Originally posted on September 30, 2013 @ 7:31 AM
A paradigm is a distinct set of concept and thinking that result in distinct practices. In recent times it has occurred to coroners at inquests, auditors and government that poor safety culture has a central role in normalising unsafe practice. Inspectors and auditors are now ever mindful that despite physical, technological, engineering, administrative and legislative measures to control safety, people are still being injured at work. We now know that these five controls in themselves are not the complete story about safety. Unfortunately when regulators and regulating agencies talk about safety culture and change, they tend to have little expertise or idea in how to influence it. So, they continue to swamp the safety world with more systems despite the fact that everyone around yells at them: ‘we are flooded by systems’. This is because a paradigm constrains one’s ability to understand the world outside of itself. So when humans make mistakes because they are overwhelmed by complexity, what do we do? Create more systems.
We all want the same thing but how do we get there?
Everyone interested in safety and wants the same outcomes, they don’t want anyone to be hurt. Injuries, whether physical or psychological, rarely bring pain to the just an individual. Injuries always have a domino effect and so the pain flows on to family, friends, business, organisations, employment arrangements, insurance, medical and therapeutic services. Any business that has regard for their employees and their families wants the best for them. It is also in their best business interests that they see employees at work the next day. Business interruption and disruption is costly and also has a domino effect disrupting morale, motivation and confidence. Disconnectedness in safety vision and language can also generate negativity, scepticism, double-speak and unethical practice. These are the values that are sometimes evident in sub-cultures in organisational safety cultures that invisibly work against safety, development and learning.
What works?
There is much evidence to show that negativity, punishment and rigidity have little longitudinal effect in changing behaviour. The prison system is a testimony to the fact that punishment doesn’t work. Whilst demand for more correctional facilities continues to increase the recidivism rate remains extremely high. From the time of the convicts we don’t seem to have learned much from history about punishment. Whilst simplistic approaches to zero tolerance are espoused by various factions in the media, most educationalists know that the result of such policies entrenches resentment and nothing much is learned or owned by the victims of the policy. Longitudinally, zero tolerance drives reporting underground, develops a sub-culture of cynicism and disregards all that is known about how people really learn and change? Unless people are motivated positively to change and own the values associated with that change then the desired behaviour will not be realised or worse still is only realised whilst the agents of control are around.
The following table may prove instructive.
Orthodox Safety | Behaviour Based Safety | Zero Tolerance Safety | Psychosocial Safety | |
Key Words | Systems RulesCompliance
Legislation Regulation Codes of Practice |
Behaviour Human ErrorActions | Compliance RegulationsLegislation
Policing Rules Consequence |
Motivation LearningDevelopment
Ownership Encouragement Values Beliefs |
Underpinning Foundations | Taylorism (Heinrich) | Behaviourism (Skinner) | Broken Window Theory (Wilson and Kelling) | Self Actualisation (Maslow) |
View of People | People are parts of scientific management | People are like machines and are the sum of inputs and outputs | People make choices and think according to rules and rule breaking | People are complex and follow what they value |
Strategy for Change | Engineering, technology, invention and design | Negative and positive reinforcement Behaviour changes values | Punishment Authority and control change culture | Motivation Culture changes as people develop ownership of values |
Focus Question | How can the environment be changed? | How can behaviour be changed? | How can breaches be enforced? | How do people learn? |
View of Culture | Culture is systems | Culture is behaviours | Culture is rules | Culture is values |
View of Organisations | Management move parts like a chess game | Mechanistic Reality is the sum of what I can observe | A traditional hierarchy with strong lines of command and control | Organisations are organic and a complexity of interrelated systems of people, groups and values |
Sub-cultures | Lemmings and LionsTechnology savesUniformity through engineered shaping | Depersonalised machine like processesTargeting indifferenceGoing through the motions
Uniformity through process |
Hidden resentmentChampions and MisfitsUniformity through compliance | EngagementHumanisingUnderstanding diversity
Harmony through understanding |
Training | Technical focus, expertise in regulation | Doing and practicing | Learning the rules and reinforcing the consequences | Engagement and influencing thinking and values |
Essential Concepts | Humans fit the machine | Changing observable acts | Policing the rules | SensemakingMindfulness, influencing the unconscious |