case study on decision-making (abcd version of ooda loop)

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What Would You Have Done? The set-up: It’s Thursday night and two mechanics who worked all day (from 0700-1700) plan to drive through rush- hour traffic to party at a club that is at least two hours away. Question #1: Supposing this was your plan, what do you think of it? Now assume that these Sailors work directly for you. In fact, they are among your best workers. They have been making this road trip once a week for three months, and nobody has said anything about it. Question #2: As a supervisor, what do you think of their plan? You decide to discuss their plan with them. They assure you that one of them will be the designated driver and that they’ll stop to rest if necessary. Question #3 and #4: Do these risk controls make you feel better about their plan? Can you do anything to improve their chance of success? Here’s another factor. Work tempo at the command has been high, and they have had a total of just 15 hours of sleep during the previous three days. Questions #5 and #6: What do you think of their plan now? Do you see any red flags? The event: They stay at the club until 0300, having a great time. They start to drive back to base so that they can report to work at 0700. Even though the driver hasn’t been drinking, he feels sleepy. He pulls over to rest at 0400. However, feeling pressured to get back to work on time, they get back on the road at 0445 without getting any meaningful rest. At some point, the driver falls asleep and loses control. The car crashes. The driver isn’t buckled up and is killed. The passenger (who was wearing his seatbelt) survives with injuries. Question #7: How does the loss of two of your best workers affect your team? You have just lost two of your best performers, and it will take some time before BUPERS details new personnel into your command. As the supervisor, it’s not just a workload and mission issue (others are going to pick up the tasking, which increases their risks) that you are going to have to deal with. Work-center morale and family concerns of the lost members are going to complicate the situation that you must address. Questions #8, #9 and #10: What does it say about the culture of a command when personnel think that they can party all night, getting little or no sleep, and still be able to do skilled, technical work the next day? What risk does this pose to the command’s

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Page 1: Case Study on Decision-Making (ABCD version of OODA loop)

What Would You Have Done? The set-up: It’s Thursday night and two mechanics who

worked all day (from 0700-1700) plan to drive through rush-

hour traffic to party at a club that is at least two hours

away.

Question #1: Supposing this was your plan, what do you think of it?

Now assume that these Sailors work

directly for you. In fact, they are among

your best workers. They have been making

this road trip once a week for three months,

and nobody has said anything about it.

Question #2: As a supervisor, what do you think of their plan?

You decide to discuss their plan with

them. They assure you that one of them will

be the designated driver and that they’ll stop

to rest if necessary.

Question #3 and #4: Do these risk controls make you feel better about their

plan? Can you do anything to improve their

chance of success?

Here’s another factor. Work tempo at the

command has been high, and they have had

a total of just 15 hours of sleep during the

previous three days.

Questions #5 and #6: What do you think

of their plan now? Do you see any red

flags?

The event: They stay at the club until

0300, having a great time. They start to

drive back to base so that they can report to

work at 0700. Even though the driver hasn’t

been drinking, he feels sleepy. He pulls over

to rest at 0400. However, feeling pressured

to get back to work on time, they get back

on the road at 0445 without getting any

meaningful rest.

At some point, the driver falls asleep and

loses control. The car crashes. The driver

isn’t buckled up and is killed. The passenger

(who was wearing his seatbelt) survives with

injuries.

Question #7: How does the loss of two of your best workers affect your team?

You have just lost two of your best

performers, and it will take some time

before BUPERS details new personnel into

your command. As the supervisor, it’s not

just a workload and mission issue (others are

going to pick up the tasking, which increases

their risks) that you are going to have to deal

with. Work-center morale and family

concerns of the lost members are going to

complicate the situation that you must

address.

Questions #8, #9 and #10: What does it say about the culture of a command when

personnel think that they can party all night,

getting little or no sleep, and still be able to

do skilled, technical work the next day?

What risk does this pose to the command’s

Page 2: Case Study on Decision-Making (ABCD version of OODA loop)

mission? Do you think these Sailors

understood ORM?

They apparently felt bullet-proof. They

had done some planning and had had the

same routine for three months. The hazards

of driving while fatigued, driving impaired,

sometimes not wearing seatbelts and ending

up not fit for duty the next day were all

additional risks that weren’t adequately

controlled.

Their execution of their “plan” wasn’t as

routine as they had thought. Time Critical

Risk Management would have been

appropriate to use and should have come

into play for both the Sailors and their

supervisor.

Let’s assume that these Sailors weren’t

afraid to call their supervisor to confess that

they would be late.

Using the A-B-C-D mnemonic, they could

have:

● Assessed the plan at the point where

they were too tired to drive.

● Balanced Resources by getting a hotel

room or stopping in the car for a longer rest

period.

● Communicated with their supervisor

(another resource, via a cellphone call or

text) that they would be late and would

make up for the lost work.

● Debriefed, after the event, by

discussing how to better plan this event in

order to have controlled the known risks, so

that no last-minute phone calls would have

been necessary.

________________________________________________________________ DISCUSSION POINTS

● As a supervisor, what could you do in your span of control to improve these

Sailors’ risk management? What could leadership do in terms of effectively teaching

Sailors how to balance work and play, and how to make sensible plans as a result?

● Why was there not some kind of command “trip wire” for leadership to provide to

their Sailors under circumstances like these?

RESOURCES AND MITIGATION STRATEGIES ● Have a Leave or Special Liberty Chit stashed for just such an emergency, so that

personnel are covered (to some extent) if they are late. This doesn’t mean they’ll

evade any repercussions, but you are protecting them.

● Establish a phone tree so personnel know who to call when their plans aren’t

working.

● Identify rest areas or lodging that can be easily accessed.

● Modify work hours so that Sailors can drive during daylight. Offer earlier secure to

avoid rush-hour traffic, thereby reducing driving time, or a late report the next day.

It’s better to lose a few hours from people than to lose the people.

● Duty driver.

● Different liberty schedule.

BY DEREK NELSON, HEAD MEDIA DIVISION

_________________________________________________________________________

Supervisors: Use this page to guide safety discussions with your personnel

Send your feedback to: [email protected]