133: Confusing/Complex/Difficult to Use
Definition/Typical Issues
Were data recorded incorrectly because the procedure was confusing/complex or otherwise difficult to use?
Were the instructions in the procedure unclear? Could they be interpreted in more than one way? Was the grammar unclear/complex?
Were the instructions in the procedure unclear? Could they be interpreted in more than one way? Was the language or grammar unclear/complex?
Were data recorded incorrectly because the procedure was ambiguous or confusing?
Examples
Example 1
- An instruction called for cutting XYZ rods into 10-foot-long pieces. The intent was to have pieces 10 feet long. The person cutting the pieces cut 10 pieces, each a foot long.
Example 2
- A step in the root cause analysis procedure stated "Use the RCM to assist in determining the management system deficiencies that contributed to the event." The supervisor assumed it meant to use reliability-centered maintenance not the Root Cause Map™.
Typical Recommendations
- Have procedures validated by a team of subject matter experts (workers) and by walkthroughs in the field.
- To find difficult steps, have the newest employee walk through the procedure without coaching.
- Avoid procedures that require employees to make calculations. Instead, provide employees with precalculated tables or worksheets with easy-to-fill-in blanks and with thorough training in their use. Or, automate calculations within the system.
- Allow technical editors to review procedures to ensure that ambiguous terms have been avoided.
- Perform a hazard review of critical procedures to determine other accident scenarios related to errors in procedures and to determine whether sufficient safeguards are provided to ensure that employees follow the written procedures.
- Ensure that procedures clearly state what to do and, for critical steps or tasks, how to determine whether the step or task was completed correctly.
- Develop a procedure numbering or index system that is logical to the end user.
Cross-References
| Version 10 Element(s) | |
|---|---|
| Node ID | Node Name |
| 124 | Ambiguous or Confusing Instructions/Requirements |
| Maritime Element(s) | |
|---|---|
| Node ID | Node Name |
| 127 | Multiple Actions per Step |
| 129 | Content Issue |