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702 Effective Accident Investigation
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The Systems Approach

The systems approach to understanding causation accounts for the dynamic interplay of various factors within the overall safety management system.

Assume the system needs fixing.
  • Investigators typically believe that accidents are due to defects in the safety management system.
  • The investigation's main goal is to fix the system, not to place blame.
  • If the safety management system fails to support employees, discipline is inappropriate.
  • Individual behavior is just one element of a much larger and complex system.
  • Accidents usually result from various weaknesses or flaws within the system.
  • The investigator's task is to uncover the root causes in the safety management system.
  • Preventing accidents requires improving the design and implementation of the system's structure, processes, and outcomes.
  • This mindset leads to long-term, cost-effective solutions.

Knowledge Check Choose the best answer for the question.

1-5. In the systems approach, accidents are assumed to be caused by _____.