“Teamwork is Often Undervalued”

photo: Dr. Susan L. Koen

What are the most common risks associated with “routine” operating procedures?

Koen: When people perform the same tasks time and time again, they can fail to recognize changes and the risks associated with those changes. They are unwittingly doing their work automatically and unconsciously. In these situations, the brain switches – on its own – to what we call the “Fast Brain”, an area of the brain that is preconscious and unable to think. We humans are only able to think when we are operating from our cerebral brain, what we call the “Slow Brain” because it takes longer to activate than the “Fast Brain.” The result is that we often perform routine tasks literally without thinking.

Why are precisely defined working procedures important in performing hazardous tasks?

Koen: The first clues as to the inconsistency and fallibility of human performance were discovered in 1935, as pilots switched from one type of airplane to a more complex one. In concentrating on mastering the bells and whistles of the new plane, they had straight-up forgotten important procedures, leading to a series of crashes. Against this background, Boeing developed a checklist for pilots. It’s not the step-by-step checklist alone that produces performance reliability in aviation. Rather, it’s the recognition among pilots that they’re fallible. It’s the commitment to not operate from memory, since human memory is not reliable. And, most importantly, it’s the system of having two people cooperate in working through and crosschecking each critical task on that checklist.

Are checklists and cross-checking enough on their own?

Koen: Checklists are just one aspect of our workplaces among 19 that need to be adapted to the functioning of the human brain. Additionally, there are different levels – the organizational, team and personal levels. At the organizational level, leader-ship behaviors and corporate culture play a large role in preventing human error, because these elements set a tone, generate expectations and directly influence the individual performance of employees. Work instructions must be brain-aligned, taking into account the human vision system and how it best accesses and processes visual information. Also, teamwork is often undervalued in business, yet this level can function as an important bridge between the organizational and individual levels. Successful teams work well together and support their members, as illustrated in the example of pilot and co-pilot.

How should work instructions be formulated?

Koen: Work instructions should always be created from the perspective of the person that will be performing the job. The optimal solution is to involve the employees in the instructions’ creation, or have them create the instructions entirely. Presentation also plays a huge role – work instructions should be well laid-out and accompanied by graphical representations or photographs to add clarity. If work instructions are not formatted appealingly, the human eye simply won’t process the information on the printed page or electronic display.

Your research has demonstrated that we see things more with our brains, rather than with our eyes …

Koen: Our brains determine what we see. In other words, they decide where we look. In one experiment, we investigated how we optically scan our environments. In an oil refinery, a sample needed to be taken and analyzed from an alkylation plant. In the pre-task briefing, attention was drawn to the specific dangers of taking that sample, as well as where employees should focus while doing so. In the briefing, the employee’s brain was conditioned or “primed” to pay attention to certain items in their work situation. The consequence, however, is that the brain becomes “blind” to other parts of it, resulting in poor situational awareness. We have to understand this potential exposure and do more brain-aligned briefings.

People often become ill through their work with–out ever noticing it themselves. How can this be prevented?

Koen: If we fail to get enough deep sleep phases during our daily sleep time, our brains are unable to fully recharge and restore themselves. As a result, the signaling ability of our synapses is impaired and the brain cannot function at full capacity. It is important to make people aware of the indicators and symptoms of cognitive or brain fatigue. It is only when these red flags are recognized and heeded that the process can be interrupted and a total burnout avoided. If suffering from mild brain fatigue, a short-term solution is to consume glucose – an essential food for the brain. A good, tried-and-tested source of this is whole fruit, not fruit juice. This is just a quick, short-term fix though – fructose is no replacement for deep, restful sleep.

Is it possible that we also need to reconsider management styles?

Koen: It has been recognized at some management levels that companies must do more to lead people effectively. Sadly, many people are still in the dark when it comes to how leaders affect performance. When both sides have access to the same knowledge, they are better able to communicate with and adapt to one another, driving towards the same goal of human performance reliability. I myself have witnessed how companies are able to change for the better and achieve lasting gains in safety and reliability. So I know that it’s possible.

Interview: Norbert Böwing