Why Do Corrective Actions Fail Over Time?

Insight to non-fool proof solution ( when automated action is not possible )

Weak support system to sustain the corrective action. When corrective actions are implemented, end in mind is continuity & the action to be self-sustaining.

Compliance to adhere, to the new set of action is a must at 1st place. Having a non-robust sustaining mechanism is a sure fail, over a long period of time.

Modification could be made after the gap assessments are made especially on possible risk of non-compliance.

 The below scenario is part of a critical process & having a check + balance actions are needed due to “unavailability of automated triggering / system driven initiatives )

Scenario : Oil seal replacement has been revised from 18 months to 15 months due to wear & tear issue coupled with hot temperature.

Existing checklist is revised to indicate change interval & maintenance personal is tasked with the replacement.

3 corrective action proposed

Corrective action option 1 : Maintenance checklist has been revised to reflect the above changes

Corrective action option 2 : Maintenance checklist has been revised to reflect the above changes + issuance counter have a separate checklist that defines the time the change should occur.

Corrective action option 3 : Maintenance checklist has been revised to reflect the above changes + issuance counter have a separate checklist that defines the time the change should occur+ issuance counter triggers mail loop ( to respective PIC/Superiors ) if retrieval / issuance does not take place.

Action in option 1 have a major weakness similar to all general checklist that is being used industry wide. Majority of checklist that are created, focuses on 1 owner, where tasks are completed & verified by 1 person. Verification process may be available on the checklist but does not help to validate. Eg, owner completes checklist & end of task period, supervisors acknowledge the checklists.

Major breakdown may occur if task are

  1. Not completed but action ticked in checklist
  2. Supervisor acknowledge without physical affirmation

Action in option 2, revised to have a close loop between task owner & item issuer. 2nd verification by issuer have a record, which indicates when the change should happen. The gap here is that, there is possibility task owner don’t proceed for ordering & issuer waits for the order to take place. Revision on this action can be taken to have a triggering back to task owner.

 Action in option 3, completes the verification loop, where for non-conformance, triggering will be made by 2nd party ( material issuer to maintenance superior that a planned change does not occur )

Close loop action are safer, ensures better compliance with check & balance but still requires periodic assessment.

The above approach can still be utilized & modified to suit automated part replacement system as loop holes as below still exist

  1. Auto triggering done but new part not replaced. Reuse of expired parts due to convenience
  2. Reset of triggering mechanism available

 Given examples above is not a fit all solution, meaning changes or modification may be required to fit nature of problem, corrective action & industry specif.The goal of this article is to emphasize sustainable corrective action to prevent similar occurrences in future.

 Rgds, Daniel

 

 

                            

 

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