With today’s announcement the drama surrounding the Chairman of the NRC has played out to its foreseeable conclusion. The merits of the Chairman’s leadership of the agency are beyond the scope of this blog, but there are a few aspects of his tenure that may be relevant to nuclear safety culture in high performing organizations, not to mention in high places.
First we should note that we have previously blogged about speeches and papers (here, here and here) given by the Chairman wherein he emphasized the importance of safety culture to nuclear safety. In general we applauded his emphasis on safety culture as being necessary to raise the attention level of the industry. Over time, as the NRC’s focus became absorbed with the Safety Culture Policy Statement we became less enamored with the Chairman’s satisfaction with achieving consensus among stakeholders as almost an end to itself. The resultant policy statement with a heavy tilt to attitudes and values seemed to lack the kind of coherence that a regulatory agency needs to establish inspectable results. As Commissioner Apostolakis so cogently observed, “...we really care about what people do and maybe not why they do it….”
Continuing with that thought, and if the assertions made by the four other Commissioners are accurate, what the Chairman’s did as agency head seems to have included intimidation, lack of transparency, manipulation of resources, and other behaviors not on the safety culture list of traits. It illustrates, again, how easy it is for organizational leaders to mouth the correct words about safety culture yet behave in a contradictory manner. We strongly suspect that this is another situation where the gravitational force of conflicting priorities - in this case a political agenda - was sufficient to bend the boundary line between strong leadership and self interest.
NRC Chairman Jaczko, addressing the recent INPO CEO conference, warned about possible increasing complacency in the nuclear industry.* To support his point, he noted the two plants in column four of the ROP Action Matrix and two plants in column three, the increased number of special inspections in the past year, and the three units in extended shutdowns. The Chairman then moved on to discuss other industry issues.
The speech spurred us to ask: Why does the risk of complacency increase over time? Given our interest in analyzing organizational processes, it should come as no surprise that we believe complacency is more complicated than the lack of safety-related incidents leading to reduced attention to safety.
An increase in complacency means that an organization’s safety culture has somehow changed. Causes of such change include shifts in the organization’s underlying assumptions and decay.
Underlying Assumptions
We know from the Schein model that underlying assumptions are the bedrock for culture. One can take those underlying assumptions and construct an (incomplete) mental model of the organization—what it values, how it operates and how it makes decisions. Over time, as the organization builds an apparently successful safety record, the mental weights that people assign to decision factors can undergo a subtle but persistent shift to favor the visible production and cost goals over the inherently invisible safety factor. At the same time, opportunities exist for corrosive issues, e.g., normalization of deviance, to attach themselves to the underlying assumptions. Normalization of deviance can manifest anywhere, from slipping maintenance standards to a greater tolerance for increasing work backlogs. Decay
An organization’s safety culture will inevitably decay over time absent effective maintenance. In part this is caused by the shift in underlying assumptions. In addition, decay results from saturation effects. Saturation occurs because beating people over the head with either the same thing, e.g., espoused values, or too many different things, e.g., one safety program or similar intervention after another, has lower and lower marginal effectiveness over time. That’s one reason new leaders are brought in to “problem” plants: to boost the safety culture by using a new messenger with a different version of the message, reset the decision making factor weights and clear the backlogs.
None of this is new to regular readers of this blog. But we wanted to gather our ideas about complacency in one post. Complacency is not some free-floating “thing,” it is an organizational trait that emerges because of multiple dynamics operating below the level of clear visibility or measurement.
NRC Chairman Jaczko recently gave a speech* where he presented three ongoing challenges to the nuclear industry: knowledge management, safety culture and public outreach. We applaud the chairman for continuing to emphasize safety culture. He indicated it was important to have a strong safety culture, all industry participants need to have a consistent focus on safety, and complacency is a potential pitfall.
Unfortunately, he plowed no new ground in his remarks. We think the chairman should have mentioned the potential for lessons learned from recent disasters in other industries. In addition, with the U.S. nuclear renaissance trying to get underway, we believe he could have pointed out the need for a strong safety culture at all the players who will be involved in building new plants: designers, fabricators, suppliers, contractors, owners, and many others.
* Jaczko, G.B., “Focus on Regulation.” Prepared Remarks for the Goizueta Directors Institute, Atlanta, GA, (NRC S-10-031) August 10, 2010.
The link below is to a September 29, 2009 speech by Chairman Jaczko of the Nuclear Regulatory Commission, outlining the NRC’s current initiative regarding safety culture and safety conscious work environment. There is no big news in the speech, mostly it is notable for the continuing focus on safety culture issues at the highest level of the agency.
Perhaps of some significance is that almost all of Jaczko’s comments regard initiatives by the NRC on safety culture. Not surprising in one sense in that it would be a logical focus for the NRC Chairman. However I thought that the absence of industry-wide actions, perhaps covering all plants, could be perceived as a weakness. Jaczko mentions that “We have seen an increasing number of licensees conducting periodic safety culture self-assessments…”, but that may only tend to highlight that each nuclear plant is going its own way. True? If so, will that encourage the NRC to define additional regulatory policies to bring greater uniformity?
The link below is to a recent interview with Gregory Jaczko, newly appointed Chairman of the Nuclear Regulatory Commission. In the interview he indicates that he wants to reinforce the need to maintain a safety culture at the agency and the nuclear industry. Safety culture has been an ongoing theme of much of Chairman Jaczko's public statements since coming on the Commission four years ago, and still seems to be on his mind.
