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High Reliability Organizing (HRO):The Third Component of a Safe and
Productive Unit
Presented at the Pacific Northwest Fire Operations WorkshopPortland, OR – March 17, 2010
by David Christenson
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Already an HRO?
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1
Respect feedbackRespect feedback
Be willing to shareBe willing to shareconcernsconcerns
Be a studentBe a student
Rules don’t and can’t cover every
situation
2 J
ust
Rep
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Lea
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Safety Culture
Three Components of A Safe And Productive Unit
Track small failures
Resist oversimplification
Sensitive to operations
Maintain capabilities for resilience
Take advantage of shifting locations of expertise
HRO Principles:3
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Fundamental to success in HRO implementation are the connection of people and the trust necessary for optimal knowledge flow.
Building on Strengths
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Thrive or Survive?
Study: Since the year 2000 about seventy-five percent just survive at work.
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My Experience
Since 1978 my experiences have taught me that:
The tools of: Organizational LearningLeadership Developmentand High Reliability Organizing
Are effective ways to begin connecting people and engaging them in their work.
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1978- 1982
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1994
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Human Factors & Org. Learning
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Roberts
Weick
Sutcliffe
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Vulnerable --- Fallible
PressureSocialPoliticalEconomicPeer
Human FactorsStressFatigueEgo
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Challenges that Call for HRORoberts & Rousseau, 1989
Hypercomplexity Tight Coupling Extreme Hierarchical Differentiation Multiple Decision-Makers in a Complex
Communication Network High Degree of Accountability Need for Frequent, Immediate Feedback Compressed Time Constraints High Workforce Mobility
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Swiss Cheese ModelJames Reason’s Epidemiological Model Analogy
The Field Guide to Understanding Human Errorby Sidney Dekker, 2006
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Swiss Cheese Model vs. Metaphor
Conditions
Conditions
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Recognition Primed Decision-MakingGary Klein
S CA 2007
S CA 2003
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Recognition Primed Decision-MakingGary Klein
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New: Critical Thinking Skills Training
A deliberate, systematic awareness of the process and products of one’s own thinking
Targets the common errors of:
Overlooking important details
Misinterpreting information
Making incorrect assumptions
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Critical Thinking
Improving the probability of a desirable outcome by improving your judgment
Combine Both Recognition Primed Decision-Making and Critical Thinking
Recognition/ Metacognition
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Critical Thinking Through Dialog
Teamwork and Communications ImproveDetermine the acceptability of a belief or
actionQ & A about alternative possibilities Improves understanding of the situation
and planLearn more about beliefs, assumptions and
interestsGenerate more successful decisions
and create novel solutions
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AARs & Sand Tables
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Dynamic Decision-Making
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Principles of HRO
1. Tracking Small Failures
2. Resisting Oversimplification
3. Sensitive To Operations
4. Maintaining Capabilities For Resilience
5. Taking Advantage Of Shifting Locations Of Expertise
Weick & Sutcliffe, Managing the Unexpected 2001
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HRO Audits & Implementation
Fundamental to success in HRO implementation are the connection of people and the trust necessary for optimal knowledge flow.
Is the HRO information arriving in the context of a fertile learning environment where people are connected, engaged, and where knowledge flows?
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Context
“To treat information as context-free, that is, independent of circumstances, places us at risk for mindless thoughts, decisions, and behaviors. Placing information within context leads to mindfulness.”Ellen Langer, publishing Mindfulness. in 1989, and The Power of Mindful Learning in1997
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We All Needed To Learn Quickly
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Connected
“Mindlessness develops from automatic behaviors, repetition, and use of a single perspective.” (Langer 1989)
Mindfulness welcomes new information, becomes inclusive of the process used and the environment actors are in, rather than only on the outcome.
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Soft Aspects?
Connection improves bothindividual and groupperformance
So paying attention to creatingan optimal work environmentrequires paying attention to theso-called soft aspects
Such as the meaning of work and the way people treat each other.
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So What?
Connection in positive work relationships provides: A sense of well-being, minimizes stress, and
makes us more trusting.
Without connection: People feel lonely, isolated, confused and
become distrusting, disrespectful and dissatisfied. ..Corrosive environments.Dr. Edward Hallowell at Harvard Medical School.
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Costs
“The Gallup Organization conservatively estimates the annual economic cost to the American economy from the approximately 22 million American workers who are extremely negative or “actively disengaged” to be between $250 and $300 billion.”
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Vision + Value + Voice = Connection
Vision when everyone is united by common values, proud of their unit’s reputation, and motivated by their mission
Value exists in an organization when everyone understands the basic psychological needs of people, behaves in ways that appreciates their positive, unique contributions, and acts to help them achieve their potential.
Voice exists in an organization when everyone seeks the ideas of others, share ideas and opinions honestly, and safeguards relational connections.
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“Next step”in the evolution of organizations
Beyond masters of task excellence
Beyond “star systems”
…we in it shall be remembere’d,We few, we happy few, we band of brothers:
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Inspirational Leadership
Leaders know that one of their main responsibilities is to inspire the people they lead.
Vision represents the cultural element of inspiring identity
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Inspirational Leadership
Human value in a culture is: About treating people with
respect and dignity About empowering them to
achieve their potential.
Leaders need to identify and remove the obstacles that make people feel devalued.
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Delete What Devalues
Eliminating disrespectful, condescending and rude behavior.
Going easy on criticism.
Minimizing unnecessary rules and excessive controls.
Eliminating excessive signs of hierarchy.
Getting rid of devaluing managers.
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Add Elements that Enhance Value
Making a human connection with as many people as possible.
Treating and speaking to employees as partners.
Helping employees find the right roles.
Educating, informing, and listening to employees.
Decentralizing decision making.
Recognizing the human need for work/life balance
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Leaders Increase Trust
“Contrary to what most people believe, trust is not some soft, illusive quality that you either have or you don’t; rather, trust is a pragmatic, tangible, actionable asset that you can create – much faster than you probably think possible…I contend that the ability to establish, grow, extend, and restore trust is not only vital to our personal and inter-personal well being; it is the key leadership competency of the new global economy.”
Stephen M. R. Covey, The Speed of Trust: The One Thing That Changes Everything
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Trust – The Hidden Variable
Strategy x Execution = Results
should be changed to show it by:
(Strategy x Execution) Trust = Results Following charts from: a study of trust in business by LogicaCMG and
Warwick Business School in 2005; another by Watson Wyatt, WorkUSA study in 2002; and another study about trust in schools presented by Stanford professor Tony Byrk, in 2004, published in 2002.
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The 60% Tax (Very Low Trust)
In the organization… In personal relationships…
•Unhealthy working environment
•Unhappy employees and stakeholders
•Intense political atmosphere with clear camps and parties
•Excessive time wasted defending positions and decisions
•Painful micromanagement and bureaucracy
•Hostile behaviors (yelling, blaming, accusing, name-calling) followed by periods of brief contrition
•Guarded communication
•Constant worrying and suspicion
•Mistakes remembered and used as weapons
•Real issues not surfaced or dealt with effectively
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The 40% Dividend (World-class Trust)
In the organization… In personal relationships…
•High Collaboration and partnering
•Effortless communication
•Positive, transparent relationships with employees and all stakeholders
•Fully aligned systems and structures
•Strong innovation, confidence, and loyalty
•True joy in family and friendships, characterized by caring and love
•Free, effortless communication
•Inspiring work done together and characterized by purpose creativity and excitement
•Completely open transparent relationships
•Amazing energy created by relationships
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Inspiring trust
Extending “smart trust,” restoring trust when it has been lost, and developing a propensity to trust.
“…where people begin to trust each other and share ideas…(changes occur.)
Cultivating “Knowledge Flow” increases connection and people begin to make better decisions, increase creativity, and inspire innovation so they start thriving in a healthy environment.”
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Knowledge Flow The expanded connection
component called Voice
Increases creativity and innovation Sgt. Curtis Cullen’s idea for
the Rhino tank when it quickly made its way to Gen. Omar Bradley in time to liberate France in WWII
AIM-7F and Raytheon Missile Systems
After Action Reviews
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What “Learning Organizations” Do
Learning organizations becomeskilled at continuously:
1.) Creating, acquiring, interpreting, transferring and retaining knowledge
2.) And at purposefully modifying their behavior to reflect new knowledge and insights
Definition by David Garvin in Learning In Action: A Guide
To Putting The Learning Organization To Work, 2000
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A Litmus Test
Does my org. have a defined learning agenda?
Is my org. open to discordant information?
Does my org. avoid repeated mistakes?
Does my org. lose critical knowledge when key people leave?
Does my org. act on what it knows?
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A Supportive Learning Environment
Psychological safety
Appreciation of differences
Openness to new ideas
Time for reflection
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Leadership & Reinforcing Learning
Invite input
Ask probing questions
Encourage multiple points of view
Provide time for reflection
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Information to Knowledge
Informed Culture
Timely AvailableCandid Disseminated
Learning Culture
“If timely, candid information generated by knowledgeable peopleis available and disseminated, an informed culture
becomes a learning culture.”
Weick & Sutcliffe, Managing the Unexpected 2001
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HRO = A Mindset
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Total Immersion In A Mindset That Holds Our Foundations Together
Fundamental to success in HRO implementation are the connection of people and the trust necessary for optimal knowledge flow.
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You can do this!
Not everyone will right away Org. Learning, Leadership & HRO thinking,
behaviors and principles are worth the effort Quality – Likelihood of harm to your processes and
products will be reduced Safety – Likelihood of harm to your people and
your publics will be reduced Reliability – Absence or reduction of harm in
extreme, uncertain, or unexpected environments. Trust and confidence will increase internally and
externally
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Questions? Need Resources?
Contact information:David ChristensonWildland Fire Lessons Learned CenterNational Advanced Fire & Resources Institute
[email protected] www.wildfirelessons.net