{"id":1454,"date":"2012-10-01T08:46:47","date_gmt":"2012-10-01T13:46:47","guid":{"rendered":"http:\/\/www.jmcampbell.com\/tip-of-the-month\/?p=1454"},"modified":"2012-10-23T08:12:29","modified_gmt":"2012-10-23T13:12:29","slug":"should-unplanned-maintenance-jobs-be-recorded-as-near-misses","status":"publish","type":"post","link":"http:\/\/www.jmcampbell.com\/tip-of-the-month\/2012\/10\/should-unplanned-maintenance-jobs-be-recorded-as-near-misses\/","title":{"rendered":"Should unplanned maintenance jobs be recorded as near misses?"},"content":{"rendered":"

OSHA mentions \u201cnear-misses\u201d as recordable requirements in several passages as: \u201cAn unplanned and unforeseeable event that could have resulted, but did not result, in human injury, damage to property or the environment or other form of loss\u201d.\u00a0 <\/em>And we know that all industrial maintenance organizations have a history of reactive, run-to-failure-then-run-to fix, maintenance management behaviors.\u00a0 JMC\u2019s emphasis on process and equipment reliability and operations management helps to bring facilities out of the reactive mode, but reactive maintenance jobs are still all too prevalent.\u00a0 Some, or many of these reactive jobs \u201ccould have resulted, but did not result, in human injury, damage to property or the environment or other form of loss\u201d.<\/p>\n

Safety is everyone\u2019s number one goal.\u00a0 Most corporate safety programs define near-misses, but few connect the dots between recordable incidents and the degree of reactive, unplanned maintenance work.\u00a0 The famous safety pyramid is quite familiar, but that\u2019s only the tip of the safety iceberg.\u00a0 Below the \u2018water line\u2019 of recordable first aids (lagging indicators) lie near-misses and, at the base of it all, safe behavior.\u00a0 These are the leading indicators of our safety performance. This Tip of the Month will tie reactive maintenance and safe behavior together.<\/p>\n

Recent data, compiled by Belgian\u2019s BEMAS, clearly links accidents with injuries to the percent of reactive maintenance work (the opposite of planned and scheduled work).\u00a0 If, indeed, a company uses the near-miss definition, how can it not require the recording of some, if not all, unplanned maintenance jobs?<\/p>\n

An iceberg is a good metaphor for Safety; most of its mass lies beneath the surface and we see only the tip.\u00a0 The safety pyramid compares the quantity of accidents in layers with fatality on the top and reportable incidents on the bottom.\u00a0 But the real basis of safe behavior lies underneath the reporting surface and is comprised of near misses and unsafe behaviors.<\/p>\n

For over 33 years I have been focused on driving down unplanned maintenance jobs through training and consulting on control of work.\u00a0 We all should know that planned maintenance is simply safer!\u00a0 But we have been reluctant to tie urgent, reactive jobs to unsafe practices.\u00a0 In 2012, it\u2019s time to ask \u201cShould unplanned maintenance jobs be recorded as near-misses\u201d?<\/p>\n

In a nearly parallel development path, our emphasis and understanding of safe work environments has also been refined.\u00a0 With the help of several catastrophic events, like the Texas<\/p>\n

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\n<\/a>City refinery and, more recently Deepwater Horizons, and many smaller injury-causing accidents, our industry has put safety on the front burner.<\/p>\n

A useful way to look at the safety pyramid (Figure 1) is to draw the dividing plane at what is reported and not reported.\u00a0 This brings behavior-based safety programs, which we all talk about, into perspective. A key point here is the separation of leading indicators and lagging indicators.\u00a0 It\u2019s obvious to record Incidents and Accidents after<\/span> they happen, but less obvious to capture near-misses and instill safe behaviors.<\/p>\n

Recent data (Figure 2), presented by Wim Vancauwenberghe [1] of the Belgian Maintenance Association (BEMAS) at last year\u2019s SMRP (Society for Maintenance and Reliability Professionals) annual conference shows the impact of unplanned maintenance jobs on the rate of accidents with injuries; and subsequent reduction in injuries as the percentage of planned work increases.<\/p>\n

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This raises the question in this paper, and it\u2019s time we asked.<\/p>\n

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Clearly, not every unplanned maintenance job involves the same level of risk.\u00a0 We can use a risk-based approach as in Figure 3 to indicate when an unplanned job becomes a near miss.\u00a0 When we look at the spectrum of behavior from risk averse upwards to reckless, we can begin to establish some range of criteria for defining what to report. Applying the risk spectrum to the nature of unplanned jobs, we would expect risk to increase due to some factors.\u00a0 Typical risk matrices compare event likelihood to its consequence to determine level of risk.\u00a0 Should we develop something similar for unplanned jobs?\u00a0 This tip attempts to describe the conditions that would determine the level of risk in jobs.\u00a0 Perhaps there are companies who have successfully addressed this issue and, hopefully they will contribute to this discussion.<\/p>\n

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\n<\/a>OSHA distinguishes Accident, Incident and Near Miss with the definitions in Figure 4.\u00a0 However, trying to define what \u2018could\u2019 have happened in every urgent job opens a Pandora\u2019s Box that probably wouldn\u2019t be very productive.\u00a0 On the other hand, we could approach the near miss issue by defining \u2018failure\u2019 more carefully.\u00a0 Taking the familiar P-F curve, we might be able to say that earlier definition of failure at the P point and the subsequent maintenance job would inherently be safer than reacting to a failure at the F point.\u00a0 Figure 5 shows how that might work.\u00a0 We could say that anytime we have an unexpected complete failure of equipment, it must be reported as a near miss, whereas, if we detect a potential failure and plan and schedule the maintenance action before complete functional failure, it wouldn\u2019t need to be reported because it is not a near miss.<\/p>\n

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If we are going to require near misses to be reported, another issue is raised:\u00a0 How is a near miss to be reported?\u00a0 What do we do with the report?\u00a0 How much information\/data is required on such a report?\u00a0 If we\u2019re going to require a report, we will have to define what and how much detail is required.<\/p>\n

There are several possible uses for a near miss report.\u00a0 Whatever decision we take, will impact our staff with more information gathering tasks.\u00a0 What is it worth?\u00a0 How can we successfully use the report to lower near misses and effect safer behavior?\u00a0 Or, drive down reactive maintenance work?<\/p>\n