managing human factors in the signalling programmemanaging human factors in the signalling programme...

Managing Human Factors in the Signalling Programme

The latest development in the work of the Human Components Mapping

Dr. Amanda C. Elliott – Safety Team Banedanmark

Presentation Outline

1. Introduction

2. Linking human factors and hazards

3. The story of Human Components mapping

4. Outline steps for the method

5. Summary & conclusions

Overall aim:

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– To present the development of a method being used by the

Signalling Programme to improve the completeness of hazard

analysis, risk assessment and operational testing.

Agenda:

1. INTRODUCTION

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Introduction

– The Signalling Programme is complex, with both S-Bane and

Fjernbane having major upgrade works.

– The modifications to the railway encompasses:

o Infrastructure

o Onboard equipment

o Operational Rules

– The Signalling Programme Safety Team are working with the

G-ISA and the NSA and applying CSM-REA.

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The Signalling Programme

Introduction

The safety and human factors teams work closely together

on the Signalling Programme because we recognise that whilst

the technical implementation is the “deliverable”;

the human elements are what will make or break the system

in terms of operational performance and safety.

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Safety and human factors

2. LINKING HUMAN FACTORS& HAZARDS

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Linking human factors and hazards

– The evidence from the (technical) supplier closes

very few (if any) hazards completely at a railway level.

Yet…

– In the past much focus has been on providing evidence

related to the technical aspects of hazards, with less rigorous

effort spent on the human aspects.

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It’s about the bigger picture of hazard composition


– Our intensity of focus is still on technical products.

– The methods we use often push human beings to be

“measured” in a similar way to technical components.

– What reasons do we give ourselves in the safety community

for this?

– Especially when our technical solutions are more robust and

reliable than they ever were?

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What do YOU think?

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Is it because

we are more comfortable with solid numbers

and figures that we can model and justify?

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Is it because

the complexities of a socio-technical system

can be interpreted in so many ways?

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Is it because

we can’t put humans into simple boxes?

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HF concepts in 50126

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Allocation of function

Human interfaces to the system

Environmental ergonomics

Working patterns

CompetenceTask design

Interworking and team interaction

Human feedback

Railway organisational structure

Railway culture

Professional railway vocabulary

New technology introduction

Motivation and aspirational support

Human behavioural changes

Operational safeguards

Human reaction time and space

HMI communications

Density of information transfer

Rate of information transfer

Quality of information

Reaction to abnormal situations

Training

Human decision making support

Contribution to human strain

Human /system interface design & operation

Human error

Deliberate rule violation

Involvement and intervention

Monitoring and override

Perception of risk

Involvement in critical areas

Anticipation of system problems

Independence

Human V&V

Human interface for automated tools

Systematic failure prevention/ processes


Is it because

conclusions are hard to determine

when people are so changeable, so adaptable

and so uninform?

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Is it because

our educational practices, standards and regulations tend to

place the humans outside of the measurable system?

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What do YOU think?

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– It can be argued that CSM-RA now places more emphasis on

considering the whole system, including the human and

operational aspects because it is focused on what the change

means.

The challenge is…

– Will we and can we start to change the way we present our

safety cases, hazard analysis and testing evidence?

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– We also have the lessons learnt:

o It has become clear to the Signalling Programme that HF

and human components are essential as key measures of

operational testing.

o There’s been a lot of emphasis placed upon the

competence and confidence in individuals

(which is a regular occurrence for HF).

o The complexity of Fjernbane railway is higher, with more

suppliers involved.

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2. THE STORY OF

HUMAN COMPONENT MAPPING

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The story of Human Component mapping

– The apportionment of hazard causes was

agreed with the NSA.

– For most hazards, the human components

determine the outcome.

– Leading to our first awakening – the

recognition that there’s a lot riding on us

providing a means to support our closure

arguments through human factors analysis!

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First awakening – the recognition of humans!


– What methods could be used to meet our needs:

o Justifiable (to all authorities and beyond)

o Understandable (by all)

o Communicable (between all parties)

o Connectable (links to hazards)

o Re-usable (for all different situations / hazards)

o Measurable (can be structured & recorded but not

necessarily quantitative)

o Repeatable (person-independent)

o Possible (in the timescales presented)

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Next – Allocating the complexities of humans in a viable way


1. Knowledge, skills & experience

2. Practices & processes

3. Information

4. Workload

5. Communications

6. Team work

7. Supervision & management

8. Equipment

9. Work environment

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Simplification isn’t easy to do

E.g. Incident Factor Classification System (IFCS) – UK RSSB/NR

still uses abstract terms and is focused on past events…


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For S-Bane, 3 HC areas were developed for key measures


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For S-Bane, 3 HC areas were developed for key measures

OT06 Fail a (northbound) train in station (Birkerød) & turn back at Holte

OT02

Close & Open station

OT09 Set & Remove Reduced

Braking Rate

OT12Run Yellow Fleet Vehicle into single

possession at Lyngby


– There are now 4 HC’s:

o Application & Comprehension

o Design

o Communications

o Workload (has been added)

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Fjernbane distinctions


– So an overview may look like this:

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– But that doesn’t show the whole story

– The HC’s are allocated in 3 contexts:

o Roles

o Products

o Organisation

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For Fjernbane, there are more distinctions


– Leading us to allocation by HC:

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Roles

Products

Organisation

Or allocation by context…


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Or a combined “map”

Description of Hazard XYZ Role 1 A&C HC1

Role 1 A&C HC2

Role 1 A&C HC3

Role 1 W/L HC1

Role 1 W/L HC2

Role 2 A&C HC1

Role 2 A&C HC2

Role 2 W/L HC1

Role 3 A&C HC1

Role 3 A&C HC2

Product 2 D HC1

Product 4 D HC1

Product 1 D HC2

Product 1 D HC1

Product 1 A&C HC1

Product 3 D HC1

Product 3 A&C HC1 Organisation 2 A&C HC1

Organisation 1 A&C HC1


Organisation 1 C HC1




ROLES PRODUCTS ORGANISATION


– It’s true that the human components of any situation,

scenario or hazard have complex interactions; their nuances

can’t be captured.

– However, we do have a need to move forward and support

the safety case, as well as operational testing.

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So how does this help us?


– The HC mapping method allows us to record one version of the

hazard:

o There’s a clear step-wise method to produce the result

(justifiable).

o The HC map of a hazard can be shown as a single, one-page

output that summarises the HC’s (understandable &

communicable).

o One HC map can be produced per hazard and other scenarios

e.g. a HC map of an Operational Rule (re-usable).

o There is a syntax for each type of HC, which is agreed with

the operational testing team for Fjernbane (measurable).

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o The method can be done by anyone with the right

competences, so that there is no over-reliance upon history &

individuals (repeatable).

o The HC map is the central point for connection to other

elements of the Signalling Programme, using a database and

taxonomy and can be used to structure the HF records

(connectable).

o We have already completed HC maps for all Operational Rules

and a large majority of programme level hazards (possible).

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The final outcome…

3. OUTLINE OF STEPSFOR THE METHOD

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Outline steps for the method

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6 Steps to Human Component mapping

• STEP 1: Set rules and questions for each of the HC’s and produce context specific pick-lists.

• STEP 2: Identify HC structure and allocate HF records using HC structure.

• STEP 3: Describe hazards and other elements in terms of their HC’s.

• STEP 4: Validate descriptions.

• STEP 5: Complete HC mapping and link evidence.

• STEP 6: Identify where further evidence & tests are required.


– The aim of this step is to produce a set of rules and questions

that suit the particular project, so that HC’s can be allocated

correctly.

– In order to be repeatable and verifiable, sets of questions and

pick-lists were built up.

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Step 1: Set rules and questions for each of the HC’s and produce context specific pick-lists


– Example for Application & Comprehension:

o Q: “Does the situation require a person to comprehend

and apply the <equipment/system> OR <operational

rule> OR <organisational context>?

– Example for Communication:

o Q: “Does the situation require communication between

individuals or a group of people that is initiated by a

person and sent to a person?”

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o Examples for HC statements (A&C and Comms):

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– Iterative with Step 1, as the structure develops, new thinking

will evolve and gaps will be identified.

– Once the high level structure has been developed, brainstorm

Human Component content and HF grouping using:

– HF best practice and experience.

– Operational concept.

– Systems definition.

– Review of the hazard log.

– Any reference HF issues logs, scoping, etc.

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Step 2: Identify HC structure and allocate HF records using HC structure


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Application & Comprehension

Possible deeper level of structure for each type of activity:

◦ Groups of duties; Different conditions of service

◦ Different conditions of equipment; Understanding information inputs

◦ Compliance with procedures; Understanding & applying specific communication types

◦ Situational awareness

Workload

Possible deeper level of structure for each role for workload management/ increase/ significant reduction:

◦ Specific reasons for workload increase

◦ Specific reasons for workload significant reduction

◦ Specific content that requires workload management

Design

Possible deeper level of structure for each product:

◦ Usability

◦ Availability

◦ Technology introduction

◦ Equipment integration

◦ Layout and placement

◦ Product specific concerns

◦ Maintainability

Communications

There are limited levels of structure for each “Role with Role” communication. It may be necessary to add a purpose:

Possible deeper level of structure for each

◦ Normal operations

◦ Emergency situation

◦ Failure condition

◦ To fulfil a specific task


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– Once you have understood the content and power of the HC

groups and statement idea, you can use them to analyse the

project hazard records.

– Each hazard should be analysed by the appropriate people

(e.g. expert users, development team, safety team & HF team).

– Where possible, carry out this analysis with separate groups, so

that you gain a more detailed and thorough review from each

interested party (they will come together at the formal workshop

in Step 4).

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Step 3: Describe hazards and other elements in terms of their HC’s


– The aim is to produce a full understanding of the hazard, with respect

to HC’s, so that anyone seeing this can:

o Understand the scope of HC’s;

o The roles involved;

o The products they use and the HMI design elements;

o What they have to apply and comprehend;

o Who communicates with whom;

o What workload changes they may be subjected to;

o What organisation/ group they work within;

o Get a clear view of the potential complexity of the HC’s involved;

o Therefore, gauge the hazard and understand the wider human

context.

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– We produced a tool in Excel & used pick-lists wherever possible, with additional free-form text to record the exact HC statements.

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– Use a systematic process to agree the descriptions and allocations.

– Our suggested approach (for completeness argument) is to have

each and every potential HC actively allocated to either:

o “dismissed”

o “relevant”

o “causal”

– Organise a workshop with the appropriate people to allow a

“once and for all” approach to check the HC map of the hazards.

– Having a visualisation to communicate the process and outcomes is

valuable…

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Step 4: Validate descriptions


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Remember the HC map…

Description of Hazard XYZ Role 1 A&C HC1

Role 1 A&C HC2

Role 1 A&C HC3

Role 1 W/L HC1

Role 1 W/L HC2

Role 2 A&C HC1

Role 2 A&C HC2

Role 2 W/L HC1

Role 3 A&C HC1

Role 3 A&C HC2

Product 2 D HC1

Product 4 D HC1

Product 1 D HC2

Product 1 D HC1

Product 1 A&C HC1

Product 3 D HC1

Product 3 A&C HC1 Organisation 2 A&C HC1









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Here’s the same for the HC’s that are actively NOT part of the HC map

Role x A&C HCx

Role x A&C HCx

Relevant but not casual

HC’s

Role x W/L HCx

Product x D HCx

Organisation x C HCx

Product x D HCx


Role x W/L HCxRole x W/L HCxRole x W/L HCxRole x W/L HCxRole x W/L HCx

Role x A&C HCxRole x A&C HCxRole x A&C HCxRole x A&C HCxRole x A&C HCx

Product x D HCxProduct x D HCxProduct x D HCxProduct x D HCxProduct x D HCx

Product x A&C HCxProduct x A&C HCxProduct x A&C HCxProduct x A&C HCxProduct x A&C HCxProduct x A&C HCx

Dismissed HC’s

Organisation x C HCxOrganisation x C HCxOrganisation x C HCxOrganisation x C HCxOrganisation x C HCxOrganisation x C HCx

Organisation xA&C HCxOrganisation xA&C HCxOrganisation xA&C HCxOrganisation xA&C HCxOrganisation xA&C HCxOrganisation xA&C HCx


– This step makes the connection between the structured HF records and the HF work

completed as a matter of course within a project.

– The linking can be done by:

o Direct many to many linking content within a database (where the HF records log

is in DOORS & the HF evidence is listed e.g. document titles/ numbers);

o One HF piece of work to many HF records linking in a report-based approach

(e.g. summaries of HF evidence and how they close HF issues);

o One HF record or HF issue to many HF pieces of work.

– In reality, a combination is often required to satisfy the authorities but what should

NOT be needed is to go through each and every hazard repeating HF evidence; the

mapping through HC’s takes care of this.

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Step 5: Complete HC mapping and link evidence


– Human Components are the centre of the mapping:

o HC’s of hazards are linked to HC groups

o Which in turn are linked to HF records

o Which in turn are linked to HF evidence

– So they can be used to identify whether there are gaps in the

current documented design evidence. Also, what needs more

emphasis in testing due to theory & design being unable to

provide enough.

– Gaps in the HF evidence for HF issues may require further work,

as would be the case through a traditional HF issues log.

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Step 6: Identify where further evidence & tests are required

5. SUMMARY & CONCLUSIONS

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Summary and conclusions

– There is a need to link to human factors

– Human components of hazards have complex interactions

– The Signalling Programme is attacking the issue head-on!

– The work on S-Bane has been effective and has directly guided

the operational testing.

– The Fjernbane is more complex and we have lessons learnt from

S-Bane.

– The development of the Human Component maps and mapping

method is the direction being used to produce results.

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So where are we?

Summary and conclusions

“All things appear and disappear because of the concurrence

of causes and conditions. Nothing ever exists entirely alone;

everything is in relation to everything else.”

Buddha

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Final remarks

Managing Human Factors in the Signalling Programme

The latest development in the work of the Human Components Mapping

Dr. Amanda C. Elliott – Safety Team Banedanmark email: [email protected]

managing human factors in the signalling programmemanaging human factors in the signalling programme...

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