Guest post by Judy Agnew.
Finally, we hear the truth! In a July 21st NY Times article, “Workers on Doomed Rig Voiced Concern About Safety” results of a confidential survey completed by employees in the weeks before the rig exploded are unveiled. Most alarmingly, safety concerns of workers on the rig included: fear of reporting mistakes, observed unsafe behavior, unreliable and unsafe equipment and poor decision making. A spokesperson for Transocean is also cited as saying “the Deepwater Horizon had seven consecutive years without a single lost-time incident or major environmental event”. How can an organization hail low or zero incidents when their corporate culture is one of fear and unsafe practices?
As someone who has consulted with companies large and small about their behavior-based safety practices, I can tell you that this issue, although mostly unintentional, is present to some degree in many organizations. When senior leaders focus on incident rate as their primary measure of safety they will never really know how safe their organizations are. Is it a fluke that this rig had seven years without an incident and then had an incident leading to 11 deaths and the most devastating and catastrophic oil spill in history? No. There were plenty of predictors, many of them highlighted in the report. All of them pointing to poor safety leadership. Based on my expertise with the science of behavior and in working in these environments, I offer a scientific perspective to the concerns that were revealed:
Fear of reporting mistakes
Organizations can never achieve safety excellence if they have a culture of fear. The survey showed that rig employees feared reporting mistakes or other problems. The fear undoubtedly came from senior leaderships’ use of negative reinforcement and punishment (one worker was quoted as saying “The company is always using fear tactics”). The side effect of this strategy is that mistakes, near misses and other problems are not brought forth to be corrected, they are hidden like a ticking time bomb, that in this case ignited.
Unsafe behavior
Employees stated that company plans were not carried out properly and they “often saw unsafe behavior on the rig”. It appears they had a behavior-based safety process in place but it was being pencil-whipped at least some of the time. What was leadership doing to ensure the integrity of the system? Just having a system in place isn’t enough; the system needs to demonstrate impact.
Equipment/maintenance problems
Workers reported equipment reliability problems, failure to inspect on a regular basis, and a huge backlog of maintenance jobs undone. Maintaining a safe physical environment is one of the most important roles of leadership in safety but clearly it was not a priority in this case.
This article is a must read for anyone wanting to understand the genesis of this disaster as it highlights the danger of the approach many senior leaders take to safety: focus on production and let incident rate be your barometer of when the focus needs to shift to safety. The question is, are you safe by accident? I urge you to take steps now to strengthen your safety leadership.
Judy Agnew is Vice President of Safety Solutions for Aubrey Daniels International and co-author with Aubrey C. Daniels of an upcoming book on safety leadership.

Recent events in mining, oil production, and even drug manufacturing uncover costly and more importantly deadly mistakes. Understanding the laws of behavior and applying them to environments where safety practices are present would do much to prevent such tragedies. But who is accountable? Companies are clear on the importance of safety, but leaders must create a culture where safety is valued and practiced at all levels. In essence the ‘corporate will’ to make safety a real priority can only be seen in the visible changes made by company leaders in the physical environment and in the daily safe practices on the part of all employees.
For the past few months, I’ve been working on a safety leadership book with my colleague, Judy Agnew and it really got me thinking about the evolution of behavior-based safety. I began writing about where it began and those who have influenced what it is today. While it won’t make it into the new book, I think it’s worth a read. Or, maybe I just didn’t want these ideas to go to waste, so please take a look. 