Following a very consequential truck accident the citizens of the State of Connecticut may be on the brink of a debate on this topic. Few are rooticians. They...
Sorry, Bill. Try http://groups.yahoo.com/group/Root_Cause_State_of_the_Practice_III/database Your input is needed. Take care, Bill Corcoran W. R. Corcoran,...
Jeff, Thanks, Jeff, but I don't feel heard. I'm not sure you got my point. I've pasted the Governor's press release below. Below that I pasted my letter to the...
Here is my slide of the week. Thanks to the FAA. Please send yours in reply. Take care, Bill Corcoran W. R. Corcoran, Ph.D., P.E. NSRC Corporation 21 Broadleaf...
Terry, Thanks ever so much. As you know, my experience in root cause analysis makes me very suspicious of claimed "isolated matters" and "isolated cases." If...
A MESSAGE FOR NEW MEMBERS (AND HOLD-BACKS) (We have 401 members and the 90-10 Rule seems to apply; 90% of the contributions come from 10% of the members. This...
Scroll down for a story from The Hartford Courant. What do you think is wrong with this picture? Take care, Bill Corcoran W. R. Corcoran, Ph.D., P.E. NSRC...
Bill C., You and I have different counting systems. In your "Ten Commandments" database, I count 20 line items, none of which bear the number "10". Is this...
Bill, What are the underlying common causes for these incidents? If they are not identified, how do they know the actions taken will prevent recurrence? ...
Bill Salot, Thanks for snapping my jock, Old Man, but look again. I pasted the table below for your convenience. OBTW: When a Yahoo! table has more entries...
Here is an article on After Action Reviews. Do you do them at your facility? How do they work for your organization? Take care, Bill Corcoran W. R. Corcoran,...
Tim, You ask good questions. In a case like this it is important to get down to deep underlying causes and to explore broader ramifications. Take care, Bill...
Hello to all, I use this foil in my training on Root Cause as an Icebreaker or Energizer, perhaps you would like to try this one. Ill send the answer in a...
I am looking forward to the answer. Take care, Bill Corcoran W. R. Corcoran, Ph.D., P.E. NSRC Corporation 21 Broadleaf Circle Windsor, CT 06095-1634 Voice and...
Bill C., I love "after action reviews". I tend to be a critic by nature, and AARs give me the opportunity to vent to a generally captive audience without too ...
Hi All I have a healthcare client interested in hearing definitions of " a near-miss" that are not confuses and subject to great misinterpretation. Can anyone...
To Bob L. In James Reason's book "Managing the risks of organiziational accidents" he defines a "near miss" as any event that could have had bad consequences...
Thank you Thomas. ... From: Root_Cause_State_of_the_Practice@yahoogroups.com [mailto:Root_Cause_State_of_the_Practice@yahoogroups.com]On Behalf Of Niessen,...
MessageTom, Thanks. The Rooticians' Dictionary says: Near Miss: An event or situation that could have had more severe actual consequences except for a fragile...
Bob and others: The most likely reason the healthcare audience is getting hung up on this definition is that much of the culture views them as "good luck" and...
Close call, near miss, near hit, lesson learned or free lesson are monikers for "an event or condition that could have caused an accident" and "contain...
Bob, I plead ignorance on this one. I have some experience with organizations that do things that they call: a.. Post Scram Reviews b.. Post Trip Reviews c.....
Dear All, RootCause is all about gathering evidences and analyzing them, once you have gathered the evidences , you will know whats wrong with this picture. ...
Hi Bob We consider a near miss an event or situation that could have resulted in an adverse event but did not, either by chance or through timely intervention ...
John, The counter argument would be that the ones that got by successfully managed to get past the first barrier and if this number is not VERY small, then the...
Hello to All, Here's the answer to the puzzle : Evidence number 1 : Why did someone place the socket near the ceiling ? Evidence number 2 : Why are the...
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