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A Risk-based Approach to Training Paul Cheeseman & Kerry MacDonald
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Introduction A risk-based approach to safety is generally accepted as good practice in railways Typically applied to major change projects or re-organisations Too often “training” is expected to catch and fix all issues that are “too hard” to deal with another way Tools and techniques of risk can also be applied to the design, development, delivery and assessment of training activity used to support the case for safety
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As Low As Reasonably Practical
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Control Measures e c n e u q e S d r a z a H
Generic Hazardous Event Description q Specific Hazardous Event Description Hazard Cause Hazard Outcome Details Details e c q n Existing Cause Existing Outcome e u Control Measures Control Measures q e S d a r z Frequency Consequence a Category Estimate Category Estimate H q Existing Risk Ranking Additional Potential Risk Control Measures Residual Risk Ranking
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History Tells Us That….. Most accidents are due to human error - perhaps all accidents are? Errors (like failures) can cause hazards Hazards can lead to accidents and harm Control measures can protect against causes and consequences Control measures include training Training is often an inappropriate control measure Training can be provoked beyond its resilience and may break at the critical moment
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Hierarchy of Control Measures
Removal, of the hazard Replacement, of the hazard with something less hazardous Separation, of the hazard away from sensitive population or equipment Protection, erection of a barrier to protect sensitive population or equipment, or installation of safety devices Procedures, implementation of working methods that mitigate the hazard
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Risk-based Approach The really important elements can be clearly identified during the training and in manuals / instruction The reasons why (or why not) can be explained The learning can be tested The element can be preserved so that it is not inadvertently lost or modified
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Implications Additional training facilities can be justified for really critical areas The cost of training (and certification and monitoring) can be weighed through ALARP with other engineering solutions and other training needs In the extreme, the demands on training may be too great and higher integrity control measures may be necessary.
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“documenting and implementing procedures to identify and manage risks”
Motivation Not a new requirement but latest AQTF standards require: “documenting and implementing procedures to identify and manage risks” Led StateRail to produce a Risk Management Policy and supporting procedures for training & development Based on AS4360 and subsequently aligned with RailCorp’s Risk Management Framework Recommendations from Waterfall enquiry (specifically vi, vii, viii) “Whole of work” approach adopted looking initially at the Training Needs Analysis (TNA) process used when the requirement for a training intervention is identified.
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Pilot Study #1 – Hunter Cars
Identify existing driving tasks Identify new tasks requiring training intervention Identify the elements, conditions and standards associated with each task Risk assessment and ranking to prioritise training needs
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Pilot Study #2 – Protection Officer Role
Identify changes in role of Protection Officers in both the StateRail and Rail Infrastructure Corporation Identify training control measures Assess the best strategy for delivery (generic & modules / separate) Identified changes to curriculum
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Pilot Study #3 – Shunters’ Tasks
Identify shunting activities at two locations Risk assessment and ranking Identification of control measures (ALARP) Incorporation into a revised curriculum Expert review of result
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Difficulty, Importance, Frequency (DIF)
Enhancement to TNA applied once tasks have been identified Tabular-based ranking: Very high – training to formal standards is required and assurance that skill is retained - high risk High – training to a defined competency standard is required - medium risk Moderate – Off-the-job training followed by coaching – medium Low – Formal training on the job low risk No formal training – Informal on-the-job training – low risk Adds consideration of personal and safeworking risks
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DIF Pilot - Weighbridge Operations
Check shim thickness – No new learning, already covered by existing training, DIF =2 Ensure installed bogie is in place for 24 hours before weighing (to allow suspension to settle) – No new learning, covered by custom and practice, DIF =5 Ensure weighbridge is zeroed before weighing – Yes relating to weighbridge computer interface, personal risk is low but safeworking risk is medium, DIF = 2
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Lessons Learnt Overall, this is a useful approach
Often provides the first real assessment of an existing task or job Has identified disconnects between custom and practice and defined practices Opportunities arise to improve safety in a wider arena Involvement of stakeholders and Subject Matter Experts very valuable both for their contributions and for achieving buy-in.
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