Tags » Just Culture

A Closer Look at Training

The county budgets for the past few years have been littered with comments about their commitment to training. I know because I just spent a lot of time doing what I’ve been telling people to do for several years now. 1,432 more words

Local Politics

Learn your lessons (or crash and burn)

(this article was first posted at eSocSci.org.nz)

On 31 October 2014, the world’s first commercial passenger space ship crashed, killing the co-pilot and seriously injuring the pilot. 1,373 more words

The Straits Times: Doctor fined $2k for chemo-drug error

In this conservative society of Singapore, we don’t often hear about medical mistakes from the newspapers, but they do happen, such as this article from the Straits Times. 671 more words


Lessons from a Cat

After three years of amazing litter box use (she even went in the litter box to cough up hairballs), my cat Muffin looked me in the eye and pooped right on a rug outside of her litter box. 326 more words

Human Factors

How Much Are You Willing to Risk?

 (Edit: Lapse made while typing in the title, I missed a ‘You’ out. See, we are all human!)
I have just finished reading a chapter in Daniel Kahneman’s “Thinking. 801 more words


Blameless RCA

Let ye without failure cast the first stone.

I am involved in a workgroup at work that is exploring Root Cause Analysis in the hopes that we can come up with a way to help everyone improve their RCA process and procedures.

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Destructive Goal Pursuit, or not knowing when to say stop

Destructive goal pursuit is the inability to stop an activity because the goal is so important (especially in the eyes of the leader) that it takes precedence over everything. 486 more words