Written by:  Brett Read, Rod Ritchie
Safety Leaders Group
August, 2015

Executive Summary

There is something missing in how we are currently trying to achieve safety performance improvement in the workplace.  At an industry level this has led to a plateauing in safety over the last 5 to 6 years.

Significant improvements in safety have been made since the 1980’s as a result of engineering and management developments.  The improvements mean that when the established systems and procedures are applied as intended our workplaces are safer than they have ever been.

We are now seeing industry statistics that tell us that as many as 90% of incidents that occur are happening because people are not implementing and following established systems and procedures properly.  The problem here is not one of training and/or complacency; it has to do with commitment.  The solution to a lack of commitment is a leadership challenge not a management one.

But there are no commonly understood and used measures of safety leadership – the 4th Dimension of Safety Performance.  If we are to continue to improve safety performance, this needs to change.  We need tools to measure and develop the effectiveness of safety leadership at all levels in the workplace.

Safety Leaders Group has developed a framework for effective safety leadership called 4D Safety? that companies can use as lead indicators to proactively identify and mitigate current gaps in safety leadership.

Safety Leadership is Not Safety Management

There is a gap in the way many businesses currently approach safety performance improvement.

Note that we did not say “the way many businesses currently manage safety performance improvement”.

There is a reason for this and that is that our over focus on management is at the heart of the problem.  In the management world we manage and track 3 Dimensions in our business.  These Dimensions are:

1. Cost
2. Schedule and/or production (Time /Output)
3. Systems and processes

It is essential that we get these 3 Dimensions right as they are enablers of performance.  If any of these Dimensions are not adequately planned or managed then performance will suffer or possibly fail all together.

However, what seems to not be understood by many business managers is that getting these 3 Dimensions right is not enough, these 3 Dimensions are merely enablers of performance; they create compliance with a system not commitment to a value.  We need to move beyond compliance to focus on a commitment to drive and create safety performance.  That requires us to move beyond the realms of management and into the world of leadership.

In every successful company that we have worked for this 4th dimension, what we call safety leadership was present and was being done very effectively.  Note that when we talk about a successful company we mean a company that performs in a professional manner, is cost effective and safe.

When you get this 4th Dimension working in harmony with the other 3 Dimensions you get great operational performance.  The first 3 Dimensions are about management and creating a safe workplace.  There is no getting away from the fact that a business that is not managed well will fail to perform.  This is why they must be understood for what they are: enablers of performance.  To restate this point, fail in the planning and management of the enablers and the business will fail.

However, an over reliance on management – an overly complicated and burdensome focus on the first 3 Dimensions actually restricts performance.

This is because performance in business is delivered by people, and people need to be led not managed.  This is where the conflict arises.  We need to lead our people; the 4th dimension of performance.  In this regard, we are talking about two things: firstly the distinction between good management and bureaucratic managerialism and secondly achieving balance between good management and great leadership.

We are now seeing industry statistics that tell us that as many as 90% of incidents that occur are happening because people are not implementing and following established systems and procedures properly.  The problem here is not one of training and complacency; it has to do with commitment.  The solution to a lack of commitment is a leadership challenge not a management one.

Too many businesses are getting this balance wrong.  Consider in your business how much time is spent planning, implementing, doing and tracking things that are part of the first 3 Dimensions, compared to how much time is spent on the 4th dimension – Safety Leadership.  Does your company even have measures of safety leadership and are they tracked?

So what are we missing?

Why does this gap exist?  To understand the reasons for this we need to shift our focus, we need to not label things as wrong, and instead we need to focus on what’s missing.  We need to understand the gaps in our current thinking and therefore our approach.

“Our acts can be no wiser than our thoughts, our thinking can be no wiser than our understanding”

George Clason,
The Richest Man in Babylon, 1926

From our 20 years of researching leadership and performance and applying that understanding with our clients we have come to understand the gaps to be multidimensional and this in turn led us to the framing of the 4D Safety? approach.

The gaps in current thinking and lack of understanding of what truly drives performance has led to an imbalance between leadership and management.

Some of what we have observed as missing is:

1. Our universities are almost solely focused on the world of management. MBA’s have a heavy imbalance towards the first 3 Dimensions and pay little or no attention to measures of effective leadership or safety leadership.
2. Companies that are not run by MBA graduates are headed up by engineers and managers with science degrees. This leads them to feel comfortable in the left brained realms of the first 3 Dimensions while for many the 4th dimension seems to be a complete challenge and therefore avoided.
3. Being effective in all 4 Dimensions is essential. As a consequence of the gaps in points 1 and 2 we lack an integral approach to safety performance and effectively to business performance in general.

So how much difference does knowing something make?

These gaps are often identified by individuals in the workplace who are not listening to and are very well understood by the experts who investigate Major Accident Events (MAE’s) in industry and the root causes are almost always correctly linked back to an imbalance between management and leadership.  The question to be answered is – why are these calls for change not being listened to?

In the NASA Challenger disaster it was in fact two very insightful engineers who were recommending caution and a delay to the launch, but they were overruled by senior managers.  This cost the lives of seven astronauts. 1

In the Piper Alpha oil rig explosion in the North Sea the company had created such a heavy reliance on the unquestioning application of the 3D management approach that any leadership initiative was manifestly missing.  Workers on the connected claymore oil rig did not feel empowered to shut down the flow of oil to Piper Alpha even though they could see that Piper Alpha had suffered catastrophic explosions and was engulfed in flames.  The workers on Piper Alpha also rigidly stuck to their procedures and waited in the accommodation for rescue which because of the continued flow of oil was impossible.  167 workers died as a result. 2

Sadly, one of the worst examples of repeated company myopia in terms of the difference between safety management and safety leadership is BP.  Over a 10 year period this Oil and Gas major had multiple MAE’s that in every case have been linked back to cost cutting and poor safety leadership. 3, 4, 5

1. 2000 BP Grangemouth Refinery, Scotland. Major explosion and asset damage. 
2. 2005 BP Texas City Refinery, Texas. Major explosion and asset damage, 15 fatalities and more than 170 injuries.
3. 2006 BP Pipelines Prudhoe Bay, Alaska. Major corrosion and loss of containment resulting in a huge environmental disaster.
4. 2010 BP Macondo Well, Gulf of Mexico. Major blow out on the Transocean Deepwater Horizon drilling rig.  11 fatalities, the loss of the Deepwater Horizon and the largest environmental disaster in US History.

After each MAE BP made commitments to their stakeholders that they were effectively addressing their shortcomings.  However, the recurring nature of these MAE’s in BP’s operations suggests a fundamental lack of understanding of the debilitating effect of major inconsistencies between the rhetoric of the first 3 Dimensions and observable actions in the 4th dimension.  The result has been the very sad loss of life of many BP workers and major environmental disasters in Alaska and the Gulf of Mexico.  The financial impact for BP shareholders has also been enormous. BP has incurred repeated convictions in UK and US courts, paid out tens of Billions of dollars in fines and compensation which erodes shareholder value and also damages the reputation of the industry.

It has now been five years since the Macondo blowout; hopefully BP has learned and has addressed the gaps that created these repeated disasters.

In our leadership workshops we often ask the question.  “Who knows that they would be healthier and possibly live longer if they lost 5 kilos or more in weight, please raise your hand?” The majority of hands go up.

We then ask people to put their hands down if they are effectively doing something about it right now.  The majority of people keep their hands up.  That’s how much difference knowing something makes.

What does it take to make a change?

To make an effective change requires several things.

1. An understanding and real acknowledgement that there is a need for change and the courage to make it happen.
2. A values based commitment to make that change happen. An intellectual knowledge that “I should” change isn’t enough.
3. A framework to help guide and influence decision making and actions to achieve the desired change.
4. Measurement and tracking of results to create a sustainable change.

A Framework for Influencing the 4th Dimension of Safety

The issue is that the way our system currently functions it creates safety managers not safety leaders; people who think that managing the 3D enablers of safety is enough.  Of course not everyone who comes through this system thinks like this.   There are many good leaders out there, but when we talk to them we are more frequently hearing that they are observing and experiencing a growing lack of leadership in industry.  Regulators and the companies that are employing contractors are increasingly relying on a managerial approach, resulting in more and more complex systems and audits to create a safe workplace.  We call this a “management solution to a leadership issue.” With-in Safety Leaders Group we say:

“A system or a procedure never achieved anything, it’s people being committed to implementing the system that achieves the performance needed.”

The current system is not effectively focusing on and addressing the complete picture.  Huge levels of resources are committed to measuring and monitoring the first 3 Dimensions while very little exists that allows managers to actually track and monitor the effectiveness of safety leadership in their business.  The result of this imbalance is that young engineers, supervisors and managers are being taught to focus on KPI’s that measure and reward compliance with the 3D systems, but are not taught to understand the 4th dimension, i.e. what a real commitment to safety and the appropriate safety leadership practices look like.   Then, when the gaps in their thinking and understanding result in an accident, we blame the individual instead of addressing the shortcomings in the overall approach.

What is needed is a framework that guides and influences their decision making such that we keep all four Dimensions of safety in balance.

4D Safety?

Safety Leaders Group has worked with our clients over recent years to develop an effective framework for safety leadership called 4D Safety?.  This framework addresses the gaps in safety leadership and provides both a guide to help safety leaders at all levels understand their role and where their focus should be.  4D Safety? has been designed to:

• Allow senior managers to track and monitor the safety leadership in their business. This is done through a Dashboard that tracks lead indicators of safety leadership performance at team and individual level.  This effectively enables managers to be confident that what they expect to happen is actually happening.
• The 4D Safety? tools also provide measurement and feedback to help individuals target any identified areas for development.

The interesting outcome of this journey to develop the tools and measures of performance was that we were able to optimise and shorten the leadership development and training programs that companies typically put their people through.  Previously we would deliver 3 to 5 day Supervisor Leadership or Safety Leadership Courses aimed at teaching the skills needed to be an effective leader.  We found that for many leaders this was a waste of their time and the company’s resources.  It became clear that when you provide a framework that spells out what is wanted from leaders and give them feedback on how well they are doing it, many leaders can work it out themselves and improve their leadership effectiveness on the job.  This is consistent with the principle of:

“What gets expected gets respected.”

Typically, when working with leaders there are three groups that we can identify.  The first group, which often makes up about half of the leaders either have or will develop the required skills once they know what’s expected.  The second group, typically 30-35% of leaders, will need some coaching to help them in their development. The third group 15-20% of leaders seem to struggle with either the skills or the desire to adopt the leadership practices that are required.  These leaders tend to leave the organisation or in some cases will put their hand up for a non-leadership role.

The tools that we have developed as part of the 4D Safety? framework include:

• The Safety Leadership Site Review – a review process that achieves two critical functions, firstly, to provide guidance and feedback at the individual level and secondly for managers it confirms that the expected safety leadership practices are actually happening in their work teams.
• The Safety Leadership Practices Scorecard – a self-assessed individual development tool.
• The Safety Leadership Profile – an upward feedback tool that was developed from our research of effective leadership practices in over a 1,000 work teams across three companies.
• Pre-task Safety Meeting Feedback – EARS ON 4 Safety – a work team review and development tool used to improve the effectiveness of pre-task meetings.
• STOP Work Meeting Review – a simple work team review and development tool used to ensure that lessons are learned out of a “Stop the Job” situation.
• Post Task or After Action Review – one of the reasons Special Forces perform as well as they do is that they are continually learning and tapping into the vast knowledge and experience in their teams. This tool is designed to help industry work teams create the climate needed for workplace learning.
• 4D Safety Dashboard – the dashboard enables a composite view of the safety leadership performance of a team or cohort of leaders in an organisation.

A good metaphor for how these tools work is to think of the different views of an onion when cut on different angles.  Each of these cross sections looks very different; however each of them is a valid picture of what the onion looks like from that angle.  The message is that one cross section on its own does not provide a complete understanding of the whole onion.

The 4D Safety tools are the same in that each of them provides a different cross sectional view of the team or the individual.  The power of the 4D Safety Dashboard is that it enables a composite view of all the different views.

To find out more about 4D Safety? please contact Safety Leaders Group.

About the Authors

Brett Read

Brett Read, BBus. & Grad. Cert. (Mgmt), Grad. Dip. (Survival & Rescue Management), is the Managing Director of Safety Leaders Group, Australia.  His passion is for safety performance improvement through leadership, team culture and organisational development strategies.

He has twenty years global consulting and coaching experience specializing in safety leadership and the development of high performance teams in the oil & gas, mining and construction industries.  He has pioneered new thinking and approaches in safety which has enabled clients to achieve consecutive years of Lost Time Injury (LTI) free operations. 

Brett has held leadership roles in a range of high risk workplaces and has developed a detailed understanding of what it takes to create a culture of safety in hazardous work environments.  Prior to consulting Brett had 15 years’ experience in management in the corporate sector working for multi-national Corporations and in the Australian Army where he served in the SAS Regiment as a Troop Commander and a Major.

Brett is the author of several articles and SPE conference papers and is a regular conference speaker in the areas of Safety Culture Change and Safety Leadership.

Rod Ritchie

Rod Ritchie, Petroleum Engineer, is the Director of Safety Leaders Group, New Zealand.  He is also on the Board of New Zealand Oil & Gas Limited.  Rod has 38 years of global experience as a line manager and a HSSE Executive in the Oil and Gas industry.  He has chaired the Global Society of Petroleum Engineers (SPE) Safety Sub-Committee for several years and sat on the International Association of Oil & Gas Producers (IOGP) Safety Committee. 

Rod is passionate and dedicated to HSSE in the Oil and Gas Industry and uses his vast experience to provide executive consulting in safety leadership, helping companies develop a culture with a strong HSSE bias and performance ethic.

Copyright ? Safety Leaders Group Pty Ltd 2015, all rights reserved

References

1. National Aeronautics and Space Administration (1986), “Report of the Presidential Commission on the Space Shuttle Challenger Accident”, NASA History Office, Washington D.C., 6 June 1986
   https://history.nasa.gov/rogersrep/51lcover.htm
2. The Hon. Lord Cullen, (1990)“The Public Enquiry into Piper Alpha Disaster”, The Department of Energy, Volume 1-2, Nov 1990
3. Hopkins, A. (2005) “Safety, Culture and Risk: The Organisational Causes of Disaster”, CCH
4. Hopkins, A. (2008) “Failure to Learn: The BP Texas City Refinery Disaster”, CCH/Wolters Kluwer; 1st Edition
5. US Chemical Safety and Hazard Investigation Board (2007), Investigation Report – Refinery Explosion and Fire, BP Texas City, Report No. 2005-04-I-TX, March 2007
6. SPE Conference Paper – Mumbai, January 2010. Winter, J., Owen, K., Read, B. and Ritchie, R. (2010), “How Effective Leadership Practices Deliver Safety Performance AND Operational Excellence”, Society of Petroleum Engineers, Paper No. SPE-129035-PP, January 2010