Improving Human Performance
Copyright Material IEEE
Paper No. ESW2012-05
D. Ray Crow
Senior Member, IEEE
DRC Consulting, Ltd.
336 36th Street #389
Bellingham, WA 98225
USA
draycrow@aol.com
Abstract - Electrical safety incidents and injuries can be the
result of inappropriate work behavior or what is referred to as
“unsafe acts.” This occurs even though training and education
have been provided on the electrical hazards and the possible
consequences. Providing training to people is not enough to
motivate them to follow the procedures. When unsupervised,
those people who are aware of the hazards may still believe
they are qualified to take risks because previous “unsafe acts”
have not resulted in an incident. This presentation will provide
information on what motivates people to intrinsically follow
proper electrical safe procedures. By understanding these
principles, human performance can be positively changed and
the electrical work practices of personnel can be improved to
consistently follow safe work procedures.
Index Terms — Human Behavior, Electrical Safety,
Performance
I. INTRODUCTION
There is a difference between behaviors and performance. If
we are to improve performance then changing behaviors is one
element to study. Certainly, it is not the only element as there
are many other factors that impact performance. Of the many,
three stand out.
There are three critical elements to electrical safety [1].
Figure 1 shows these elements.
Fig. 1 Critical Elements of Electrical Safety
978-1-4673-1062-8/12/$31.00 ©2012 IEEE
Danny P Liggett
Senior Member, IEEE
DuPont Company
4415 Eagle Mountain Ct
Richmond, TX 77406
USA
danny.liggett@ieee.org
Equipment safety deals with the design and operation of the
tools. How things are manufactured is also involved in order to
protect and provide safety to the worker. The improvement of
electrical equipment has been a topic of much discussion.
There have been improvements to make equipment more
inherently safe. Many papers have been written about Safety by
Design. This concept is now accepted, and work continues in
this area.
In the past detailed attention has been given to the
“Managing Systems” element of safety. This element involves
procedures and compliance with standards set by NFPA 70E
and the OSHA regulations. These are important. Having the
right procedures and controls in place provide the boundaries
within which people can operate or perform. Compliance
programs, regular audits, safety teams and other types of
programs commonly exist in companies today based on the
efforts of the studies in the “Managing Systems” area.
The one element that has not had enough attention is how
we can improve the performance of people who interact with
electrical equipment. This paper will provide information on how
to improve human performance. The overall electrical safety
performance of the organization is directly tied to the issues that
drive human behavior. The people at facilities interact daily with
electrical equipment. These interactions can be uneventful or
they can have disastrous results.
In an effort to change the inappropriate behaviors that lead to
unsafe acts, it is easy to say “they need more training”. Training
is only one means of achieving improved performance. Most
problems in the workplace stem from the environment in which
workers perform the tasks, not new procedures or new
information about how to do the work. Training will not fix
problems that exist due to the work environment. Things such
as weather, timelines, lack of personnel, lack of information,
improper tools or equipment, etc. cannot be changed by
training.
Human performance improvement is a means to the end of
achieving improved safety results. Understanding the decisions
and actions that cause incidents is imperative to improving
electrical safety performance. Most studies have been focused
on the consequences of the incidents, injuries, or fatalities.
However, focusing on the root cause(s) and not the
consequences, leads to understanding the changes necessary
for improved human performance. Based on that root cause
data, positive steps can be taken for continuous improvement in
organizational safety performance.
 II. FACTORS TO HUMAN PERFORMANCE
There are many factors that impact human performance.
Below is a list of what experts in the field of human
performance believe are the key factors [2].
x Data and information
x Resources, tools, and environmental supports
x Consequences, incentives, and rewards
x Skills and knowledge – internal to the individual,
when skills and knowledge are missing this
leads to poor performance by the individual.
x Individual capacity – Has to do with talents or
capability to perform. Different jobs require
different talents.
x Motives – deeply embedded characteristics
possessed by people. Motives include why
people do what they do, how they view
themselves, their needs, desires, and internal
personality traits.
It is important to notice that the first three items are external
influences and the second three are internal influences. Any, or
all of these, can have an impact on the performance of people.
They can have a positive impact or they can become barriers to
performance. The external influences can cause a good
performer to become a marginal or bad performer or can
improve their performance. The external influences will be
discussed in Section A of the paper. Internal influences will be
reviewed in Section B.
A. External Factors
External factors are things that influence performance that
are beyond the control of the individual. These factors are
typically under the control of the employer or a regulatory body.
Company procedures and OSHA regulations are two typical
external factors people face within their work environment. The
person cannot control these. It becomes imperative the
employer provide clear, correct and concise information
regarding what is expected from the person in their job
performance relating to those things beyond their control.
1) Data and information. There are many elements to these
two factors. The one that is probably the most important is
expectations. Establishing and communicating the expectations
to the individual is vital. If people do not know what is expected
they cannot deliver the appropriate performance. They need to
know not only what to do, but how to do it. As an example, let’s
look at how a procedure for a test for the absence of voltage
may be communicated. Some procedures may say only: “Test
for the absence of voltage” and nothing more. This leaves the
employee with questions (or not) about the type of equipment to
use, whether testing the tester before and after the actual test is
required, If there are installation standards to be met, what
materials must be used, and other factors encountered within
special job site situations. Not all people will ask questions or
seek information when they are unsure. Making assumptions
within communications is one of the most common errors in
procedure writing. Lack of clarity, or failing to mention the
obvious – which is not always obvious to everyone and not
getting too detailed are all problems companies face when
attempting to communicate important and vital information for
employees to understand and follow.
Another example of the significant information is the scope of
a task and the schedule. These are important for a task to be
executed safely. Understanding where the boundaries are for
the task is critical especially if lockout/tagout is involved. Both of
these examples clearly demonstrate the need for data and
information to be clear.
People will do what they have always done unless they are
told what the expectations and procedures are to the point they
clearly understand. Too often managers and supervisors
assume that people know what the “right things” to do are and
will unfailingly do them. Many of the performance problems that
exist can be attributed to a lack of clearly stated expectations,
standards, and feedback.
2) Resources, Tools, and Environmental Supports. It is the
responsibility of supervision and management to provide the
resources for work to be accomplished. Supervision must
provide adequate manpower so that the job can be finished in a
timely manner. If the installation standards are to be met then
the right materials must be supplied. If the right materials are
not supplied then people will use what is available or leave
things out.
The environment people work in does have an impact on
their performance. If the area is messy then people will continue
to allow it to be that way. Poor or messy housekeeping is a
contributor to incidents and injuries.
Other items such as the correct type of test equipment,
voltage rated gloves and arc flash PPE must be supplied can
also be an issue. Mismanagement of equipment is a factor in
injuries and incidents. Failure to properly control equipment
type is commonly seen. Often employers allow the employee to
use personal equipment which may be inappropriate for the
environment or the task. The company may assume the
employee knows and owns the proper type equipment for all
circumstances in which the equipment will be used. Over time
this would seldom be true. Poor, irregular or no maintenance of
equipment can also be the case.
3) Consequences, Incentives, and Rewards. Consequences
can send an unintended or completely wrong signal when used
incorrectly. Used appropriately, it can motivate people to act
responsibly.
There must be consequences for inappropriate actions and
performance. While there may be an expected level of
performance, consequences set the level of performance that is
perceived as acceptable. A lack of consequences sends the
signal that there are no boundaries. Consequences must be
consistently applied or they will be constantly challenged until
the employees find the lowest level of acceptable performance.
If consequences are not handed out for an infraction, a new,
lower level of performance has been set. Consequences must
be immediate. Delayed consequences lose their impact; this
can sometimes create the opinion that an action is allowed if
you don't get caught. [3].
Rewards and incentives are influential to results. However,
they must be managed correctly to achieve the desired
outcomes. Rewards and incentives must be focused on specific
actions. Giving awards for getting the job done, when everyone
knows short cuts were taken, sends the signal that it is
permissible to take shortcuts. How the job gets done is as
important as getting the job done. Too often we fail to provide
positive feedback. Giving positive, specific praise and feedback
reinforces the right things often more strongly than monetary
compensation. [4]
B. Internal Factors
Internal factors are things over which the person has some
control or has some ability to change. Understanding what
drives behaviors is necessary in order to change the behaviors.
Internal factors such as a person’s own beliefs drive their
behavior. Changing what a person believes works best to
improve human performance because it will influence behaviors
on a long-term basis. Once a belief has been changed,
behavior automatically changes in-line with the new belief.
1) Skills and knowledge. These are two absolutely critical
elements to good work performance. There is a difference
between knowing what to do and knowing how to do it.
The first external factor discussed in this paper was data and
information. The employer can provide the information but the
person must attempt to become knowledgeable of the
information. The person must seek assistance when the
information is not clear or the person does not understand what
is being shared. “First-hand knowledge” is often referenced
when information or data has been learned by an individual and
they have complete understanding and experience of the
subject matter.
Skills are essential. If the person does not have the right skills
then errors will be made. A person can read all the material on
how to do electrical work, memorize it and repeat it; h owever,
that person will not be able to go into the field and perform work
with any degree of effectiveness. The opposite is also true. A
person can be very skilled at doing tasks but not truly have the
necessary level of knowledge and information that is critical to
his/her safety. Both of these elements, knowledge and skills,
must be present in personnel in enough quantity and quality to
effectively manage their tasks.
2) Individual capacity. This factor involves the physical
abilities of the person. Does the person have the physical
capability to perform the task? While a person cannot
completely control their physical attributes, it is a key
consideration when a supervisor is assigning tasks. A person
with vertigo is not the best person to assign to a high climbing
task. The individual being assigned a job also has the
responsibility to say when a task is beyond their personal
capacities to do the job safely and effectively. A supervisor may
be unaware of a physical limitation such as vertigo, especially if
it is a temporary condition due to illness. People must
understand their own capacities on an on-going basis and
responsibly act on that awareness.
3) Motives. Everyone has a reason for the things they do.
Some times the reasons are different than what other people
think. It is important to understand through communication
exactly what it is that motivates the people working with you.
Intrinsic or internal beliefs can have a major impact on the
behaviors of people. If the person wants to make a good
impression or enhance their reputation by getting tasks done
quickly then there is a chance that shortcuts may be taken in
order to accomplish that. This type of motive can have a
negative impact on safety. Conversely, establishing a good
safety record and reputation due to performing work in a safe
manner that prevents injuries can be a positive motivator.
III. Types of Errors
There are two major types of errors or inappropriate
behaviors, active or latent. Active errors are the result of
cognitive failures [5] while performing a task. Latent errors are
the result of external factors. When incidents occur due to an
error, there is usually a deficiency in the “managing systems”
element of safety. A third type of error, while not major, is an
intentional error.
1) Active Errors. Active errors are caused by some failure in
the thinking process of the person. Examples of this are
inattention, memory failure or a lack of knowledge.
Lack of concentration often causes active errors to occur.
This is a common risk when performing repetitive tasks. Being
on “Automatic Pilot” works as long as things are the same but
when things change our subconscious cannot deal with it and
an error is likely to occur.
Forgetting important information occurs frequently when
people are busy or there are multiple demands on their
attention. Safety requirements or safe work practices can be
temporarily forgotten in just such a situation. Forgetting
important details happens all the time.
The company or site may have good procedures to cover
what is required but sometimes the information is not effectively
communicated. The person simply may not know what the
requirements are because of the lack of effective
communication. Management believes they have conveyed the
information to all the right parties only to find that those who
needed the information the most were left out of the
“information loop.”
2) Latent Errors. These errors are caused by a void in
procedures, lack of training, unsafe designs, or the culture of
the organization. If the procedures do not cover all hazards at
the site and do not provide information on safe work practices
to be used, then latent errors or inappropriate behaviors are the
most likely outcome. The design of equipment can hamper the
employees’ awareness of electrical hazards which cause
incidents, injuries, and fatalities to occur. Inherently safer
designs can prevent incidents from occurring. For example, the
design may limit the ability to see exposed parts that may be
energized. It can be said in this case the person was not
qualified because the person was not knowledgeable of the
construction of the equipment. The person may have been
aware of the hazard but was exposed due to the design of the
equipment.
Training plays a key role in safety. Personnel need to be
trained in the construction and operation of the electrical
equipment they will interact with. The equipment may look alike
but may be designed differently. This situation demonstrates an
error could occur from either a lack of knowledge or an unsafe
design. The culture of the organization can influence the
behaviors of personnel. This is easily identified when you hear
comments like “we’ve always done it this way” or “real
electricians don’t wear voltage-rated gloves”. Understanding
and working within the organization’s culture will determine
safety outcomes. Being aware of and striving to improve safety
cultures within organizations is a vital function of people within
that company in order to reduce latent errors.
3) Intentional Errors. While not considered as a major type of
error it is still a cause of incidents, injuries and fatalities. When
the person knows the requirements, understands the risks and
makes unsafe decisions that result in incidents, injuries and
fatalities it is considered an intentional error. This becomes a
disciplinary issue and employees should have immediate,
appropriate consequences for their decisions and actions.
IV. Error Traps
In the previous section of the paper, types of errors were
outlined. In this section, a list of potential traps leading
personnel to make errors is explained.
1) Communication. George Bernard Shaw once stated “The
single biggest issue with communications is the illusion that it
has occurred”. Too often we assume we have effectively
communicated a thought or a requirement. People often feel
uneasy asking questions. Also a completely different concept
may have been communicated than was intended. Information
is filtered through our beliefs and people try to make it fit within
what they believe and understand is right.
2) Excessive Work Load. Heavy workloads can lead to
stress on personnel. When under stress people will make
decisions they would not make under normal conditions. Any
compromised decision is error prone.
3) Time Pressure to Complete Work. Shortened time frames
cause people to become nervous, lose their concentration on
the task, focus only on time, and generally complete their tasks
at a lower level of performance. Pressure is counter-productive
to completing error free work.
4) Time Near the End of Shift. As we near the end of the day, it
is easy for us to become distracted with thoughts about other
obligations or activities. We will rush tasks in order to get them
done before the end of the day. This is a common trait and
incidents occur due to the lack of attention or focus on the job at
hand.
5) Long Hours. Many studies have shown productivity is
reduced the more hours worked. The ability to think clearly is
impaired without adequate breaks and rest between work
periods.
6) Returning After Absence. It takes some time to readjust
back to the routine of work. People need to be retrained when
they return to work after a long absence. Memory cannot be
relied upon to unfailingly support the person in assuming their
work duties. Changes happen within workplaces on a
continuing basis and many are not recorded. It is important all
procedures be reviewed when an absence has occurred.
7) Improper Work Instructions/Guidance. Closely tied in with
communications is another element about assuming people
already know what needs to be done. This sets up the situation
where people have to make their own decisions based on what
they know from previous experience or lacking that, they must
guess what needs to be done.
8) Guidance Does Not Match Previous Experience. If new
guidance is given without explanation or clarification, people will
revert to what experience has told them has worked in the past.
New procedures are often not implemented by personnel due to
the lack of information and guidance. When people do not
understand something, they will not risk their life to do it.
9) Lack of Use of Existing JSAs and SOPs. People do not do a
job safety analysis (JSA) or use standard operating procedures
(SOPs) because they believe they already know what to do and
what the hazards are in this current situation based on past
experience. Things change. Without a job safety analysis these
changes go unrecognized.
10) Tasks Performed Infrequently. If a person only performs a
task once every two years the details become lost. Our minds
cannot access information infrequently requested. When we
forget the details we set ourselves up for failure or errors.
11) Distractions. Multi-tasking is the best example of being
distracted. The increased car accident rates from cell phone
use while driving has shown that distractions will not allow one
to be completely successful in either task. While everyone
deals with a certain amount of distraction on a daily basis, there
is a limit beyond which someone cannot perform their work
without errors.
12) Lack of Focus. If we are preoccupied or have our mind on
another subject, we will most likely make an error with the
subject at hand. Inattention is a common malady within the
workplace and cause for many incidents and injuries.
13) Overconfidence. Making a positive assumption about the
level of knowledge attained is an easy mistake to make. How
does one measure what they don’t know? In a world of ever
increasing rates of change, making assumptions about
knowledge can only become more dangerous. Be cautious
when phrases like “I’ll figure it out” or “I know what I am doing”
are used. The world is in a constant state of change. The
practical application of listening and learning at every stage is
critical to continued success on the job.
14) Impatience. Getting in a hurry can lead to shortcuts or can
cause a person to miss something critical within the process.
Taking the time to recognize the hazards of the task and
ensuring all of the steps necessary have been taken can control
the error rate and reduce incidents.
15) Lack of Control of Work. Understanding who can make the
call on performing hazardous tasks is critical to appropriate
planning. If there are several tasks being done simultaneously
there must be someone who is coordinating the overall effort
and keeping everyone safe.
V. HUMAN PERFORMANCE TOOLS
Before we try to change the performance we need to
understand what the performance is. Simply stating “we haven’t
had injuries” is not a true indication of performance. Having
injuries is one indicator. While having “no injuries” is desirable,
there are other indicators that need to be considered.
How many electrical shocks are occurring within your facility
or company? Typically electrical shocks are not reported unless
they are seen or cause an injury. Most people do not want to
admit they made a mistake.
How many “near miss” incidents are occurring?
Understanding the number and type of “near miss” incidents
that are occurring will tell you where to focus your attention.
Metrics need to be developed to measure what is truly
occurring. Misconceptions due to the lack of valid information
can drive human performance efforts in the wrong direction and
cause more harm than good [6].
Auditing actual work is another way to identify areas that may
need improvement. Are all of the safe work practices for a
specific task being utilized? Do personnel understand how to
use electrical PPE? Are the appropriate testers being used? Is
the right level of planning being performed?
Once we understand what the performance is we can start
the necessary actions to correct the behaviors that drive the
performance. There are many tools on the market that can help
with driving change.
 One item that is typically not addressed when trying to create
change is what people think about the procedures and
standards they are asked to follow. Involving those who have to
execute the procedures in creating the change is important.
Only with their buy-in will meaningful sustainable change occur.
VI. CONCLUSIONS
If we want to make improvements in electrical safety
performance we must make improvements in the three critical
elements of safety performance. Equipment, Managing
Systems, and People are all parts of the equation of people
who interact with electrical equipment.
Measurements in each area, root cause analysis, and
action plans to change the status quo equip each company to
make forward progress in reducing incidents, injuries and
fatalities.
To begin, determine what the current performance is in
each area. Where are the incidents and injuries occurring?
Break down the incidents and analyze and understand what
behaviors are causing the incidents. Once the behaviors are
identified, a plan can be put in place to change the behaviors.
Changing safety performance is not just about how people
act. The equipment people must interact with needs to be
critically reviewed to determine if it is setting traps for
personnel or if it can further assist in reducing hazard
exposure. Utilizing inherently safer designs will assist in
improving organizational safety performance and reduce
incidents and injuries.
The managing systems need to be carefully reviewed and
revised to cover all of the hazards at the facility and provide the
safe work practices necessary for personnel to use to improve
performance. This must be done on an on-going basis as
change is ever present in the environment. Communication is
key in remaining focused and clear about the safety and
performance of the organization.
Improvements can always be made within any program or
organization. Understanding how these elements connect to
improve the lives and safety of all concerned is a vital piece of
information most do not have. All three of the elements
discussed at the beginning of the paper need to be addressed
to substantially improve the safety program of an organization.
The recommendations for steps to improve each area
contained within this paper will lead to more effective safety
programs and more lives saved.
VII. ACKNOWLEDGEMENTS
Ray Jones had a tremendous impact on the authors’
understanding of this concept. Ray has promoted this concept
for over 20 years. Participants at the IEEE IAS Electrical Safety
Workshop have also provided influence on the development of
this paper. The authors would like to express gratitude to
everyone we have had a discussion with on electrical safety.
Each person brings a unique perspective to electrical safety
because of their experiences and beliefs. These discussions
impact our thinking and lead to advancing electrical safety.
VIII. REFERENCES
[1] Danny Liggett, “Refocusing Electrical Safety”, IEEE
Transactions on Industry Applications, Sept/Oct 2006
[2] T.F. Gilbert, Human Competence: Engineering Worthy
Performance, New York, NY, McGraw Hill, 1978
[3] Krause, Hidley, and Hodson, The Behavior-Based Safety
Process,1990
[4] Daniel H. Pink, Drive: The Surprising Truth About What
Motivates Us, Riverhead Books, Copyright 2009
[5] E Scott Geller. The Psychology of Safety Handbook, New
York, NY, Lewis Publishing, 2001
[6] Mary Capelli-Schellpfeffer, H Landis Floyd, Kim
Eastwood, Danny Liggett, “How We can Better Learn
From Electrical Accidents”, IEEE Industry Applications
Magazine, May/June 2000
IX. VITA
Daryld Ray Crow (S’68, M’72, SM’03, LSM’07) graduated
from the University of Houston in 1969 with a BSEE degree.
After graduation Ray went to work for the Aluminum Company
of America where he provided engineering support for Alcoa
plants worldwide on the design, installation, and operation of
power and rectifier systems, provided plant engineering support
which included electrical safety, served as team leader for
writing a number of Alcoa electrical standards including the
development of and training for Alcoa’s electrical safe work
practice standard. He retired from Alcoa in 1996. After retiring
from Alcoa, Ray worked for Fluor Global Services and Duke
Energy as a Principal Technical Specialist providing design and
consulting electrical engineering for plant power distribution
systems and safe work practice programs, standards, and
assessments/audits.
Ray presently is the Principal Technical Specialist for DRC
Consulting Ltd. and performs consulting work on electrical safe
work practices standards, assessments/audits, electrical safe
work practice training, and electrical engineering projects.
He was chair of the Petroleum and Chemical Industry (PCIC)
Safety Subcommittee 2004-2006, chair of the 2004 IEEE IAS
Electrical Safety Workshop, is an alternate member on the
NFPA 70E technical committee “Standard for Electrical Safety
in the Workplace”, a member of the IEEE 1584 Committee, and
was the working group vice chair for the 2007 revisions to IEEE
463 “Standard for Electrical Safety Practices in Electrolytic Cell
Line Working Zones”.
Ray has co-authored and presented papers and tutorials on
electrical safety and auditing for the PCIC and has presented
safety topics and tutorials at the IEEE Industry Applications
Society Electrical Safety Workshops and IEEE IAS Pulp and
Paper Industry Conference. In 2010 Ray received the IEEE IAS
Petroleum and Chemical Industry Committee Electrical Safety
Excellence award.
Danny P. Liggett (M’91, SM’98) has been employed by
DuPont since 1989. He was employed by an
engineering/construction firm from 1968 until his employment
with DuPont. During his employment with the
engineering/construction firm he worked as an electrical
superintendent for 15 years. During his employment with
DuPont he has worked as an Electrical Consultant with
primary focus on construction activities and electrical safety.
His work also involves work with maintenance activities at the
DuPont sites. He is a member of the DuPont Corporate
Electrical safety Team, Senior Member of IEEE, Past Chair of
the IEEE IAS PCIC Safety Subcommittee and Past Chair of
the PCIC Tutorials Subcommittee. He currently serves as
Chair of the PCIC IAS Electrical Safety Workshop
Subcommittee. Danny served as Chair of the 2000 IEEE IAS
Electrical Safety Workshop. He has served on the NFPA
National Electrical Code Panel 8 representing the Cable Tray
Institute and the NFPA National Electrical Code Panel 6
representing the American Chemistry Council. He currently
represents the American Chemistry Council on the National
Electrical Code Technical Correlating Committee, as an
alternate on National Electrical Code Panel 3 and as an
alternate on NFPA 70E. He has authored or co-authored 15
papers on electrical safety, 10 of which have been published.