Tag Archives: Rail

A perspective on the Bavarian train incident

Human error. A term used when companies are unable to blame systems, technology or process when things go wrong. It’s a throw away phrase which has been used as an acceptable excuse for countless major incidents and catastrophes in recent times.

Human error apparently took the lives of 11 people and injured at least 80 more when two passenger trains collided at 100kmh in Germany on the 9th of February. The man supposedly responsible is looking at involuntary manslaughter charges with a possible 5 year jail term.

 

So why did the seemingly experienced and qualified Area Controller, sitting in a signal box in Germany one Tuesday morning decide to open the track to two trains on a collision course only to notify both drivers afterwards?

The Chief Prosecutor Wolfgang Giese said: “if he had complied with the rules…there would have been no collision”.

Perhaps that seems slightly obvious?

 

Of course company audits will take place and it may even be found that he took (and passed) all the required training, was apparently aware of the correct processes and was an experienced and genuinely good employee. But how accurate a picture would this really be?

The rail industry is not alone in having invested countless millions, if not billions, embedding systems, technology and process to mitigate risk and improve efficiency.  But as we may see as the detail behind this sad case unfolds, ultimately it is people who are more likely to expose you, because it is their fundamental responsibility to build, implement and follow the processes and to work with the systems and infrastructure.

You may have come across the Swiss Cheese Model – 99.9% of the time your systems, processes and people will align and work together despite small gaps in some places, with no issues. However there will at some point be an occasion when all the “holes” align and everything can change in that instant.

The majority of people want to do their best for their company, however, rightly or wrongly, people have always found ways of navigating around standard procedure, process, and best practice. It may be they are instructed to work outside of process by their manager or peers because it’s ‘quicker’, or ‘the way we’ve always done it’. These process tweaks can be effective, but they can also expose you on a mammoth scale if not embedded appropriately.

This is what Cognisco calls exposing yourself to People Risk.

 

So why does this happen? You will recognise typical responses that follow incidents like the Bavarian train crash, such as ‘we’ll thoroughly review our processes’ and ‘we’ll invest in more training’. However in Cognisco’s considerable experience, that approach won’t make any difference if the process or the training wasn’t the root cause.

If the process wasn’t adhered to before, why would another more refined one work? What would be the benefit of enforcing more training on people that clearly didn’t apply it or understand how to apply it last time, and expect anything to change going forward?

 

A different analytic must be applied to support the infrastructure.

For example, wouldn’t it be much more effective if organisations had a view of what their people actually understood about their role from the training provided and the embedded processes, and if they had confidence in delivering in all aspects of their role?

Take the Bavarian train Signaller – and this can be applied equally to other people and roles. With this insight on him, the organisation would have been presented with a view of the exact development areas he specifically required and any risk areas would have been have flagged, meaning they could have provided tailored interventions, reduced risk and possibly pre-empted this major catastrophe.

Taking it a step further, wouldn’t organisations benefit from insight on the gaps in understanding across whole teams and indeed whole organisations and if everyone was directed to the specific learning, training or support that they actually required? In essence giving companies a ‘global view’ of the team and/or organisation’s understanding, capability and confidence rather than ‘sheep dipping’ everyone with the same “solutions”.

 

Having people centred data is key, i.e., data that actually aligns to people, their understanding, their capability and their confidence in real time.

The reality is that this data IS available and IS working for some of the largest and most well respected organisations globally.

Cognisco enables companies to understand not only people’s capability, but their confidence in delivering against their required competencies. Supporting the robust systems, technology and processes that organisations have invested in, it gives them critical people data which allows them to:

* Implement strategic people based decisions

* Evidence regulatory compliance

* Reduce the cost of audit and litigation

* Accurately target L&D investments

* Retain, develop and attract the very best people

 

We have enabled our clients to transform the way they develop their teams and given them insight into their competence and confidence, enabling them to understand the issues and challenges they face in their roles. This complete visibility of an often global workforce and accessible data at an individual, team and company level has enable organisations to identify ways to improve their performance across many disciplines in many sectors, maximising people potential and mitigating the latent People Risk.

Clearly investigations are ongoing in Germany, according to reports Prosecutors do not believe the man acted deliberately, however he needed to (and did) push the button himself in order to allow the trains through.

It’s possible that we may never know exactly why it happened, but what is clear, is that many of the incidents that are blamed on a ‘human error’ are avoidable, can be pre-empted and the risk of them re-occurring can be significantly reduced. A more in depth view and analytic on your people, their capability and their confidence quite possibly holds the key to aligning your organisations existing investments, supports an optimised workforce and significantly reduces risk.

 

Maintaining a Consistently Competent Workforce

What are the benefits?

– Reduced exposure to risk of serious incidents

– Identify currently qualified staff regardless of their location

– Rapid build and deployment of new teams or workgroups

– Visibility of upcoming assessments or licensing requirements

– Roll-back capability to evidence competence of any individual at any given time

– Reduced time, cost and resource involved in issue resolution or litigation

– Easily generate management and audit level reports

– Identify gaps and issues in current workforce competence or qualification

– A direct and real time connection into your existing learning resources and platforms

 

What’s the Problem?

Organisations that operate in high risk industries with a mobile, disparate or fluid workforce are often frustrated by the inability to identify individual employees who are currently qualified, licenced or capable of carrying out a given task or operation.

Holding a record of employee certificates and licences is not enough when you need to be confident that the people you select today are currently qualified, licenced and trained and will work or deliver in the way you need them to.

For those operating in regulated industries, the ability to prove compliance and competence of each individual at a specific time and date, will prove critical in meeting industry standards and also in reducing the significant cost, time and resource involved in any incident related litigation or enquiry.

 

How could you Solve it?

Using Cognisco’s my*KNOW platform organisations can quickly and easily add and build competency frameworks. Collating and managing certifications and licences for each individual is easy and keeping a track of assessments taken, learning and development requirements identified and upcoming courses, events or activities by individual and by team is simple.

Each individual can keep a track of their own progress, can record and evidence their own skills and certificates, take online assessments and find and access any appropriate learning or development material they require.

Providing a clear and auditable trail of employee competence and accreditation at any point in time proves invaluable for both meeting regulatory compliance and in significantly reducing the cost and time involved in any incident related litigation.

So, identifying the currently qualified or licenced individuals in an organisation is now straightforward and building them into work groups or teams is a simple “drag and drop” exercise.

 

How can you be sure?

Traditional assessment processes fail to uncover what an individual actually understands about how, when and why they should apply the knowledge (or training) they have been given in practical day to day terms. This means that even those who score highly on post training assessments may well apply their recently acquired knowledge incorrectly when faced with a real life situation.

Over the course of 20 Years and countless thousands of assessments, Cognisco are able to evidence that on average up to 30% of any workforce will unwittingly have a low enough level of understanding to place the organisation at significant risk.

Where required, Cognisco’s unique approach to employee assessment evidences where there are hidden gaps in each individual’s understanding of any given subject or process that may pose a risk to your operation.

 

What will we do?

– Work with you to review your current Competency Frameworks /help you build them if you don’t have them today and upload then into our my*KNOW platform in just a few hours.

– Help you integrate any existing employee certifications, records or related documents

– Create the real time links into your existing data and knowledge platforms to enable employees to get the specific learning and insight they need – fast.

 

Where appropriate

– Deliver an assessment that will discover and expose the specific gaps in employee understanding that may pose a risk to your operation.

– Provide your staff with my*KNOW to access and take small, regular and focussed assessments and direct them to the specific learning tools and information they need to plug any gaps.

– Provide your team leaders and managers my*KNOW’s intuitive dashboard reporting to enable then to identify and address development or coaching issues before they become a problem.

– Enable the wider organisation to structure, plan and budget training for the future and to manage, monitor and mitigate any potential risks with my*KNOW reports.

 

Would you like to know more?

Email: information@cognisco.com

Or call us directly: 01234 757520

 

 

Cognisco to showcase competency management and people risk solution at Rail Safety Summit 2015

The Royal College of Physicians, London, 1st May 2015

21 April 2015 – Cognisco, a specialist in assessing, managing and mitigating People Risk, will be demonstrating the latest version of my*KNOW – its competency management and People Risk solution at the Rail Safety Summit 2015 – the UK’s leading conference for rail safety executives, infrastructure owners, train operators, rail stakeholders and training professionals.

Over the past ten years investigations into major rail accidents have highlighted human performance including employees’ misunderstanding key aspects of their roles or making mistakes on the job as a major accident contributor.

At the Rail Safety Summit, Cognisco will present the many benefits and features of my*KNOW and discuss how the platform is helping leading rail companies such as Network Rail, Eurostar and South West trains assess and monitor the competence and behaviour of front line staff, identify their training needs and produce auditing records that demonstrate workforce compliance to industry regulators.

The company will also demonstrate how my*KNOW provides rail companies with a single hub for tracking, monitoring and reporting on employee competency as well as managing assessments, training, e-learning and certification.

Mary Clarke, CEO at Cognisco says: “All rail companies must be able to demonstrate the competence and compliance of their staff to regulators. Our my*KNOW platform provides a simple and effective way for companies to assess and track workforce competence and produce audit records for compliance. It also gives managers clear insight and understanding of their workers’ likely behaviour and decision making – information which can help companies realise and mitigate their People Risks, which is key to improving the safety of workers and passengers.”

We are looking forward to meeting people in the rail industry responsible for safety and managing People Risk and discussing how our unique assessment methodology and platform can help them to ensure a competent, confident and compliant workforce.”

Network Rail is using my*KNOW to measure the competence of over 11,000 front line operators including signallers, controllers, graduate engineers, station staff and capacity planning employees and provides insight into other HR, training, simulation and verification systems. Through my*KNOWmanagers have an up to date competence record and schedule, training needs, progress and performance of every individual – all in one place.

Rail-Safety-Summit-Logo-Image-300x112

More from your investment in Health and Safety training

What are the benefits?

– Increased awareness of Health and Safety issues and practices across the organisation

– Greater level of reporting of minor incidents (which if left unchecked often result in a serious incident)

– Reduction in formal training costs

– Reduction in time spent “off the job” by employees

– Faster and more effective on-boarding and induction process

– Improved audit, reporting and management data

 

What’s the Problem?

Meeting both the operational demands and the commercial drivers of any business is a constant challenge. It’s especially tough for organisations that are required to scale up the workforce rapidly and cost effectively but still ensure that the highest standards of health and safety are met. When you combine the pressure for operational efficiency and the drive for a reduction in expenditure, with a legal and ethical requirement to ensure Health and Safety of your employees, it’s not surprising that those operating in high risk environments are looking for both a cost efficient and a highly effective alternative to the costly and traditional “sheep dip” approach to training.

 

How can you Solve it?

Cognisco shows organisations smarter, faster and more cost effective ways to address the challenge.

Putting fewer people through formal training and yet achieving a higher awareness and understanding of Health and Safety issues practices and procedures across the operation.

Gaining a clearer understanding of where formal training interventions are actually required (rather than delivered by default) and where more informal (and less costly) coaching and learning approaches can deliver better results.

Providing the organisation with the means to track, manage, monitor and report on individual employee’s current level of Health and Safety knowledge and understanding.

  

How does that work?

Traditional approaches to training assume that everybody has the same level of knowledge and understanding, that the same approach to training will net the right result for everybody and that the best way to gain understanding and compliance across the organisation is to put every employee through the same process.

As a result, training is often “optimised” to minimise the time off the job and to suit the needs of an assumed lowest common denominator.

Cognisco can evidence that formal training is not only not required for a number of employees in any organisation, but that it is often either entirely ineffective or at worst detrimental.

Cognisco’s expert Occupational Psychologist consultants and our team will work with you to

– Review and assess existing and planned training interventions and learning materials to ensure they are aligned to address the specific needs and requirements of your staff and the operational and commercial objectives of the organisation.

– Deliver insights and recommendations that will evidence if and where efficiencies and improvements could be achieved.

 

Where appropriate we will also

Design a new style of assessment that will discover and expose the specific gaps in employee knowledge and understanding that may be more efficiently addressed by lower cost interventions.

– Provide your staff with my*KNOW to access and take small, regular and focussed assessments and direct them to the specific learning tools and information they need to plug any gaps.

– Provide your team leaders and managers my*KNOW’s intuitive dashboard reporting to enable then to identify and address development or coaching issues before they become a problem.

– Enable the wider organisation to structure, plan and budget training for the future and to manage, monitor, mitigate and report both Health and Safety compliance and any potential risks using my*KNOW reports.

 

 Download your PDF version here: More from your investment in Health and Safety training

The right people in the right place

Britain has one of the safest rail transport systems in Europe but there is still room for improvement. Mary Clarke takes a look at the human element.

The Annual Safety Performance report 2013/14 released in July by the Rail Safety and Standards Board (RSSB) revealed that a record number of the public were killed on Britain’s railways last year, and 293 trains went through red lights and signals.

 

The report said that 300 people were killed, either by taking their own lives or from accessing areas out of bounds. There were also 293 signals passed at danger last year, 43 more than the year before. While suicides are impossible for rail companies to safeguard against, errors made by front line staff shouldn’t be happening.

The risks involved in trains going through a red light are all too clear. Such incidents could cause crashes and derailments and lead to serious injuries and even deaths. The boss of Network Rail, Mark Carne, has said he wants to make the network safer and his predecessor Sir David Higgins also regularly said that safety came first in everything he did on the network.

Reducing risks on the rail network

But what exactly can be done to improve rail safety, especially as more trains are running and passengers numbers are growing?

One of the key things is ensuring rail employees are competent in their roles and comply with regulations at all times. Organisations operating in high risk industries with a mobile, disparate or fluid workforce are often frustrated by the inability to identify individual employees who are currently qualified, licenced or capable of carrying out a given task or operation.

 

Holding a record of employee certificates and licences is not enough when you need to be confident that the people you select today are currently qualified, licenced and trained and will work or deliver in the way you need them to.

For those operating in regulated industries like rail, the ability to prove compliance and competence of each individual at a specific time and date, is critical in meeting industry standards and also in reducing the significant cost, time and resource involved in any incident related litigation or enquiry.

 

Tackling human error
Over the past ten years investigations into major rail accidents have highlighted human performance as a contributory factor. Misunderstanding or employee error can result in safety breaches that cause injury and death. Driving through a red light is likely to be a result of human error, and before rail companies can prevent such incidents they need to identify why they are happening.

It could be an error of judgement, a lack of knowledge, a lapse in concentration, even possibly intentionally – as can happen on the roads where someone feels they have just enough time to get through a red light. Rail bosses need a better understanding of their employees and their likely behaviour on the job.

 

All rail companies must have formal competency management systems in place to maintain and assess the competence of operators responsible for safety critical work and ensure front line workforces are monitored and assessed.

Maintaining a consistently competent workforce is crucial to reduce exposure to risk of serious incidents and help to identify gaps and issues in current workforce competence or qualification. Such systems identify currently qualified staff regardless of their location and can rapidly build and deploy new teams with the right skills and experience.

 

These systems also offers visibility of upcoming assessments or licensing requirements, essential for ensuring that the organisation is compliant with industry regulations.

Network Rail and Eurostar

We have been working with both Network Rail and Eurostar for several years to implement penetrative situational judgement assessments, and our competency management system, my*KNOW, not only provides them with a unique insight into their employees’ competencies but also their skills, knowledge and confidence. The system allows for different elements such as observation, training intervention and assessment, maybe even allocation of self-evidence of a competency to be recorded, audited and reported on.

An assessment provides insight not only into how knowledgeable a person is but how they might act when performing their jobs and the decisions they might make at work by asking employees a series of multiple response questions based on common on the job scenarios. The results reveal a heat map of the strengths and weaknesses the individual has in relation to their role. It highlights knowledge gaps, but more importantly the confidence factor shows which areas might be an issue or pose a risk. The more confident they are the more likely they are to carry out that decision. If the subsequent knowledge is poor this is potentially a high risk.

 

The key objective for Network Rail was to minimise risk, to ensure that only competent people carry out safety critical and safety-related work, and to comply with the requirements placed upon them most notably in line with the ORR (Office of Rail Regulation). They needed a formal competency management solution to maintain and assess the competence of operators responsible for safety critical work, and for managers to have an up to date competence record and schedule, training needs, progress and performance of every individual – all in one place.

The system, referred to internally as the Academy is the central hub which measures the competence of over 11,000 front line operators including signallers, controllers, graduate engineers, station staff and capacity planning employees, and provides insight into other HR, training, simulation and verification systems.

 

For Eurostar and Highspeed, their key goal was complete visibility of the competence of their front line, engineering, rolling stock and maintenance staff, as well as a simple way of reporting on the status and scheduling of competencies, tying this into existing assessment and training frameworks. The system tracks their assessment processes, and in Eurostar’s case it logs driver observations, training courses, as well as medical facts, documents and the processes and schedules for assessments too.

In all cases the system has given uniformity in managing competence across each company, regardless of nationality, function, role or location. And for the first time, managers have complete visibility of the global workforce and accessible data about the team, route, depot and individual competence status. The robust reporting facility makes it easy for managers to produce regular reports which can be used internally or externally for auditing and compliance purposes.

Conclusion

Human behaviour is always going to play a part in health and safety on the rail network, and having a better understanding of how front line staff behave while performing their job is essential for minimising risk, improving health and safety and ensuing regulatory compliance. This competency management system has gone one step further, by joining all these elements in to one centralised function, producing live transparent, accessible data. It provides a cradle to grave approach and links not only their competencies but all the requirements that the individual needs to optimise their performance and improve the performance of the organisation.

How can safety on Britain’s railways really be improved?

Rail safety may be the safest land transport in the UK, however, the latest Annual Safety Performance report 2013/14 from the Rail Safety and Standards Board (RSSB) reveals that a record number of the public were killed on Britain’s railways last year and 293 trains went through red lights and signals.

The report says 300 people were killed, either by taking their own lives or from accessing parts they were not supposed to, and there were 293 Signals Passed at Danger last year, 43 more than the year before. Whilst suicides are impossible for rail companies to safeguard against, errors made by front line staff shouldn’t be happening.

The risks involved in terms of a train going through a red light are all too clear.  These incidents could cause crashes and derailments, which could lead to serious injuries and even deaths. The new boss of Network Rail, Mark Carne mentioned he wanted to make the network safer in his job interview and his predecessor, Sir David Higgins, also regularly said that safety came first in everything he did on the network.

But what exactly can be done to improve rail safety? Over the past ten years investigations into major rail accidents have highlighted human performance as a contributory factor. Misunderstanding or employee error can result in safety breaches that cause injury and death. Driving through a red light is likely to be a result of human error, and the key for rail companies in preventing these incidents is to identify why they are happening and then address them.

 

It could be an error of judgement, a lack of knowledge, a lapse in concentration, even possibly intentionally – as can happen on the roads where someone feels they have just enough time to get through a red light. Rail bosses need a better understanding of their employees and their likely behaviour on the job.

All rail companies have to have formal competency management systems in place to maintain and assess the competence of operators responsible for safety critical work and ensure front line workforces are monitored and assessed, but how these systems work varies.

 

We have been working with both Network Rail and Eurostar for several years to implement penetrative situational judgement assessments, and our competency management system my*KNOW that provides a unique insight into employees skills, knowledge and confidence.

The results provide insight not only into how knowledgeable a person is but how they might act when performing their jobs and the decisions they might make. Such assessments work by asking employees a series of multiple response questions based on common ‘on the job’ scenarios.

 

The scenarios include specific ‘at risk’ circumstances and the answers can’t be guessed unlike multiple choice assessments. The results reveal how competent a person is in all aspects of their role and highlight knowledge gaps and where confidence might be an issue or pose a risk.

Whilst rail is much safer than it was in the past, more does need to be done to make it safer. We believe our unique approach is one way that rail companies could do this to really understand likely human behaviour on the job and ensure measures are in place to tailor training where it is needed. Only by having a fully competent workforce can rail companies be confident they are operating as safely as possible.

 

What do you think could be done to improve rail safety? Can rail companies really safeguard against human error? Please comment and share via your social media networks using the hashtag #railsafety