and organizational root causes, and we encourage readers to take some time to look at the respective incident investigation reports. The US Chemical Safety Board has a great video on the Texas City Refinery explosion on its website that, in our humble opinions, is mandatory viewing for any safety professional. (The associated video on Deepwater Horizon is expected to be released within a few months, last time we checked.) However, it is very interesting that in both cases the organization used lagging indicators primarily to measure safety performance and, in both cases, the organization was blind to the forthcoming catastrophe.
The bottom line is that the low frequency, high severity events, those events that typically lead to serious injuries and fatalities, require that we think about safety in a new way. It’s somewhat counter-intuitive, but you can’t measure the effectiveness of the safety program merely by the absence or presence of incidents. Sure, having no incidents is the goal, but when other factors, such as luck, influence when an incident happens, how do we know that when a project happens without an incident that it was because of our efforts and not just plain old dumb luck. If all your organization does to measure safety performance is use lagging indicators, it's sort of like saying that a car driver must be a good driver because he or she didn’t get into an accident today. Intuitively we know that’s not true - to know how safe the driver is we’d want to look at how the person drove, did they follow the safe driving procedures, did they take advantage of the safety equipment available to them (wearing a seat belt), etc.
And this is the essence of what we call “leading indicators.” We all know that if you want to avoid accidents in your car then you need to obey the rules of the road, practice good defensive driving techniques, and use the available safety equipment. Therefore, if we wanted to identify the good drivers from the bad drivers, we’d look for these things. In the same way, if you want to identify an organization’s real safety performance you need to look earlier, before the incidents happen. What are they doing on a daily basis to minimize risks and prevent incidents? The sad trend in serious injuries and fatalities requires that we think about safety in a new way. Dr. Todd Conklin points out that safety is not the absence of incidents – safety is the presence of controls and defenses.
If you want to know how safe your organization truly is - look at the controls and defenses that are in place. That’s how you identify your leading indicators, and that’s how you ensure that your organization doesn’t have blind spots that may lead to catastrophe.