Lessons Learned: Key Considerations and Real World Learnings of a Large Transit Safety Culture Improvement Initiative May 4, 2015 Gary Webster

TTC Context Ridership 540 million annually Third largest system in North America Fleet 678 subway cars 28 SRT 248 streetcars 1800 buses 60 year old subway

Early 1990s – Leader in North America TTC Reputation Early 1990s – Leader in North America Ridership growth 1970s and 1980s Subway and system expansion New streetcar fleet ICTS technology – SRT APTA, CUTA Safety Awards

Subway train rear-ended a stopped train August 12, 1995 Subway train rear-ended a stopped train 3 customers killed, numerous injuries “Failsafe” system failed block signal system with trip cocks and train stops “Accident couldn’t happen” TTC publicly accepted responsibility

Maintenance standards/ practices not acceptable Training not adequate Conclusions Maintenance standards/ practices not acceptable Training not adequate culture of operation too “loose” Rail maintenance not well managed Lack of systems approach/ integration Didn’t know what we didn’t know

More to the Story Action Followed – Management Tools New org structure Asset management Safety oversight Strengthened “public” safety We recognized “culture of operation too loose” We missed the poor safety culture – deeply embedded at TTC – public safety plus employee safety

Employee Incidents 2006 “Wake up Call” 8 workers overcome by carbon monoxide almost died Procedures in place, workers trained Procedures not followed Why not? When happen again? No good answers – unacceptable TTC Our workers Their families “Wake up Call”

Then – We Realized Initial Action Focused on procedures specific incident never happen again Then – We Realized Needed to understand WHY employees behave the way they do Sought external help – get this right

Consultant Partnership Reduce lost time injuries by 50% Plan – “Leading with Safety®” Leadership training and coaching More employee involvement/ observations Improve safety systems

2007 – employee killed, 2 seriously injured Then 2007 – employee killed, 2 seriously injured procedures not followed Reinforced need for different approach Employee feedback – very critical of leadership’s attitude to safety Very Painful

Leadership – training and coaching Worker Engagement Leading with Safety® Leadership – training and coaching Worker Engagement Worker-led committees Behavioural Accident Prevention Process® (BAPP®) Union support – key Improved Safety Systems

Work Safe – Home Safe Program Lost-Time Injury Avoidance

Three Year Results 25% not 50% reduction, but pleased Leading with safety/ safety culture change  journey Addressing the root problem – safety culture Actions need to be consistent with good safety culture

Lessons Learned Better processes – only part of solution Leadership actions consistent with words address problems Employees real engagement identify behaviours, problems Unions do not underestimate their role

Lessons Learned – Specifics Improved Safety Culture More commitment everywhere- employees see we care Absenteeism Labour relations, customer service How to deal with problems, etc. Needs to be engrained at every level Address the “frozen middle” Fine tune/ modify existing safety structures Incorporate new roles, address problems/behaviours Employee, union roles

Lessons Learned – Specifics cont’d Leadership – good safety culture must be core value Corporate strategy – easy Corporate action – challenging/ ongoing Transit – difficult environment Transportation Maintenance Finally understood- System Safety Management Plan (SSMP) 1 on 1 challenges Strong leadership Employee engagement effective Most high risk/ catastrophic outcomes

So What? Do you know what you do not know? Are you really okay? Are your actions consistent with your words? Do you have a right safety attitude/ culture? Is it engrained in “how you do business”?

Why Lead with Safety? Why Change Approach to Safety? Reaction: No need to act. Not a problem. We can manage our issues. TTC winner of APTA and CUTA Awards for years – thought there was no problem…

Why Lead with Safety? Why Change Approach to Safety? Cont’d We Were Wrong Procedures and training only are NOT enough Need to understand behaviour to change it; i.e., why are procedures not followed? Safety Culture Value we place on safety Leadership and employee involvement

We missed the signs of our public and employee safety problems Final Thoughts We missed the signs of our public and employee safety problems but, we responded well to the crises Better to react to symptoms by dealing with root problems before crises result