Books By Sidney Dekker
*The Latest* Random Noise: Measuring Your Company's Safety Performance
In the realm of safety management, this book embarks on a profound exploration of how the political economy was reshaped in the last two decades. Much like privatization, deregulation, and financialization altered the economic landscape, this narrative unveils how safety management has been affected by the intertwined dynamics of asset underinvestment, privatization, self-regulation, workplace flexibilization, and market-driven policies.
Just Culture (3rd Edition)
A just culture is a culture of trust, learning and accountability. It is particularly important when an incident has occurred; when something has gone wrong.
How do you respond to the people involved? What do you do to minimize the negative impact, and maximize learning? This third edition of Sidney Dekker's extremely successful Just Culture offers new material on restorative justice and ideas about why your people may be breaking rules. Supported by extensive case material, you will learn about safety reporting and honest disclosure, about retributive just culture and about the criminalization of human error. Some suspect a just culture means letting people off the hook. Yet they believe they need to remain able to hold people accountable for undesirable performance. In this new edition, Dekker asks you to look at 'accountability' in different ways. One is by asking which rule was broken, who did it, whether that behaviour crossed some line, and what the appropriate consequences should be. In this retributive sense, an 'account' is something you get people to pay, or settle. But who will draw that line? And is the process fair? Another way to approach accountability after an incident is to ask who was hurt. To ask what their needs are. And to explore whose obligation it is to meet those needs. People involved in causing the incident may well want to participate in meeting those needs. In this restorative sense, an 'account' is something you get people to tell, and others to listen to. Learn to look at accountability in different ways and your impact on restoring trust, learning and a sense of humanity in your organization could be enormous.
Awesome book a real insight and has opened my eyes to interesting ways to develop a culture within a work place. I have adopted some of the practices and they work very well.
The Field Guide to Understanding 'Human Error'
When faced with a 'human error' problem, you may be tempted to ask 'Why didn't these people watch out better?' Or, 'How can I get my people more engaged in safety?' You
You might think you can solve your safety problems by telling your people to be more careful, by reprimanding the miscreants, by issuing a new rule or procedure and demanding compliance. These are all expressions of 'The Bad Apple Theory' where you believe your system is basically safe if it were not for those few unreliable people in it. Building on its successful predecessors, the third edition of The Field Guide to Understanding 'Human Error' will help you understand a new way of dealing with a perceived 'human error' problem in your organization. It will help you trace how your organization juggles inherent trade-offs between safety and other pressures and expectations, suggesting that you are not the custodian of an already safe system. It will encourage you to start looking more closely at the performance that others may still call 'human error', allowing you to discover how your people create safety through practice, at all levels of your organization, mostly successfully, under the pressure of resource constraints and multiple conflicting goals. The Field Guide to Understanding 'Human Error' will help you understand how to move beyond 'human error'; how to understand accidents; how to do better investigations; how to understand and improve your safety work. You will be invited to think creatively and differently about the safety issues you and your organization face. In each, you will find possibilities for a new language, for different concepts, and for new leverage points to influence your own thinking and practice, as well as that of your colleagues and organization. If you are faced with a 'human error' problem, abandon the fallacy of a quick fix. Read this book.
"It's in the world's best interest to read Dekker's book. The Field
Guide is nothing short of a paradigm shift in thinking about
'human error'"
The Safety Anarchist
Work has never been as safe as it seems today. Safety has also never been as bureaucratized as it is today. Over the past two decades, the number of safety rules and...
... organizations themselves are creating ever more internal compliance requirements. At the same time, progress on safety has slowed to a crawl. Many incident- and injury rates have flatlined. Worse, excellent safety performance on low-consequence events tends to increase the risk of fatalities and disasters. Bureaucracy and compliance now seem less about managing the safety of the workers we are responsible for, and more about managing the liability of the people they work for. We make workers do a lot that does nothing to improve their success locally. Paradoxically, such tightening of safety bureaucracy robs us of exactly the source of human insight, creativity and resilience that can tell us how success is actually created, and where the next accident may well happen.
It is time for Safety Anarchists: people who trust people more than process, who rely on horizontally coordinating experiences and innovations, who push back against petty rules and coercive compliance, and who help recover the dignity and expertise of human work.
Great insight. This all makes a lot of sense. The bureaucratic pendulum has swung way to far towards command and control.
Drift into Failure
What does the collapse of sub-prime lending have in common with a broken jackscrew in an airliner's tailplane? Or the oil spill disaster in the Gulf of Mexico with the burn-up of Space Shuttle Columbia?
These were systems that drifted into failure. While pursuing success in a dynamic, complex environment with limited resources and multiple goal conflicts, a succession of small, everyday decisions eventually produced breakdowns on a massive scale. We have trouble grasping the complexity and normality that gives rise to such large events. We hunt for broken parts, fixable properties, people we can hold accountable. Our analyses of complex system breakdowns remain depressingly linear, depressingly componential - imprisoned in the space of ideas once defined by Newton and Descartes. The growth of complexity in society has outpaced our understanding of how complex systems work and fail. Our technologies have gotten ahead of our theories. We are able to build things - deep-sea oil rigs, jackscrews, collateralized debt obligations - whose properties we understand in isolation. But in competitive, regulated societies, their connections proliferate, their interactions and interdependencies multiply, their complexities mushroom. This book explores complexity theory and systems thinking to understand better how complex systems drift into failure. It studies sensitive dependence on initial conditions, unruly technology, tipping points, diversity - and finds that failure emerges opportunistically, non-randomly, from the very webs of relationships that breed success and that are supposed to protect organizations from disaster. It develops a vocabulary that allows us to harness complexity and find new ways of managing drift.
"Professor Dekker explodes the myth that complex economic, technological
and environmental failures can be investigated by approaches fossilized in
linear, Newtonian-Cartesian logic."
The End Of Heaven
In this unique book, Sidney Dekker tackles a largely unexplored dilemma. Our scientific age has equipped us ever better to explain why things go wrong.
But this increasing sophistication actually makes it harder to explain why we suffer. Accidents and disasters have become technical problems without inherent purpose. When told of a disaster, we easily feel lost in the steely emptiness of technical languages of engineering or medicine. Or, in our drive to pinpoint the source of suffering, we succumb to the hunt for a scapegoat, possibly inflicting even greater suffering on others around us. How can we satisfactorily deal with suffering when the disaster that caused it is no more than the dispassionate sum of utterly mundane, imperfect human decisions and technical failures? Broad in its historical sweep and ambition, The End of Heaven is also Dekker's most personal book to date.
"At once wretchedly fascinating and personal and intellectually demanding"
Safety Differently
The second edition of a bestseller, Safety Differently: Human Factors for a New Era is a complete update of Ten Questions About Human Error: A New View of Human Factors and System Safety.
Today, the unrelenting pace of technology change and growth of complexity calls for a different kind of safety thinking. Automation and new technologies have resulted in new roles, decisions, and vulnerabilities whilst practitioners are also faced with new levels of complexity, adaptation, and constraints. It is becoming increasingly apparent that conventional approaches to safety and human factors are not equipped to cope with these challenges and that a new era in safety is necessary.
In addition to new material covering changes in the field during the past decade, the book takes a new approach to discussing safety. The previous edition looked critically at the answers human factors would typically provide and compared/contrasted them with current research and insights at that time. The edition explains how to turn safety from a bureaucratic accountability back into an ethical responsibility for those who do our dangerous work, and how to embrace the human factor not as a problem to control, but as a solution to harness.
See What's in the New Edition:
- New approach reflects changes in the field
- Updated coverage of system safety and technology changes
- Latest human factors/ergonomics research applicable to safety
Organizations, companies, and industries are faced with new demands and pressures resulting from the dynamics and nature of the modern marketplace and from the development and introduction of new technologies. This new era calls for a different kind of safety thinking, a thinking that sees people as the source of diversity, insight, creativity, and wisdom about safety, not as the source of risk that undermines an otherwise safe system. It calls for a kind of thinking that is quicker to trust people and mistrust bureaucracy, and that is more committed to actually preventing harm than to looking good. This book takes a forward-looking and assertively progressive view that prepares you to resolve current safety issues in any field.
"As expected, Sidney Dekker compels us to the next level of productive thinking."
Foundations of Safety Science
How are today's 'hearts and minds' programs linked to a late-19th century definition of human factors as people's moral and mental deficits?
What do Heinrich's 'unsafe acts' from the 1930's have in common with the Swiss cheese model of the early 1990's? Why was the reinvention of human factors in the 1940's such an important event in the development of safety thinking? What makes many of our current systems so complex and impervious to Tayloristic safety interventions? 'Foundations of Safety Science' covers the origins of major schools of safety thinking, and traces the heritage and interlinkages of the ideas that make up safety science today.
Features
- Offers a comprehensive overview of the theoretical foundations of safety science
- Provides balanced treatment of approaches since the early 20th century, showing interlinkages and cross-connections
- Includes an overview and key points at the beginning of each chapter and study questions at the end to support teaching use
- Uses an accessible style, using technical language where necessary
- Concentrates on the philosophical and historical traditions and assumptions that underlie all safety approaches
Sidney Dekker is concise and very illustrative with the historical compilation work done and, at the same time, is not prone to lecture on its New Vision for Security approach (next, if not brother of Human Organizational Performance). I'm really enjoying this work and even more so with his blog: "SAFETY DARKY". It's a headline book to reread again and again...
Second Victim
How do people cope with having "caused" a terrible accident? How do they cope when they survive and have to live with the consequences ever after? We tend to blame and forget professionals who cause incidents and accidents, but they are victims too.
They are second victims whose experiences of an incident or adverse event can be as traumatic as that of the first victims'. Yet information on second victimhood and its relationship to safety, about what is known and what organizations might need to do, is difficult to find.
Thoroughly exploring an emerging topic with great relevance to safety culture, Second Victim: Error, Guilt, Trauma, and Resilience examines the lived experience of second victims. It goes through what we know about trauma, guilt, forgiveness, and injustice and how these might be felt by the second victim. The author discusses how to conduct investigations of incidents that do not alienate second victims or make them feel even worse. It explores the importance support and resilience and where the responsibilities for creating it may lie.
Drawing on his unique background as psychologist, airline pilot, and safety specialist, and his own experiences with helping second victims from a variety of backgrounds, Sidney Dekker has written a powerful, moving account of the experience of the second victim. It forms compelling reading for practitioners, risk managers, human resources managers, safety experts, mental health workers, regulators, the judiciary, and many other professionals. Dekker provides a strong theoretical background to promote understanding of the situation of the second victim and solid practical advice about how to deal with trauma that continues after an event leading to preventable harm or even avoidable death of a patient, consumer, or colleague.
I'm not what you would call a touchy-feely person by any means, but the three books by Sidney Dekker that I've read (Second Victim, Just Culture, and Drift into Failure) have really changed my outlook on life.
Patient Safety
Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge.
Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors perspective, Patient Safety: A Human Factors Approach delineates a method that can enlighten and clarify this discourse as well as put us on a better path to correcting the issues.
People often think, understandably, that safety lies mainly in the hands through which care ultimately flows to the patient―those who are closest to the patient, whose decisions can mean the difference between life and death, between health and morbidity. The human factors approach refuses to lay the responsibility for safety and risk solely at the feet of people at the sharp end. That is where we should intervene to make things safer, to tighten practice, to focus attention, to remind people to be careful, to impose rules and guidelines. The book defines an approach that looks relentlessly for sources of safety and risk everywhere in the system―the designs of devices; the teamwork and coordination between different practitioners; their communication across hierarchical and gender boundaries; the cognitive processes of individuals; the organization that surrounds, constrains, and empowers them; the economic and human resources offered; the technology available; the political landscape; and even the culture of the place.
The breadth of the human factors approach is itself testimony to the realization that there are no easy answers or silver bullets for resolving the issues in patient safety. A user-friendly introduction to the approach, this book takes the complexity of health care seriously and doesn't over simplify the problem. It demonstrates what the approach does do, that is offer the substance and guidance to consider the issues in all their nuance and complexity.
"…takes the complex nature of healthcare seriously and pulls no punches."
Behind Human Error
Human error is cited over and over as a cause of incidents and accidents. The result is a widespread perception of a 'human error problem', and solutions are thought to lie in changing the people or their role in the system.
For example, we should reduce the human role with more automation, or regiment human behavior by stricter monitoring, rules or procedures. But in practice, things have proved not to be this simple. The label 'human error' is prejudicial and hides much more than it reveals about how a system functions or malfunctions. This book takes you behind the human error label. Divided into five parts, it begins by summarising the most significant research results. Part 2 explores how systems thinking has radically changed our understanding of how accidents occur. Part 3 explains the role of cognitive system factors - bringing knowledge to bear, changing mindset as situations and priorities change, and managing goal conflicts - in operating safely at the sharp end of systems. Part 4 studies how the clumsy use of computer technology can increase the potential for erroneous actions and assessments in many different fields of practice. And Part 5 tells how the hindsight bias always enters into attributions of error, so that what we label human error actually is the result of a social and psychological judgment process by stakeholders in the system in question to focus on only a facet of a set of interacting contributors. If you think you have a human error problem, recognize that the label itself is no explanation and no guide to countermeasures. The potential for constructive change, for progress on safety, lies behind the human error label.
This text is a well structured reference on human error, starting with a summary of how our views of human error have changed over the last decades, summarizing and bringing together much of the recent work in the field and finally brining it all into focus at the end relating human error to overall safety. A fine text for anyone involved in accident or incident investigation and a solid background read for human factors professionals in general.
Ten Questions About Human Error
Ten Questions About Human Error asks the type of questions frequently posed in incident and accident investigations, people's own practice...
managerial and organizational settings, policymaking, classrooms, Crew Resource Management Training, and error research. It is one installment in a larger transformation that has begun to identify both deep-rooted constraints and new leverage points of views of human factors and system safety. The ten questions about human error are not just questions about human error as a phenomenon, but also about human factors and system safety as disciplines, and where they stand today. In asking these questions and sketching the answers to them, this book attempts to show where current thinking is limited--where vocabulary, models, ideas, and notions are constraining progress.
This volume looks critically at the answers human factors would typically provide and compares/contrasts them with current research insights. Each chapter provides directions for new ideas and models that could perhaps better cope with the complexity of the problems facing human error today. As such, this book can be used as a supplement for a variety of human factors courses.
This is a superb book - I'm a physician - it should be part of our medical school curriculum.
Compliance Capitalism
This book identifies the market mechanisms that explain how less government paradoxically leads to greater compliance burdens for almost all workers...
In this book, Sidney Dekker sets out to identify the market mechanisms that explain how less government paradoxically leads to greater compliance burdens. This book gives shape and substance to a suspicion that has become widespread among workers in almost every industry: we have to follow more rules than ever-and still, things can go spectacularly wrong.
Much has been privatized and deregulated, giving us what is sometimes known as 'new public management,' driven by neoliberal, market-favoring policies. But, paradoxically, we typically have more rules today, not fewer. It's not the government: it's us. This book is the first of a three-part series on the effects of 'neoliberalism,' which promotes the role of the private sector in the economy. Compliance Capitalism examines what aspects of the compliance economy, what mechanisms of bureaucratization, are directly linked to us having given free markets a greater reign over our political economy. The book steps through them, picking up the evidence and levers for change along the way.
Dekker's work has always challenged readers to embrace more humane, empowering ways to think about work and its quality and safety. In Compliance Capitalism, Dekker extends his reach once again, writing for all managers, board members, organization leaders, consultants, practitioners, researchers, lecturers, students, and investigators curious to understand the genuine nature of organizational and safety performance.
Table of Contents
1 The freedom to make more rules; 2 Free markets in theory; intensive managerial control in practice; 3 The macro: sell out and pull out; 4 The meso: mistrust and monitor; 5 The micro: audit and cash in; 6 How could governments have missed this?; 7 A retreat into rules
Do Safety Differently
Over the last several years a new way to think about the safety of work has found its way into many organizations around the world. This new way to think about safety is leading to some important improvements in how work is being done and every organization wants to improve their safety performance.
- Safety: From outcome to capacity
- When the work done is not as you imagined: Do learning teams
- When things go wrong: Do investigations differently
- When there is too much compliance: Declutter your safety bureaucracy
- When your safety people are dejected: Empower them differently
- When you need to help your leaders succeed
Do Safety Differently is a discussion between two friends on what they have learned by watching organizations around the world change the way they do work. Do Safety differently is an applied discussion, a practical discussion, that will cause the reader to think about the strategies and tactics they will need to ensure the best possible scenario for successfully doing Safety Differently.
Stop Blaming: Create a restorative just culture
This book tells you how to respond restoratively. It lays out how to bend your response away from rules and violations and consequences. And to stay away from flow-chart just cultures that supposedly try to match shades of culpability with suitable sanctions. Instead, it invites you to ask what the impacts are of the incident. And what needs to be done to fix those impacts. And whose obligation is it to go do that.
Random Noise: Measuring Your Company's Safety Performance
In the realm of safety management, this book embarks on a profound exploration of how the political economy was reshaped in the last two decades. Much like privatization, deregulation, and financialization altered the economic landscape, this narrative unveils how safety management has been affected by the intertwined dynamics of asset underinvestment, privatization, self-regulation, workplace flexibilization, and market-driven policies.
- Safety: From outcome to capacity
- When the work done is not as you imagined: Do learning teams
- When things go wrong: Do investigations differently
- When there is too much compliance: Declutter your safety bureaucracy
- When your safety people are dejected: Empower them differently
- When you need to help your leaders succeed
Do Safety Differently is a discussion between two friends on what they have learned by watching organizations around the world change the way they do work. Do Safety differently is an applied discussion, a practical discussion, that will cause the reader to think about the strategies and tactics they will need to ensure the best possible scenario for successfully doing Safety Differently.