Overview
We all fail, several times each day, at home and at work. Most often our errors are without consequence, benign. However, what if we fail in a work environment when we are part of a team on a major project or in an industrial environment? Individual and team failure can then have major consequences.
Governments and industry conduct post-mortems, inquiries or investigate failure to ensure we do not repeat the same errors, learn to improve productivity, or prevent disasters. Writing the story of failure is a significant undertaking, a similar process as writing any major report, akin to writing a memorandum to Cabinet (MC) where we are faced with tackling a problem and determining a way forward.
This one-day course is based on the science and techniques used by professional investigators to uncover the causes and contributory factors leading to accidents and disasters. The examples used range from a slip or mishap at work to major industrial failures such as the 737 Max plane crashes and the Government of Canada implementation of the Phoenix pay system.