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Implicitly recognising that the potential for an accident is always present, the first approach is

based on the fundamental belief that protecting an individual from the potential for harm, either
by statutory means or via physical barriers, is the best way to proceed. The second approach is
predicated on the fundamental belief that, if the individual possesses the relevant knowledge
and skills, accidents will be avoided.
Secara implisit mengakui bahwa potensi kecelakaan selalu hadir, pendekatan pertama
didasarkan pada keyakinan fundamental yang melindungi individu dari potensi bahaya, baik
dengan cara hukum atau melalui hambatan fisik, adalah cara terbaik untuk melanjutkan.
Pendekatan kedua didasarkan pada keyakinan mendasar yang, jika individu memiliki
pengetahuan dan keterampilan yang relevan, kecelakaan akan dihindari.
Traditionally, attempts to improve safety in the workplace have addressed these issues via
legislation, engineering solutions, safety campaigns or safety training. However, as a result of
inquiries investigating large-scale disasters such as Chernobyl, the Kings Cross fire, Piper
Alpha, Clapham Junction, etc., more recent moves to improve workplace safety have focused
on the concept of an identifiable safety culture. Whilst incorporating all the traditional routes
to improve safety, the concept of safety culture goes much further by focusing on the presence
of good quality safety management control systems.
Secara tradisional, upaya untuk meningkatkan keselamatan di tempat kerja telah membahas
masalah ini melalui undang-undang, solusi rekayasa, kampanye keselamatan atau pelatihan
keselamatan. Namun, sebagai hasil dari pertanyaan menyelidiki bencana skala besar seperti
Chernobyl, api Kings Cross, Piper Alpha, Clapham Junction, dll, bergerak lebih baru untuk
meningkatkan keselamatan kerja telah difokuskan pada konsep budaya keselamatan
diidentifikasi. Sementara menggabungkan semua rute tradisional untuk meningkatkan
keselamatan, konsep budaya keselamatan berjalan lebih jauh dengan berfokus pada kehadiran
sistem pengendalian manajemen keselamatan kualitas yang baik.
Although designers, engineers and the statutory bodies addressed many of the unsafe
conditions by guarding against or legislating for the control of technological hazards, Heinrich
thought that unsafe acts were caused by poor attitudes, a lack of knowledge and skill, physical
unsuitability and an unsafe environment. This view led to much training and propaganda in
attempts to change attitudes, the effectiveness of which was, and still is, questionable. Heinrich
summarised his theory in terms of ten axioms of industrial safety that at the time were
considered to be somewhat revolutionary, with the esult that they tended to be ignored.
Meskipun desainer, insinyur dan badan hukum ditangani banyak kondisi yang tidak aman
dengan menjaga terhadap atau legislatif untuk mengontrol bahaya teknologi, Heinrich
berpikir bahwa tindakan tidak aman disebabkan oleh sikap yang buruk, kurangnya
pengetahuan dan keterampilan, ketidaksesuaian fisik dan lingkungan yang tidak aman .
Pandangan ini menyebabkan banyak pelatihan dan propaganda dalam upaya untuk mengubah
sikap, efektivitas dari yang, dan masih adalah, dipertanyakan. Heinrich diringkas teori dalam
hal sepuluh aksioma keselamatan industri yang pada waktu itu dianggap agak revolusioner,
dengan hasil bahwa mereka cenderung diabaikan.
Although some were relatively simplistic, the underlying rationale has become influential in
current safety management practices. For example, axiom 7 which states `... the methods of
most value in accident prevention are analogous with the methods for the control of quality,
cost and quantity of production, is not too dissimilar in intent to the Total Quality Management
(TQM) techniques encompassed by, and advocated in, the current MHSWR 1992.
Meskipun beberapa relatif sederhana, alasan yang mendasari telah menjadi berpengaruh dalam
praktek manajemen keselamatan saat ini. Misalnya, aksioma 7 yang menyatakan `... metode
yang paling nilai dalam pencegahan kecelakaan adalah analog dengan metode untuk kontrol
kualitas, biaya dan kuantitas produksi ', tidak terlalu berbeda dalam maksud dengan Total
Quality Management (TQM ) teknik dicakup oleh, dan menganjurkan in, MHSWR saat 1992.
Analogous to Adams tactical errors, tokens also divide into condition tokens which comprise
the situational (man-machine interface, workload, etc.) or psychological (attention, attitudes,
motivation, etc.) precursors of unsafe acts; and unsafe act tokens that are further classified on
the basis of whether they are caused by:
slips and lapses (skill-based errors)
mistakes (rule-based and/or knowledge-based errors)
volitions (deliberate infringements of safe working practices).
By its very nature an organisational matrix design requires the use of multi-disciplinary work
teams where members pool their different knowledge and expertise. Consequently, co-
operation and communication between functional departments is significantly improved in a
way that allows for much greater control of risks (for example, the impact on safety of a
particular course of action in many operational areas can be assessed prior to implementation).
In relation to safety, the net effect of being overly concerned about controlling people is that
knowledge of near misses and dangerous practices is kept suppressed as people try to avoid
placing themselves in the line of fire. Because of a fear of discipline or sanctions, there is once
again a danger that people will engage in `unauthorised problem-solving which could result
in someone being injured, maimed or killed.
Problem-solving tools. One type of problem-solving tool, decision trees, begin with the actual
problem (e.g. how do we synthesise and align all of our systems to produce a positive safety
culture?) and are used by problem solvers to work their way directly towards the desired end-
(i.e. a positive safety culture) by specifying the various steps to be taken. Decision trees,
work on the assumption that the problem solver has sufficient in-depth knowledge and
understanding of the problem to solve it. In other words they require expert knowledge. In
instances, however, this expert knowledge is not readily available. Therefore, a different
will be required. Ishikawa diagrams were originally developed for use in TQM to identify the
fundamental root causes of problems, the relative importance of each of these causes and the
potential relationships between each of them. Illustrated in Figure 2.1: Ishikawa Diagram, the
diagram begins on the right hand side with the issue(s) facing the problem solver, such as the
senior management team. The major factors contributing to the problem are then identified and
labelled as causes, each of which can be further broken down into sub causes, and so on, until
the possible causes have been identified. The five major factors commonly considered are:
manpower (e.g. staffing, management styles, competences, communications, training, etc.)
materials (e.g. economic resources, corporate objectives, etc.)
machinery (e.g. plant, equipment, computers, vehicles, etc.)
methods (work practices, health and safety initiatives, risk assessments, etc.)
measurement (safety audits, accident investigations, safety training results, etc.).
As these diagrams work backwards from the specified problem, they are ideal for converting
strategic plans into action plans simply because all the factors contributing to a problem can
easily be identified. Seemingly simple, when used in the right way they are deceptively
powerful tools to aid decision-making. Although they do not require the use of expert
knowledge, analyses
of the causes are usually best conducted in teams, since most of the activities or factors
contributing to each of the causes and sub causes involve groups of people. In the context of
aligning and synthesising all of the organisations systems to develop a positive safety culture,
may prove useful to use one of these diagrams to visually represent each operational area or
organisational system (e.g. safety, quality, production, support functions, etc.). This enables
to be compared with each other to identify where the commonalities and differences between
various systems reside. Having identified the commonalities, the senior management team can
give due consideration as to whether or not it is possible to integrate any of the systems
bearing in mind the number of differences and their relative importance. If it is possible, the
management team should then consider whether or not it is desirable in light of their particular
An employees competence exerts an enormous effect on an organisations health and safety
performance. Competence is defined as `a persons ability to perform a task. Because task
performance is dependent upon peoples levels of knowledge and skill, motivation and physical
capabilities, it is important to examine each of these to determine if people are actually
to undertake the task in hand. Assumptions that someone is competent to undertake a task can
have catastrophic effects, as indicated by the case of a time served gas fitter who failed to fit a
to a heater. Two people died from fumes because the fitter did not believe a flue was available
necessary for the type of heater fitted. Examinations of a persons competence should at the
least focus on their:
levels of knowledge and skills as demonstrated by the possession of appropriate qualifications
for their job (i.e. NVQs or SVQs, City & Guilds, Industrial Training Boards Certificates,
designatory letters from a professional institution, etc.)
levels of motivation (this can be determined by using the job design questionnaire presented
in Figure 3.4)
physical attributes to ensure that people are not handicapped in any way to do their job (e.g.
good levels of hearing, good colour discrimination, appropriate and sufficient strength, height,
etc.). Assessing the levels of knowledge and skill for those employees who do not possess
formal qualifi-cations could be achieved by giving them work sample tests. This entails their
demonstrating their proficiency and competence on a range of tasks that are representative of
their jobs and the
required performance standards. Local Skillcentres run by the Manpower Services
tend to have a range of work sample tests available. Alternatively, registered Chartered
Occupational Psychologists can devise appropriate tests for any type of job (managerial,
manual or clerical). They can also determine peoples levels of motivation. Any discrepancies
identified in a persons competence would indicate an immediate training need. Any
discrepancies in peoples levels of motivation may require their jobs to be restructured, and
any discrepancies between the physical demands of the job and a persons physical attributes
would demand either a restructuring of the job or the person being placed in a job that is more
closely aligned with their physical attributes.
The accident reports, for example, also illustrate the difference between data and information.
While data consists of detailed facts and figures, information is more about knowledge
extracted from the facts. In a sense, therefore, any management information system can be
viewed as a type of `processing factory that takes raw data and transforms it into a product
called information which is subsequently used to communicate `knowledge between various
organisational functions and hierarchical levels. It follows from this that knowledge is also a
means of clarification to reduce uncertainty and increase control. For example, knowing the
specific outcomes of a pilot safety improvement activity (for example, implementing a
behavioural safety initiative) will enable a manager to evaluate its effectiveness, thus clarifying
his or her future goals (i.e. whether to continue, to adapt, or to discontinue the behavioural
safety initiative) and the means to achieve them.
Accordingly, the ability to instantly extract knowledge from an information system and
communicate it widely will, in many cases, determine the overall effectiveness of the
organisations efforts to achieve its goals. Information, however, does not just suddenly
become available out of `thin air. Its availability is generally dependent upon a formally
organised means of obtaining, storing, extracting and communicating information or
knowledge. Such systems may be computerised, manual or partially both. Nonetheless, the
effectiveness and efficiency of any management information system is usually judged by its
ability to assemble data in a format required by the user, so that the right information can be
extracted at the right time.

Does improving safety culture affect outcomes

relationship between safety climate, perceived colleagues safety knowledge and behaviour,
and an individuals own safety behaviours and performance. Safety climate and perceived
knowledge and behaviour of colleagues both impacted on safety behaviour. The more positive
the safety climate, the stronger the effect of perceptions about colleagues was on peoples own
safety behaviour.91
hubungan antara iklim keselamatan, pengetahuan keselamatan rekan dirasakan dan perilaku,
dan perilaku keselamatan individu sendiri dan kinerja. Iklim keselamatan dan pengetahuan
yang dirasakan dan perilaku rekan baik berdampak pada perilaku keselamatan. Semakin positif
iklim keamanan, semakin kuat efek persepsi tentang rekan-rekan adalah pada perilaku
keselamatan masyarakat sendiri.
Jiang L, Yu G, Li Y, Li F. Perceived colleagues safety knowledge/ behavior and safety
performance: safety climate as a moderator in a multilevel study. Accid Anal Prev 2010;

One can apply Human factors knowledge to wherever humans work. In health care, human
factors knowledge can help design processes that make it easier for doctors and nurses to do
the job right. Human factors applications are highly relevant to patient safety because
embedded in the discipline of human factors engineering are the basic sciences of safety.
Human factors can show us how to make sure we use safe prescribing practices, communicate
well in teams and hand over information to other health-care professionals. These tasks, once
thought to be basic, have become quite complicated as a result of the increasing complexity of
health-care services and systems. Much of health care is dependent on the humansthe doctors
and nursesproviding the care. Human factors experts believe that mistakes can be reduced
by focusing on the health-care providers and studying how they interact with and are part of
the environment. Human factors can make it easier for health-care providers to care for
Improving safety culture through the health and safety organization:
A case study
Kent J. Nielsen

Baseline data showed that the company performed very poorly safety-wise and revealed a lack
of management commitment to safety. Safety in general was not an important issue for
management or workers, who had productivity as the dominant top priority. There
were no objectives for safety performance or formal safety policies, nor were there any
systematic preventive efforts. This was in part due to a very inefficient and passive health and
safety organization that had no knowledge of actual safety performance and did not even
resolve identified safety issues. For instance, the company had compiled 19 unresolved
enforcement notices from the Work Environment Authorities over the last few years and was
regularly penalized for violations of the work environment law. Likewise an audit by an
external health and safety advisor, just prior to baseline, documented 110
instances of insufficient or lacking safety signposting

Pengetahuan dan ketrampilan sangat diperlukan untuk pelaksanaan tugas keselamatan dan
kesehatan kerja (task safety performance). Pengetahuan dan ketrampilan terbentuk dari
pelatihan dan proses pembelajaran melalui umpan balik atau peristiwa kecelakaan secara
praktis, yang disebut dengan intensi atau niat unutk mengikuti prosedur keselamatan dan
kesehatan kerja.
Menurut Neal dan Griffin (2000), pengetahuan menjadi moderator antara iklim keselamatan
dan kesehatan kerja dan performa keselamatan dan kesehatan kerja (Sholihah, 2014).

Npic paper
The IAEA definition of safety culture reads: Safety culture is that assembly of
characteristics and attitudes in organizational and individuals which establishes that, as
an overriding priority, nuclear plant safety issues receive the attention warranted by their
significance. Further explanations stress the importance of the following components: Individual
awareness; Knowledge and competence; Commitment; Motivation; Supervision;
Responsibility. Two components are furthermore separated, of which the first is the safety
management framework within the organization and the second is the attitude of staff at
all levels in responding to and benefiting from the framework.