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Behavior model. That is why this Analysis looks at what had caused the sequence of events in an
incident, the sequence of events themselves, how the incident happened and also of which Barriers
had failed, no matter if they had been in place or not.
The most important factor examined is the reason why those Barriers failed.
The construction of a “tree” diagram forms a graph representation of the incident mechanism which
describes the events and its relationships. The event in a TRIPOD Beta Diagram is the result of the
Hazard acting upon an Object. A Barrier is something that was made to prevent the meeting of an
object and a hazard.
When such a Barrier fails, a causation path is made to explain how and why this happened. The
TRIPOD Beta method presumes that incidents are caused by human error, which can be prevented by
controlling the working Environment. The Causation path displays this by starting wit h the Active
Failure of the Barrier, then investigating under what Precondition or in what contextual state this
happened and finishing up by identifying the Underlying Causes that led to the Accident.
By delving into the “Preconditions” World , emanating after the accident,
investigators have the
opportunity to deepen their knowledge about the Safety Culture segment of the Organisations involved
into the accident and reliably identify both Behavior Norms and Shared Values that dictated the
established patterns of actions that have driven the Causes of Accident.
The aim of TRIPOD Beta is not only to uncover the hidden deficiencies in an Organisation, the Latent
Failures, but also to offer a solid starting point to depict all subsequent changes in the Organisational
Cultures suffered by the accident. Those flaws
are
classified into eleven Basic Risk Factors (BRFs),
categories that represent distinctive areas of management activity, where the solution of the problem
lies. All the items of the TRIPOD Diagram are shown below:
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