Human reliability analysis in cobalt-therapy process using an adapted ATHEANA prospective approach (Indexed by ISI-Thomson-Reuters)

J. NÚÑEZ MC LEOD; J. BARÓN; S. RIVERA

Berlin, Germany

Congreso; Probabilistic Safety Assessment and Management 2004 & European Safety and Reliability Conference 2004; 2004

International Association for Probabilistic Safety Assessment and Management & European Safety and Reliability Association

In this work it is proposed to start from initial events centered on the patients. This means, considering the attention of different pathologies or the number of patients who are due to take care of. This approach is based on how the conformation of the personnel Knowledge Base is directly related to the treated pathologies. This implies similar treatments for similar pathologies. While the rest of the context elements do not change, the new pathologies face the personnel to non recognized situations or wrongly recognized situations. In this paper several cases are analyzed in detail, for each one of the cases the possible problems of evaluation of the pathology and planning of a course of action are analyzed. A set of recommendations arises from this analysis: development of written procedures for several activities, guidance on how to proceed, formalization of the training process, retraining of the personnel based on specific cases, etc. The work also includes the identification of administrative barriers that allow to detect the possible errors and to initiate the correction processes.  Several verification actions are proposed in different process points. Finally the analyses performed are matched with a different errors detected in a specific Cobalt-Therapy service, demonstrating the utility of the approach, the adaptation and the application.