Workplaces and Organisations are easier to manage than the minds of individual workers. You cannot change the human condition, but you can change the conditions under which people work

Dr James Reason

Human Error Prevention Defined

The Human Error Prevention (HEP) process is about understanding that Human Error is never a true root cause for an issue. The basic assumption is that people do not want to make mistakes. Thinking systematically, HEP allows you to peel back more layers of the problem, uncover the true root cause and implement permanent fixes.

Human Error Categories

Benefits of HEP

  • Develop a culture of Human Error  Prevention
  • Minimise Risk of Human Error
    • Near Misses and Accidents reduced
    • Quality Defects reduced
  • Improve Job Satisfaction
  • Reduce Cost of Poor Quality

HEP Process


Competence errors occur when a person did not have the knowledge or skill to perform the task correctly

Omission Errors occur when a person missed a step or did not perform an action

Decision Errors occur when a person makes a decision which inadvertently leads to an error

Execution Errors occur when a task is performed incorrectly, although the person was competent to carry it out

The CLS Human Error Prevention Program

Step 1: Define the Strategy

  • Define purpose of the HEP program
  • Plan to influence change
  • Communication Plan
  • Select Pilot Program

Step 2: Training on HEP

  • Identify HEP training requirements
  • Leadership Training
  • Human Error Problem solving training
  • Human Error Tools Training

Step 3: Develop HERO Score

  • Identify Baseline Human Error Risk
  • Overview HERO score

Step 4: Manage the change

  • Create an Action Plan
  • Establish a Recognition Process
  • Monitor the Change

Support Provided

To enable this productivity improvement, CLS offers a unique, personable, action-based approach, focused on “Simplifying Complexity” supporting the transition to a Lean Project Delivery System. Areas we can provide support include;


  • Human Error Prevention for Leadership
  • Human Error Problem solving Process
  • Human Error Risk Overview Score (HERO)
  • Toolbox for Human Error Prevention
  • Visual SOP Training


  • Strategy Development
  • Program Mentoring
  • HERO Workshop
  • Human Error Root Cause Analysis Facilitation

For Information on our Human Error Prevention Training Contact Us Today +353 (0)87 6226 899


Crystal Lean Solutions are one of the first consultants to receive the Mark of Commendation from LCI and are approved Enterprise Ireland and IDA Consultants.

To find out more about our flexible training program and funding available to you, contact us today.