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Original Question

Project: Part 1: Create a Barrier Analysis In this analysis, consider barriers that failed, were not used, or did not exist. A barrier analysis form and summary chart are illustrated in Figure 9.7 below, Investigation Barrier Analysis Example Scenario, and Figure 9.8 below. Please remember that a barrier analysis demonstrates that when an incident occurred, there may be barriers that could have prevented the incident, but may not have been used. From the information in the report, create a three-column barrier analysis worksheet. Use the sample form in Figure 9.7, and follow the instructions below: In the first column, list the barriers. Group the barriers by category (failed, not used, did not exist). In the second column, describe the purpose of each barrier. In the third column, evaluate the performance of the barrier. Project: Part 2: Create a Fishbone Diagram Recall that the elements of a fishbone diagram include a head, backbone, ribs, and small bones: Head: The head of the fish represents the problem statement. Identify your problem statement for this scenario. Ribs: These are the main contributing factors. You may end up with multiple branches from the main ribs as you treat each contributing factor as its mini-rib and keep asking why each factor is occurring. For this project, the contributing factors could fit into the following categories: Person Procedures Environment Equipment Conditions Small bones: In many cases, smaller bones are included on the rib bone to represent a deeper root cause analysis or weakness. Refer to Unit VI and Figure 11.2, Apollo Fishbone, 5 Why Approaches for Investigation, and Table 11.1, 5 Why Approaches for an illustration and discussion of a Fishbone Diagram. You may create your fishbone diagram in any program you choose. You can search online for fishbone diagram templates or tutorials in programs, such as PowerPoint, Word, and Excel. Alternatively, you can use a different program and submit the final product image as a PDF or graphics file. . In your diagram, the backbone of the fish should represent the incident, and the big bones should represent the people, procedures, environment, equipment, and policies. Project: Part 3: Discussion On a separate page, write a response that includes the following: Discuss what new information about the incident that is revealed in the fishbone diagram. Describe how that information might be used to identify potential corrective measures. Explain the benefits of barrier analysis. Discuss the various aspects of cause-and-effect analysis based on your barrier analysis. This part of the project should be a minimum of two pages in length. Formatting Complete all parts of the project as a single document. Your completed project (all three parts) should be a minimum of four pages in length.

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