Common operations failure modes in the process industries

The Abnormal Situation Management ® (ASM ®) Consortium (This research study was sponsored by the Abnormal Situation Management (ASM) Consortium. ASM ® and Abnormal Situation Management ® are registered trademarks of Honeywell International, Inc.) funded a study to investigate common failure modes and root causes associated with operations practices. The study team analyzed 20 public and 12 private incident reports using the TapRoot ® methodology to identify root causes. These root causes were mapped to operations practice failures. This paper describes the top ten operations failure modes identified in the analysis. Specific recommendations include how to analyze plant incident reports to better understand the sources of systemic failures and improve plant operating practices.