[darisg]

Αρχικό μήνυμα απο eye love scuba

αν εξαιρέσεις τα παθολογικά αίτια, νομίζω ότι αυτό είναι εντελώς λάθος. πρόκειται πάντα για συνδιασμό λαθών. αν όλοι μας σκεφτούμε τις βουτιές μας θα ανακαλύψουμε πολλά λάθη, τα συμβάντα όμως είναι σπάνια.
λάθη γίνονται συνεχεια, αλλά ο συνδιασμός τους, και δεν ξέρουμε εκ των προτέρων ποιός είναι αυτός, μπορεί να είναι μοιραίος.

The Incident Pit

..............My understanding is that the incident pit is the phenomenon that failures (equpiment failure, loss of kit, separation, etc) tend to increase the likelihood and negative consequence of subsequent failure. Failures make failures more likely and their consequences more serious. This combination of increased likelihood of failure and increased consequence of a failure creates increased risk.

I assume that the increased likelihood of a subsequent failure occurs due to increased stress and task loading caused by the previous failure(s). And that the increased negative consequence of a subsequent failure can result from loss of redundancy caused by the previous failure(s).

For example, separation may increase stress, increase task loading, impair good judgement, and make a second failure more likely. It would also result in zero redundancy if one's only source of redundancy is the team. This reduction in redundancy increases the potential negative consequence of a subsequent failure.