tag:blogger.com,1999:blog-9932612Fri, 13 Sep 2024 10:52:41 +0000root cause analysislatent cause analysisFailsafe Networkc. robert nelmswhy treeBlamePainc.robert nelmsAccountabilityCulture ChangeDisillusionmentGo BagGo BoxIncLCAROOTSevidencefault treeincident investigation trainingintrospectionmother source1 technique33 Ps4 significant problems with root cause analysis5911AssumptionsAttitudesBeliefsBob NelmsCSICanadianDomino AnalogyEnlightenmentEvidence GatheringEvidneceFamily ProblemGo ConceptIllusionInc.Latent Cause ExperienceLatent CausesLedcor ContractorsLitmus TestMonty GillardNTSBOswald ChambersRCARiskRob StathamSafetyScott RentonSuccess and FailureTerrorismThe Merry-Go-RoundTom StylesWisdomare you kidding yourselfaristotlebackhoebaconbiasblame viruscause mapschronic failureclean languagecomprehensive-all inclusivecouragedarknessdavid grovediscoverydominoseither-orenergyfailurefield safety advisorhumeinvestigative methodologyjessica nelms halljohn hobbesjohn lockekahlil gibranlatent cause analysis templatelatent cause analysis traininglatent cause mentalitylightlofty goalslogic treemalcolm muggeridgemarcus aureliusmiss utilityopen mother sourcepatternpersonal strugglephysical human and latent causespick listspleasureproblem solvingprofound learningpunishmentpurposereportsroot cause analysis templateroot cause analysis trainingroot cause trainingrural power failuresatellite antennaesewer linesharon smallsigmund freudspinozasporadic failurestand-by generatorstandby generatorsubstancesyntopiconthanksgivingthe Pickle Analogythings that go wrongthought processthought-provokingtolstoytriggering situationvaluing the intangiblewestern thoughtwhat you can learn from things that go wrongwhy do things go wrongwhy things existwhy things go wrongyahoo groupyou have to feed the beastzero-based root cause analysisA Collection of Thoughts about Latent and Root Cause Analysis per C. Robert Nelms at Failsafe Network, developer of The Latent Cause Experience, the Maxi-RCA, Midi-RCA, Mini-RCA, WHY Trees. Extensive RCA Training and Consulting are available through Failsafe.http://failsafe-network.blogspot.com/noreply@blogger.com (C. Robert Nelms)Blogger49125tag:blogger.com,1999:blog-9932612.post-2971662516613111765Fri, 24 Mar 2017 14:17:00 +00002017-03-24T10:17:36.573-04:00c.robert nelmsFailsafe Networklofty goalsproblem solvingroot cause analysis I have recently wondered if I'm a bit off my rocker.   Seriously. Either everyone else is missing something HUGE, or I'm the one that's living in an unreal world.   The subject of my wondering is "why do things go wrong."  I'm not sure anyone else wonders about this -- seriously wonders.   Why, in our earthly existence, do things go wrong? I'm increasinghttp://failsafe-network.blogspot.com/2017/03/maybe-im-nuts.htmlnoreply@blogger.com (C. Robert Nelms)1tag:blogger.com,1999:blog-9932612.post-448422477683421739Mon, 06 Mar 2017 14:26:00 +00002017-03-06T09:26:24.618-05:00 One of the most life-changing experiences I’ve ever had was while working at Morton Thiokol in the winter of 1986.  I was working there as a root cause analysis consultant when the Challenger exploded and was there while the incident was being investigated.   Because I was there, I suppose, I became more engrossed than most people in the causes of the event. This one event http://failsafe-network.blogspot.com/2017/03/its-not-our-systems-its-ourselves.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-3415430844508910215Tue, 21 Feb 2017 13:36:00 +00002017-02-21T08:37:26.691-05:00AccountabilityBlamec. robert nelmsFailsafe Networkintrospectionlatent cause analysisroot cause analysis IntroSpect -- an Important Concept for a People in Crisis I have been looking at things that go wrong for almost all of my adult life, and I have been drawn deeper and deeper into this fascinating field almost daily. Looking back, however, I think the most significant thing I've learned as I've confronted the many issues surrounding the "failures" of our lives is the need for: http://failsafe-network.blogspot.com/2017/02/introspect-important-concept-for-people.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-6623589179685772581Mon, 13 Feb 2017 14:52:00 +00002017-02-13T09:52:03.936-05:00  You know, NATURE is all around us and is obviously quite fascinating when you think about it.  As I look outside my window, for example, I see all kinds of things that BEHAVE according to their nature.  How about all those trees, with the pollen blowing wildly off the new growth at this time of year.  Clouds behave in a certain way also.  So do insects.  http://failsafe-network.blogspot.com/2017/02/youknow-nature-is-all-around-us-and-is.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-2677248014564292011Tue, 07 Feb 2017 18:59:00 +00002017-02-07T13:59:15.688-05:00c. robert nelmsFailsafe NetworkFamily ProblemInc.latent cause analysisroot cause analysis I wish we would have thought of something different to call our approach to learning from things that go wrong, because Latent Cause Analysis sounds like what one might find when looking for "latent organizational weaknesses," and the two would not be more different. Let me tell you a short story to help you understand its essence. A family was eating dinner together. It was Friday http://failsafe-network.blogspot.com/2017/02/latent-cause-analysis-not-what-you.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-2018234882706180449Mon, 23 Jan 2017 13:23:00 +00002017-01-23T08:23:51.835-05:00c. robert nelmsFailsafe NetworkIncRiskSafetyThe Merry-Go-Round I don’t know about you, but I have mixed memories of merry-go-rounds. I remember my first ride, when my dad took me to the county fair and put me on one of those HUGE horses.  When the MGR started, I totally freaked out.  I cried, I wanted off.  Why did my daddy do that to me? A year passed.  Time for the next county fair.  When my dad took me to the http://failsafe-network.blogspot.com/2017/01/we-are-all-on-merry-go-round.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-5691022556089583113Thu, 19 Jan 2017 18:22:00 +00002017-01-19T13:22:45.691-05:00 The following text is a personalization of a video that was created by my daughter, Jessica that can be seen at:   https://www.youtube.com/watch?v=MSNav9bRL-M&list=PLr_mplrFRmFvmxjNJcr6v5knPym9vGW9d&index=3&t=5s I used to love to go jogging. There was something about being in the open air that freed me.  I loved the feeling of my feet hitting  the ground. &http://failsafe-network.blogspot.com/2017/01/i-used-to-love-to-go-jogging.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-3784646476008591945Tue, 03 Jan 2017 16:23:00 +00002017-01-16T08:26:28.779-05:00 In my last article, I appeared to have SHOCKED some people by suggesting everything that happens TODAY is caused by people that came before us, which might have led you to think that I was saying we are not responsible for anything – that we are merely victims of the past. Well, in a way it's true that we are all victims of the past.  But it's also true that we all do things in http://failsafe-network.blogspot.com/2017/01/in-mylast-article-i-appeared-to-have.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-6986729203115477508Mon, 19 Dec 2016 21:32:00 +00002016-12-19T16:32:53.047-05:00Accountabilityc. robert nelmsDomino AnalogyFailsafe NetworkIncroot cause analysis I'd like to discuss one of my favorite analogies – the DOMINO analogy.  Actually, this is MORE than just an analogy.  Analogies are, after all, a COMPARISON between two things to help explain or clarify a thought.  But dominos are MORE than an analogy, or comparison.  They are the ACTUAL THING ITSELF.  Let me explain. Obviously, if line up all the dominos inhttp://failsafe-network.blogspot.com/2016/12/a-truth-demonstrated-by-domino-analogy.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-8157278869706599649Tue, 13 Dec 2016 19:31:00 +00002016-12-13T14:31:35.966-05:00911c. robert nelmsFailsafe NetworkLCARCATerrorism September 11, 2001 was obviously a day that most of the world will never forget. I grew up in New Jersey and spent a lot of time in NYC.  My father worked there.  My brother still works there.  I’ve eaten with my family on top of the world trade center in the Windows of the World restaurant. On September 11, 2001, however, I had already moved into our mountain house in http://failsafe-network.blogspot.com/2016/12/thoughts-about-september-11-2001.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-4530518447747658930Fri, 18 Nov 2016 19:22:00 +00002016-11-18T14:22:24.768-05:00c. robert nelmsCulture ChangeFailsafe Networklatent cause analysisRob Stathamroot cause analysisthe Pickle Analogy A few years ago I was working with an affiliate whose name was Rob Statham (www.goosebear.com).  Rob is a master at creating analogies.  My favorite of his is one about pickle juice. He said something like: People are like cucumbers who have been immersed in pickle juice.  No matter where a person lives, no matter what that person does, s/he is being influenced by the picklehttp://failsafe-network.blogspot.com/2016/11/the-pickle-juice-analogy.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-74887488986724599Tue, 24 May 2016 12:38:00 +00002016-06-01T08:48:30.997-04:00c. robert nelmsCulture ChangeFailsafe Networkroot cause analysisWelcome to my FIRST Video-Blog (VBLOG)! I will be doing my best to produce one of these VBLOGS per week.  I'll do my best to keep each one about 3 to 4 minutes in duration.  You can either look at the video, or simply read the text in this blog article. Please let me know what you think! Some say that culture has nothing to do with things that go wrong.  We say that is has http://failsafe-network.blogspot.com/2016/05/first-video-blog-root-cause-analysis.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-699109088259429042Sat, 09 Jan 2016 14:23:00 +00002016-01-11T08:20:22.894-05:00c. robert nelmsenergyFailsafe Networkpatternpurposeroot cause analysissubstancewhy do things go wrong Why Do Problems Exist -- Conclusions Part 3 of a 3 part series exploring philosophical and religious thought about why problems exist. In the first article of this series, I explored what the great Western thinkers have written about "the causes of things in general."  In the second article, I explored what these thinkers have said about "things that go http://failsafe-network.blogspot.com/2016/01/why-do-problems-exist-part-3.htmlnoreply@blogger.com (C. Robert Nelms)2tag:blogger.com,1999:blog-9932612.post-4473158347762455155Thu, 03 Dec 2015 22:47:00 +00002015-12-03T17:47:21.945-05:00c.robert nelmsFailsafe Networkfailurejohn hobbesjohn lockemarcus aureliusPainpleasuresigmund freudsyntopiconwestern thought Failure? Part 2 of a 3 part series exploring Western thought about why things go wrong. In the last article, I explored what the great Western thinkers have written about “the causes of things in general.”  A good summary of that article is that there is a fixed order of causation of all that exists:  1) final cause; 2) efficient cause; 3) material cause; and 4) formal http://failsafe-network.blogspot.com/2015/12/why-do-problems-exist-part-2.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-215417071601718986Mon, 02 Nov 2015 14:03:00 +00002015-11-02T09:04:45.027-05:00aristotlebaconc. robert nelmsdominosFailsafe Networkhumespinozatolstoywhy things existwhy things go wrong Why Do Things Exist Part 1 of a 3 part series exploring philosophical and religious thought about why problems exist. The impulse to seek causes is innate in the soul of man -- Leo Tolstoy Isn’t it interesting to think about how it all got started?  When I say “all, I mean “all.”  Everything you can imagine -- all the physical things that you can see around you  -http://failsafe-network.blogspot.com/2015/11/why-do-problems-exist-part-1.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-1709707847866962081Wed, 16 Sep 2015 13:07:00 +00002015-09-29T07:52:11.373-04:00c.robert nelmsFailsafe Networkinvestigative methodologyjessica nelms halllatent cause analysisroot cause analysisvaluing the intangible The Value of the Intangible A few months ago, I wrote briefly about a conversation with a client, where he suggested that Failsafe had better focus on helping its clients "feed the beast" or we'll start losing our clients.  That conversation happened almost a year ago, and it's been on my mind ever since. In essence, he was talking about focusing on "the measurable bottom-line" -- http://failsafe-network.blogspot.com/2015/09/the-value-of-intangible.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-5881729302986801241Wed, 19 Aug 2015 09:56:00 +00002015-08-19T05:56:41.961-04:00DisillusionmentEnlightenmentFailsafe NetworkIllusionOswald ChambersPainroot cause analysisWisdom On July 20, 2015 I read something startled me.   Disillusionment means having no more misconceptions, false impressions, and false judgments in life -- it means being free from deceptions….  Oswald Chambers I don’t know about you, but whenever I’ve heard that word in the past, I’ve always associated it with something negative -- even painful.  When I have said “I’ve been http://failsafe-network.blogspot.com/2015/08/disillusionment-path-to-wisdom.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-2475200068858685074Thu, 09 Jul 2015 13:42:00 +00002015-07-19T22:00:58.928-04:00backhoeintrospectionlatent cause analysismiss utilityroot cause analysissatellite antennaesewer linestandby generatorthought processtriggering situationIn my last blog post, I told you a story about my DELAYED and almost TOO-LATE decision to install a standby generator for our mountain home.  My wife had experienced a serious loss of power in sub-zero weather that was life-threatening.  We had similar experiences in the past, but never with such potentially disastrous consequences. In trying to "practice what I preach," I http://failsafe-network.blogspot.com/2015/07/what-is-it-about-way-i-am-that.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-4248447222905660686Mon, 22 Jun 2015 17:56:00 +00002015-08-21T09:18:32.179-04:00AssumptionsAttitudesBeliefsLatent Causesroot cause analysisrural power failurestand-by generatorAs many of you know, I live in the mountains of Virginia. Although our "Montebello" is beautiful in all seasons, and although it has taught my wife and I things we would never have learned while living in the city, there has been a definite "cost" of living in our remoteness. One of these costs are power outages.  We're on the fringes of the public power system, and often loose http://failsafe-network.blogspot.com/2015/06/this-winters-learnings-part-1.htmlnoreply@blogger.com (C. Robert Nelms)0tag:blogger.com,1999:blog-9932612.post-5009569932746567579Mon, 06 Apr 2015 17:38:00 +00002015-08-21T09:19:57.699-04:00BlameBob NelmsFailsafe Networkfield safety advisorlatent cause analysisMonty Gillardroot cause analysis Before I share the text of this blog, allow me to introduce "Monty Gillard."  Monty is one of Failsafe's Apprentices, rapidly on track to becoming a full-fledged Affiliate.  I hope you take time to read what Monty has to say.  It's more lengthy than our typical blog articles, but I think what he says will resonate within most of you.  Whatever you do, don't http://failsafe-network.blogspot.com/2015/04/about-one-year-ago-my-life-changed.htmlnoreply@blogger.com (C. Robert Nelms)2tag:blogger.com,1999:blog-9932612.post-1608028655586529715Wed, 04 Mar 2015 18:36:00 +00002015-08-21T09:20:33.228-04:00couragelatent cause analysisroot cause analysisyou have to feed the beast You have to feed the beast! As I was eating dinner with a client a few months ago, I asked him to think about how we (Failsafe) could be of better service to our clients.  I encouraged him to take time to think about his answer and to be in touch with me at a later date.  But immediately, he said “I don’t need to think about it!  Bob, if you want to be of better servicehttp://failsafe-network.blogspot.com/2015/03/you-have-to-feed-beast.htmlnoreply@blogger.com (C. Robert Nelms)5tag:blogger.com,1999:blog-9932612.post-5033467193240149615Tue, 20 Jan 2015 18:27:00 +00002015-08-21T09:20:58.189-04:00are you kidding yourselfCanadianlatent cause analysisLedcor Contractorsroot cause analysisScott RentonSuccess and Failurethought-provoking Are We Kidding Ourselves? I have been privileged to have met many thought-provoking people while jaunting around the globe sharing “The Latent Cause Experience.”  One of these people is Scott Renton, a Canadian who currently works for Ledcor Contractors in Fort McKay, Alberta.  During one of our several discussions during the class, I suggested that he put his thoughts in writing. &http://failsafe-network.blogspot.com/2015/01/are-you-kidding-yourself.htmlnoreply@blogger.com (C. Robert Nelms)12tag:blogger.com,1999:blog-9932612.post-5916411605968243943Mon, 22 Dec 2014 18:28:00 +00002015-08-21T09:21:51.600-04:00darknessDisillusionmentlatent cause analysislightroot cause analysis Conceived in darkness, and then developed in a womb which was also dark, our birth must have brought an explosion of light into our consciousness.  Come to think of it, I suppose there was a point in my life when I had no consciousness whatsoever -- another form of darkness. Light.  What is it?  Where does it come from?  Where does it go?  What does it “want?” "http://failsafe-network.blogspot.com/2014/12/let-there-be-light.htmlnoreply@blogger.com (C. Robert Nelms)3tag:blogger.com,1999:blog-9932612.post-4687482798312172581Thu, 04 Dec 2014 18:29:00 +00002015-08-21T09:22:26.111-04:00thanksgiving Thanksgiving Thursday, November 24th, 1960.    I was 13 years old.  My aunt, uncle and cousins were visiting for the Holiday.  Excitement was in the air.  The “male children” had to sleep in an unfinished and unheated attic to make room for adult guests.  We slept in army cots, with sleeping bags, and plotted practical jokes to play on my youngest cousin who just http://failsafe-network.blogspot.com/2014/12/remembering-thanksgiving.htmlnoreply@blogger.com (C. Robert Nelms)1tag:blogger.com,1999:blog-9932612.post-2298472263189447451Thu, 13 Nov 2014 18:29:00 +00002015-08-21T09:23:46.454-04:00Blameincident investigation traininglatent cause analysis trainingpunishmentroot cause analysis training A dialogue in a recent Latent Cause Experience seminar will have me thinking for a long time.  We were discussing two of the principles of Latent Cause Analysis:   When something goes wrong, no-one is allowed to blame anyone.  Instead, all involved are required to look at themselves. I had thought that this principle would encourage the ultimate in personal http://failsafe-network.blogspot.com/2014/11/i-want-to-hurt-myself.htmlnoreply@blogger.com (C. Robert Nelms)18