PowerPoint Presentation

[Audio] Behavioral Root Cause Analysis PT-119824-EN ©2025 All rights reserved. 1.

[Audio] B R C A Behavioral Root Cause Analysis Root Cause Analysis BEHAVIOUR ? Behavior is an observable response to antecedent stimuli that is followed by specific consequences. ABC MODEL A -Antecedents B- Behavior C- Consequence Anything that occurs The observable and The outcome before and triggers a behavior. measurable response of an individual. Root Cause Analysis is a systematic process for identifying the underlying reason (root cause) of a problem or failure, rather than just addressing its immediate symptoms. that follows the behavior Purpose: To prevent recurrence of the problem. Positive Key idea: "Treat the cause, not just the effect." "Do this & You'll be rewarded" Behavior Repeat reinforcement The immediate, obvious Negative Consequence "Do this & You'll be penalized" Behavior Decrease reinforcement reason a problem occurred. Direct Cause Extinction The underlying, fundamental "Ignore it and it'll go away " Behavior Stops reason the problem occurred. Root Cause PT-119824-EN ©2025 All rights reserved. 2.

[Audio] Purpose of Behavioral Root Cause Analysis (BRCA) Behavioral Root Cause Analysis (BRCA) is a structured approach to manage the consequences of employee behaviors in the workplace. It provides a fair and consistent framework to recognize exemplary behaviors and understand at-risk behaviors, enabling the establishment of a Just Safety Culture, which is essential for safety excellence. Why BRCA? How BRCA is Used What BRCA Is NOT Appreciates and Proactive: BRCA does not replace reinforces exemplary safety behaviors risk assessments or other EHS processes Day-to-day observations and identification of atrisk behaviors Ensures at-risk It complements the Reactive: existing EHS Management System behaviors are understood and addressed fairly Incident and near-miss investigations Non-behavioral risks must Same tool, same Builds trust through logic, consistent outcomes consistency and transparency be controlled using other EHS processes and the hierarchy of controls Strengthen awareness of behavioral consequences Key Objectives Reinforce safe and responsible behaviors Help leaders understand why people behave the way they do Enable fair, appropriate, and consistent actions Reinforce mutual safety expectations through constructive dialogue PT-119824-EN ©2025 All rights reserved. 3.

[Audio] Just Safety Culture Health and safety concept that balances accountability with learning. Instead of asking "Who caused the problem?", organizations look at what went wrong and how systems can be improved. The foundations of a just culture will require compliance with two principles: The acceptance that human error is inevitable and organization must review their practices, policies, and processes to manage the risk of mistakes. Individuals within an organization should be held accountable for their actions if they knowingly disobey safety protocol or procedure. Blame & Punish Blame Culture Human Error Investigate, Fix system & Processes No Blame Culture Unsafe Behavior At-Risk Behavior Coaching, corrective supervision No Blame & No Accountability Strict Disciplinary Reckless Behavior action Just Culture Accountable When Reckless PT-119824-EN ©2025 All rights reserved. 4.

[Audio] Responsibility Ensure thorough application and effective utilization of the BRCA process at site level Site Director / Operations Leadership Provide necessary support and resources to address at-risk behaviors identified through BRCA Reinforce leadership accountability in promoting a Just Safety Culture Site EHS Representative Support the Site Director and Operations Leadership in implementing the BRCA process Guide correct application of BRCA methodology and classification Ensure all BRCA cases are accurately recorded and documented in the BSI Connect system PT-119824-EN ©2025 All rights reserved. 5.

[Audio] Procedure Identify Exemplary/at-risk behavior A Classify Behavior B Identify Cause of At-Risk Behavior C Take appropriate course of action D PT-119824-EN ©2025 All rights reserved. 6.

[Audio] A. Identify exemplary or at-risk behavior Exemplary or at-risk behaviors can be identified through following scenarios: Employee exhibits exemplary behavior which goes above and beyond his/her normal job requirements (Example: Employee preventing co-worker from breaking the rule) Incident of any severity (incl. Near Miss) Routine workplace activities incl. Gemba walk, workplace audit / inspection etc. NOTE: Behavioral RCA process shall not be applied during BOP observations!! PT-119824-EN ©2025 All rights reserved. 7.

[Audio] B Classify Behavior Once the exemplary or at-risk behavior is identified, the behavior shall be classified, using Meeting Expectations Model (by Hearts & Minds). Normal Behavior Doing what is normal and required for the job. "I did my job the way I am supposed to, according to all rules and good practices." Expected Exemplary Behavior Effective Intervention Recognizing and intervening in potentially problematic situation "I identified unsafe acts/conditions, stopped work and made or suggested improvement." Behavior at or above Creating trust, good communication and clear expectations in a team. "I helped us understand and improve our work environment." expectation Creating a More Effective Work Environment Risk identification, planning or risk Excellent in Risk management has reduced the likelihood of human error or the creation of situations that lead to violations. Examples: Effective contractor management, Job Hazard Identification, Planning and Management Analysis etc. "I avoided human error and the creation of situations that lead to violations." Exemplary Sharing experience in a way that gives genuine benefit to others, e.g. Effective Sharing of highly effective communication; using lessons learned to improve a "I helped others learn from failures and successes." Lessons Learned working practice. Other "I did something exceptional that had a desirable outcome but does not fit the previous descriptions." PT-119824-EN ©2025 All rights reserved. 8.

[Audio] B Classify Behavior (contd..) "Oops!" Slips and Lapses Actions that did not proceed as planned, e.g. something was done twice, the wrong way or a step is forgotten. Human Error At-Risk Behavior "I thought I did the right thing." Mistakes Mistakes are actions that proceed as planned but do not achieve their desired end. (Incorrect decision or inadequate plan). A rule or procedure violated "I was not aware. I did not understand." Unintended because people were not aware of the rule or did not Behavior below understand it expectation A job cannot be done if the rules are followed. Instead of stopping the job it is done Situational "I cannot get the job done if I follow the rules, but I did the job anyway." anyway, and the rule is violated. The person committing the violation thought it was better for the company to do it that Organizational "It was better for the company to do it that way." Violation way. The violation was committed to improve Optimizing performance or to please the supervisor "It suited me better to do it that way." The person thought it was better for them personally to do it that way e.g. getting a longer work break, easier Personal Optimizing way of doing the job, doing it faster etc. The person committing the violation did not think or care Reckless "I do not think or care about the consequences." about the consequences. Gross negligence can be considered a part of this type of violation. PT-119824-EN ©2025 All rights reserved. 9.

[Audio] C. Identify Cause of At-Risk Behavior Once the at-risk behavior is correctly classified, using Meeting Expectations Model, the root causes of this behavior shall be identified, using following scheme: Slips and Lapses Four Critical Errors: Eyes Not On Task Four States of Mind: Rushing Mind Not On Task Frustration Human Error Line of Fire Fatigue Loss of balance /traction/grip Complacency Mistakes Behavior Unintended below Competency Gap expectation Competency Gap Situational Root cause to be identified using the ABC analysis Complete ABC analysis of at-risk behavior to understand activators and consequences Violation Organizationa l Optimizing Personal Optimizing Reckless Direct Cause Root Cause PT-119824-EN ©2025 All rights reserved. 10.

[Audio] D. Take appropriate course of action It is critical to success of this process to identify and apply appropriate course of action in order to provide the employee with the consequences that: Either strengthen behavior and motivate employee to repeat such a behavior in case of exemplary behaviors so that the appropriate course of action must be positive, immediate and certain; Or Discourage the employee to perform this behavior again in case of at-risk behavior so that the appropriate course of action must be negative, immediate and certain (see ABC model). . The consequences to address the behavior shall be applied to individual performing a behavior as well as his/her direct manager PT-119824-EN ©2025 All rights reserved. 11.

[Audio] Consequence Scheme for Exemplary Behavior & Normal Behavior Consequence Consequence for the Consequence for the Manager(s) of the Individual Individual Normal behavior Exemplary behavior Normal behavior Exemplary behavior If this behavior is Recognition from line supervisor and /or his Examples: Praise, Public Recognition, Positive performance Encouragement and recognition if whole team is working this Examples: Praise, Public Recognition, Positive performance displayed by a whole team or regularly by some team members, management Recognition / Reward – at the discretion of the line manager, in line with local HR policy and in the agreement then also Reward / appraisal etc. way appraisal etc. with HR manager. Recognition. PT-119824-EN ©2025 All rights reserved. 12.

[Audio] Consequence Scheme for At-risk Behavior caused by human error Consequence for Consequence for the Manager(s) of Individual the Individual Routine Error Routine Error (a Routine Error Routine Error (a personal history of Slips & Lapses Mistakes personal history of Slips & Lapses Mistakes (same errors by different people) errors) (same errors by different people) errors) Coaching in Error and Competence Apply process for Coaching in Error and Competence Apply process for human error Management. Performance human error Assessment of fitness to work. Competence reduction Coaching on how Coaching in Error development and Management. Performance Coaching in Error and Competence to spot errors Management reduction whole team to receive Management appraisal affected for not addressing Competence development/ coaching coaching. Consider appraisal affected for not addressing coaching alternative work clear problems clear problems Coaching on Fitness To Work. PT-119824-EN ©2025 All rights reserved. 13.

[Audio] Consequence Scheme for At-risk Behavior caused by violation: Consequence for the individual Organizational Routine (Everybody Unintentional Situational Reckless Optimizing Personal Optimizing does it like that) Routine (A personal history of violations) Formal discipline Suspension of the Consider activity pending anonymous Whole team to further Coaching Coaching Competency development Formal disciplinary action in line with receive coaching /Coaching local policy. investigation. Disci plinary action. publication of the violation and its consequences. PT-119824-EN ©2025 All rights reserved. 14.

[Audio] Consequence Scheme for At-risk Behavior caused by violation Consequence for the Manger(S)of the individual Organizational Routine (Everybody Unintentional Situational Personal Optimizing Reckless Optimizing does it like that) Routine (A personal history of violations) Performance Performance Coaching, consider Coaching on how to recognize individual Performance violators. Coaching Coaching appraisal may be performance appraisal to be Performance affected. appraisal is affected. Formal discipline for reckless supervision appraisal is affected for not being aware about problems in appraisal may be affected to be considered. own area. affected. PT-119824-EN ©2025 All rights reserved. 15.

[Audio] Behavior Risk Level Following items should be taken into considerations: Risk level associated with identified at-risk behavior (the higher risk level, the more stringent action) It is not expected to complete formal risk assessment but at least Hi-/Med-/Low risk should be determined Application of Hierarchy of controls (refer to Global EHS Standard for Risk Assessment, ch. 4.5) Determine potential severity of at-risk behavior (Hi-/Med-/Low ) (Refer to Global EHS Standard for Incident Management) In case of potential severity High and Medium, HFACS analysis should be completed The decision about potential severity and application of HFACS analysis is within responsibility of site EHS representative PT-119824-EN ©2025 All rights reserved. 16.

[Audio] PT-119824-EN ©2025 All rights reserved. 17.

[Audio] Thank You. Thank You.