Tenets of HRO
Seeing the absence of errors or surprises as a reason for healthy anxiety rather than complacency
What is preoccupation with failure
Making a point to greet team, practice civility, and making eye contact
What is using interpersonal skills
The two most critical qualities of followership or teammates
What are critical thinking and active engagement
Filling in gaps or information that isn't really there
What are heuristic traps
No matter what errors will always occur when this factor is involved in the process
What is the human factor
Avoiding too quickly concluding simple explanations of causation
What is reluctance to simplify
Avoiding this tragic situation, "Leaders who don't listen will eventually be surrounded by people who have nothing to say"
What is inviting and expecting participation
What are specific, direct, and concise
Missing information or changes due to narrow focus or minds inability to process all details
What is change blindness
Systems where errors still occur but are caught or mitigated before developing into adverse events
What are error tolerant systems
"Walking the tunnel" because how work is imagined is often much different than how is done
What is sensitivity to operations
Using acknowledgements
What is closed loop communication
Practicing this form of feedback is ineffective but common
What is hinting and hoping
Missing information due to complacency over time
What is drift
An organization that is extremely well focused on preventing failure, on expecting the unexpected, and on ensuring that errors don't result in catastrophic events
What is a Highly Reliable Organization (HRO)
Training to respond to difficult situations and contingencies
What is commitment to resilience
A short meeting guided by a checklist that emphasizes safety/quality and covers expectations
What is a safety/quality checklist
Using this tool can help organize thoughts and develop a specific, direct, and concise message when conducting difficult conversations and/or escalating issues
What are the 3Ws
What I see
What concerns me
What I want
A technique to counter threats to SA where you step back, reassess, and reallocate resources
What is the 1-2-3 Rule
Effectiveness of CRM/CTT can take a long time because it requires a change in this rather than technology advances
What is culture
Understanding that expertise is often overlooked because it is disguised by dirty coveralls and greasy hands. Valuing knowledge no matter the position.
What is deference to expertise
Balancing concern for people and task
What is the leadership grid
The next most common step when the 3W tool fails
What is the 4-step tool
A tool used to counter threats to SA that uses a sequential list of steps typically in a read and verify or read and do format
What is a checklist
While most of the content of CTT is not new it provides these common and uniform
What are language, framework, and tools