Recreation And Off-Duty Swimming ORM Brief Good morning I am Dave Smith and I work in the Traffic and Off-Duty Safety Division at the Naval Safety Center. Today It is a pleasure for me to discuss an important subject that I know will make a difference in how we protect our personnel during their leisure time activities. I will cover where our losses are and The ORM Process. Naval Safety Center Dave Smith

Operational Risk Management What is ORM? A process to assist you in performing everyday tasks safely and efficiently! Modify the process to fit the situation while still identifying and assessing risks and developing controls to reduce the hazards. So what is ORM? Most of you know it’s a process, used as a tool, adapted to support a specific requirement. It identifies and assesses hazards, and develops and implements controls to mitigate them. It makes your evolution or operation more safe and improves the probability of successful and effective mission accomplishment.

Where Are We? During FY98-02, mishaps cost the Navy and Marines: $3.7 BILLION 1,000 LIVES! 175 Sailors & Marines Died in FY01 90 (51%) PMV 25 (14%) Off-duty Shore/Rec 20 (11%) Aviation 37 (21%) Shore/Ground/MV operational 3 (2%) Surface Ships /Submarines/Diving 238 Sailors & Marines Died in FY02 140 (59%) PMV 32 (13%) Off-duty Shore/Rec 28 (12%) Aviation 32 (13%) Shore/Ground/MV operational 6 (3%) Surface Ships/Submarines/Diving Next slide: Cost and Deaths for USN and USMC

How People Died In Mishaps USN/USMC, FY98-02 Traffic Total Deaths FY00: 213 FY01: 175 FY02: 238 FY98-02: 1000 Rate per 100,000 personnel As you can see, the money costs are in aviation mishaps. The cost of lives is in motor-vehicle mishaps. Shore/ Ground Recreation Aviation Afloat 72% of deaths during FY 98-02 were off duty!!!! Sailors & Marines Off-Duty Deaths = 72% FY94-00, though substantially better than previous years, showed no decreasing trend. We are on a plateau!! The loss of one Sailor or Marine is too much. There is much work yet to be done. 569 142 136 135 18 No. of Deaths, FY98 - 02

Next slide: Human error Cost of Mishaps Navy & Marine Corps FY 98-02 Total $3.7 Billion LOST DOLLARS AND LIVES. In the naval service mishaps translate to BIG BUCKS. Accepting the status quo is an expensive and operationally unacceptable option. Dollar losses represent lost procurement opportunities and reduced war fighting capability. These “big bucks” are why we have this course - no other community does. We need trained, enlightened, proactive leaders to stem the tide - not just to investigate smoking holes in the ground. Aviation $2.9B Recreation: 56M PMV: $122M Afloat: $352M Shore/Ground: $105M Next slide: Human error

Sailors/Marines Off-Duty Alcohol-Related Deaths FY 98-02 26% Remember the TV show Cheers? It gave all of us the impression that drinking was the fun thing to do. Well times have changed. Thirty-one percent of the Sailors and Marines recreation deaths are alcohol-related. Several deaths occurred when Sailors and Marines were so drunk they died from alcohol poisoning. A good example is when a 19 year old AA was drinking multiple shots of hard liquor at a picnic. Victim was put to bed by his shipmates. BAC 0.45. He died from alcohol poisoning. Alcohol is a serious problem for off-duty personnel. Note: The 26 percent refers to recreational deaths. However, a similar percentage of our Traffic deaths are alcohol-related. Maybe more….

Top 3 Leading Causes Of Recreation Deaths Drowning Boating, Swimming, SCUBA Diving Falls Buildings, Cliffs, Snow Drifts Alcohol Poisoning/Drug Overdose

Top 3 Recreation Injury Producers Basketball Softball/Baseball Football Team sports produce more injuries for Sailors and Marines than any other recreational activity. Basketball has the highest percentage of disabling injuries among team sports. Softball and football are the next largest producers of lost-time injuries.

Findings Mishaps - Lack of Headwork Human Error 80% of Causal Factors! - Inexperience - Non-use of PPE - Alcohol Involvement Human Error MISHAP EXAMPLES: Lack of Headwork: - A 19 year old AA was drinking multiple shots of hard liquor at a picnic with Navy friends. Victim was put to bed by his shipmates. When a buddy checked on him, he found him dead from acute ethanol poisoning. BAC 0.45. - An EM3 and 6 friends were boating in a 14 foot row boat with a 15 HP motor. The boat capsized and before help arrived, the victim drowned. No PFDs worn. Water temp was 51 degrees. (Poor headwork and lack of PPE). L/kjhn’oAlcohol Involvement 80% of Causal Factors! SURVEY FINDINGS: Oversight - Safety officer staffing/training - Placement of safety in CoC - Regionalization Training - Qualifications - PRT/PT fitness ORM - Command Emphasis - Hazard Awareness Culture - “Bullet-proof” mentality - Violations - Leadership

Feeling of Invincibility Speed, Tempo of Operations Causes Of Risk Personal Work Ethic Complex Evolutions High Energy Levels Stress CHANGE!! Environmental Influences Human Nature Resource Constraints New Technology The hazards we identify by asking these questions generate risk. In retrospect, this slide could also be entitled: “The Challenges of Naval Culture” We’ve got young kids with can do attitudes, who want to do well, are afraid to say no and feel they are invincible. Couple that with sophisticated equipment, complex evolutions, arduous conditions and the infinite risk multiplier -- (Click) CHANGE -- the mother of all risk, and you have the ingredients for the disasters we read about everyday in our message traffic. Feeling of Invincibility Complacency Speed, Tempo of Operations

5 Steps Elements Of ORM 3 Levels of Application 4 Principles There are three elements of ORM. The 3, 4, 5 of ORM: 3 levels of application, 4 principles, and 5 steps. 5 Steps

3 Levels Of Application Time Critical Deliberate In Depth 90% of ORM processes are “On the run” Deliberate Complete 5 step process 3 levels: Time Critical: The actions we take almost automatically when posed with a routine hazard: Rain, slick roads: use wipers, slow down, increase distance behind vehicle ahead of you. Deliberate: The planning that goes into making a long trip over a weekend. Using the 5 step process we’ll talk about in a couple of slides. In Depth: The planning and coordination that goes into an overseas or cross-country PCS move, where much of what happens is outside our control. In Depth Other considerations outside local chain of command

4 Principles Accept Risk When Benefits Outweigh Cost Accept No Unnecessary Risk Anticipate and Manage Risk by Planning Make Risk Decisions at Correct Level Does the benefit outweigh the risk? If so, accept, if not, a decision is required. Take only those risks necessary to execute mission, and remember, they are generally more easily controlled when they are identified early in the planning process. When it is felt the risk is too high, or goes beyond the commander’s stated intent, additional guidance is needed from the COC.

5 Step Process 1. Identify Hazards 5. Supervise 2. Assess Hazards The five steps can be remember by visualizing a star. It has five points or another way is to look at your five fingers. Each one of them is important. These steps provide a means to identify what can go wrong, how to prevent it from going wrong, and how to minimize the extent of damage and injury if it goes wrong. 4. Implement Controls 3. Make Risk Decisions

Step #1: Identify Hazards Analyze Manageable Pieces of an Event Use Experience As a Guide “Experience Is the Name Everyone Gives to Their Mistakes” Oscar Wilde, 1892 Ask What If, Use Brainstorming, Think Cause and Effect The first step, this is the “What can go wrong?” part. Take a look at an impending event and list the associated hazards that could lead to damage or injury. There are plenty of sharp and experienced folks out there, who have seen what can go wrong. -- Brainstorm Ask what if ?

Prioritize Identified Hazards Based on: Severity & Probability Step #2: Assess Hazards Prioritize Identified Hazards Based on: Severity & Probability For each hazard identified in the previous step, determine the associated risk in terms of severity and probability. This can be pretty subjective and open for interpretation, but the most dangerous hazards and those most likely to occur should be pretty obvious. We’ll try it in a while.

Severity + Probability Step #2: Assess Hazards To aid in this assessment, various tools can be devised and used. This one, you can find on one of the two plastic cards I’ve given you. It lists 4 categories of varying severity. CLICK: 4 hazard probability categories, CLICK: and puts them in a matrix. Such that for any given hazard, you can assign severity and probability categories, read the corresponding matrix box and determine the RAC. CLICK CLICK: This is a tool that makes it easier to assess the hazards. Severity + Probability of Occurrence = RAC

Step #3: Make Risk Decisions Consider Risk Control Options, Most Serious Risks First Risk Versus Benefit Communicate As Required Consider risk control options, prioritizing, starting with the most serious risk first, or the lowest RAC, if you’re using that method. Determine from your perspective whether the benefit outweighs the risk. When in doubt, or you feel the decision should be made at a higher level, don’t be afraid to kick it up the chain of command.

Step #4: Implement Controls Engineering Controls Administrative Controls Personal Protective Equipment These are the three control categories: Engineering - modification of pertinent hardware Administrative - developing procedures germane to the process And use of appropriate PPE. All are designed to reduce risk by lowering the probability of occurrence and/or decreasing potential severity.

Step #5: Supervise Assure Controls Effective and in Place Same as any other supervisory process: Assure Controls Effective and in Place Maintain Implementation Schedules Correct Ineffective Risk Controls Watch for Change Final step, supervision, checking use and effectiveness of controls, and watching for changes. Your personal interest in an evolution will cause additional focus by your troops.

Part II: Applying ORM Off-Duty

ORM Five Steps Identify Hazards Assess Hazards Make Risk Decisions Implement Controls Supervise/Evaluate We all know that we can’t prevent all mishaps in the off-duty environment. Using the ORM Process and applying the five steps during their leisure-time activities will reduce the severity of mishaps . Let see how we can use these five steps for swimming.

Scenario 19 Year Old Sailor Class II Swimmer Breath-Holding And Hyperventilating Shallow Water Blackout A 19 year old SN’s dream of becoming a Navy Seal ended when he drowned. He was trying to extend his stay time under the water by holding his breath, letting it out slowly while sinking to the bottom of the pool. The victim was in a seated positioned for 90 seconds. His shipmate swam down and touched his friend’s shoulder. He interpreted his buddy’s head movement back and forth to mean “I am okay”. When he surfaced another buddy on the pool deck directed him to go back and assist the victim to the surface. CPR was performed on the unconscious victim to no success.

1. Identify Swimming Hazards Water Clarity Insufficient Water Depth Poor Swimmers Shallow Water Blackout Alcohol Thunderstorms Let’s use the ORM process to identify hazards patrons might encounter while swimming. We’ll use this activity because drownings are the number one recreational killer of Navy personnel. Can you think of any other hazards?

Risk Matrix Probability of Occurrence + Severity = The most important thing to remember is that Critical and Serious codes are the ones that can kill patrons or cause them very serious injuries and time away from work and in the hospital. They are also the ones that jeopardize the mission. You must identify the most serious hazards by examining probability as well as severity. A patron’s life may depend on it. Probability of Occurrence + Severity =

2. Assess Swimming Hazards In Terms Of Risk Insufficient Water Depth Poor Swimmers Thunderstorms Risk Assessment Serious/Probably (2) Critical/Probably (1) Take some hazards identified in step #1 and assign a RAC which has been done on this slide. These are the RAC codes I came up with. This is a subjective process so we will have varying opinions on what the RAC code should be based on experience and knowledge. Remember what we said about activities rated as having serious or critical risk assessments. Those are the ones that are the most dangerous.

2. Assess Swimming Hazards In Terms Of Risk (cont.) Hazards Risk Assessment Shallow Water Critical/Likely (1) Blackout Alcohol Serious/Probably (2) Water Clarity Critical/Likely (1) Lower level risks, after being identified, can be ignored for the most part.

3. Make Swimming Risk Decisions Based On Risks Hazards Shallow Water Blackout Water Clarity Poor Swimmers Thunderstorms Insufficient Water Depth Alcohol Totem Pole the Hazards : place hazards in order of most severe to least severe. Make sure you do something about the severe ones. If you have time, later on you can worry about those you rated as least serious.

4. Implement Swimming Controls Hazards Controls Shallow Water Blackout Place Signs Prohibiting Breath-Holding And Hyperventilating Techniques - Recognize/Measures To Take Water Clarity Qualified Person Adding Properly Balanced Chemicals - Four Inch Black On White Disc Poor Swimmers Adequate Number Of Life Guards - Offer Swimming Lessons * Look at control options, Engineering, Admin or PPE that will bring the level of risk down. For swimming pools and beaches engineering controls will be limited to pool and beach design and admin controls will be mostly warning signs and lifeguards. PPE could involve a PFD if a poor swimmer.

4. Implement Swimming Controls (cont.) Hazards Thunderstorms Insufficient Water Depth Alcohol Controls Lifeguard Clear Pool For Determined Period Of Time Check Water Depth For Diving Boards Don’t Allow Intoxicated Swimmers To Use Facility

5. Supervise/Evaluate Monitor Effectiveness Of Controls Watch For Changes

Take Away What Can Hurt Me? What Can I Do About It? What Do I Do If Something Goes Wrong? This serves as a reminder that every one of us has to expect the unexpected. Three things you need to take with you from my brief are: What Can Hurt Me? What Can I Do About It? and What Do I Do If Something Goes Wrong?

Benefits Of Risk Management Reduction in serious injuries and fatalities Reduction in material and property damage Effective mission accomplishment Benefits are obvious and substantial. ORM can significantly impact quality of life, readiness and mission execution.

Summary ORM is a process ... NOT a program Decision making tool to: Increase ability to make informed choices Reduce risks to acceptable level ORM must become an inherent way of doing business ORM is a systematic way of thinking. It can and should be used by personnel at all levels in the COC to increase awareness of the hazards and risks involved in an operation. When used, it enhances the ability to make informed decisions. But it’s not a program. You can equate it to leadership, which is not a program either, yet is essential and fundamental to our success. Leadership is folded into our training and doctrine from your first days in the service. ORM will be most effective if we can integrate it into our culture as completely and effectively as leadership.

The End Dave Smith, Code, 427 DSN 564-3520 EXT 7180 COML (757) 444-3520 E-Mail david.a.smith@navy.mil FAX DSN 564-6044 COML (757) 444-6044 Visit Our Web: www.safetycenter.navy.mil