We are primarily tasked with providing power transmission services, system services and facilitating the energy market. Our core tasks follow from our appointment as grid operator under the Dutch 'Elektriciteitswet' (E-wet) and the German 'Energiewirtschaftsgesetz' (EnWG).
TenneT has introduced a Life-Saving Rule system (LSR) consisting of six LSRs and the “FAIR Approach” in order to achieve our Safety Vision. The aim of the FAIR approach is to develop effective, long-term improvement actions that can prevent breaches of Life-Saving Rules and thus major or (potentially) fatal accidents. This is primarily achieved by modifying the “systems” in which employees work.
What is the FAIR approach?
The FAIR approach – FAIR stands for “Flowchart Analysis of Investigation Results” – is a tool which helps managers identify and categorise the underlying causes of why employees breach rules, which can be then used to derive sustainable improvement actions to enhance the system in which we work. If a SHE incident occurs involving TenneT employees or employees of (sub)contractors in which an LSR is not observed, or work was stopped to prevent a breach, the FAIR approach is to be applied by the direct manager or person responsible for the performed work.
The aim of the FAIR approach is to find out the reasons behind (potential) breaches and the context in which they occurred. Only by understanding the reasons for breaches and the situations in which they are embedded can we undertake systematic changes that will take into account the (organisational) context which evidently leads people to breach a Life-Saving Rule. As company that is keen to learn from mistakes, TenneT strives to encourage people to reflect honestly on the reasons and the context of their behaviour. This is where the FAIR approach comes into play.
How does the FAIR approach work?
The FAIR approach is a tool for classifying the underlying reasons and conditions of incidents involving LSRs and provides support in determining the most effective improvement actions possible on the basis of this classification.
The FAIR approach is based on the assumption that employees never intentionally perform their work poorly. The Life-Saving Rules are of the utmost priority to TenneT – if a Life-Saving Rule is breached, we need to learn from the incident and derive measures that can be used to prevent similar breaches in future. It is also important that it is understood why the rule was violated. It is perhaps the case that employees are unaware that a certain rule applies in a specific situation (“unintentional breach”), or they think they cannot perform their work without breaching a rule (“situational breach”), or they are of the option that they know better and more effective methods to complete their work (“optimising breach”), or – in very rare cases – the employee is aware of the negative consequences but breaches a rule nonetheless.
These various types of breaches, each with their own underlying motives, mean that various (improvement) actions are required to prevent their recurrence in the future.
Implementing the FAIR approach
The FAIR approach is always to be applied as soon as possible after an incident occurred in which a Life-Saving Rule has not been not observed. In a three-step process the FAIR approach helps managers (1) to classify the category of LSR breaches using the underlying motives, (2) to verify this categorisation via a substitution test and (3) to develop improvement actions that can be used to prevent in future such situations.
The first step involves categorising the underlying cause of the incident. An easy-to-use flowchart is used to pose targeted questions concerning the reasons for the breach and the context in which it took place. A total of 5 categories are used.
The classification of the LSR breach must then be confirmed by interviewing other employees (colleagues with similar duties who perform the same type of work under comparable circumstances with comparable training) to find out whether they would act in a similar way in such a situation. This is called the “substitution test”.
Basic rules for the substitution test: Once you have reason to assume that another individual would have done the same as the employee who breached the LSR, the improvement actions should be aimed at the system and not individual employees.
Every category has its own causes and thus demands corresponding counter-measures/actions. The improvement actions must be sustainable and effective, i.e. they must contribute to changing the superordinate system in such a way that future breaches of a Life-Saving Rule in a similar context can be prevented.