A system for the feedback of experience from events in by International Atomic Energy Agency

By International Atomic Energy Agency

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In some cases the involvement of additional expertise in the cause analysis should be considered. Very often the notions of immediate (direct, observed) causes, root causes and contributing factors are used in the cause analysis. Cause identification should be carried out for the formulation of corrective actions. The depth of the causal analysis should be adequate for ensuring the determination of appropriate corrective actions. Numerous methods of root cause analysis, many having a similar basis, have been developed or are under development for addressing the connection between root causes and corrective actions (see the annexes).

7. Information to be disseminated should be derived from a number of sources, typically including early notifications with corrective actions taken or planned, main reports of events and follow-up reports. In addition, other periodic reports issued within the framework of the system for feedback of operational experience (for example, monthly reports, annual reports, topical study reports and summary reports to highlight valuable operational experience) should also be included. 8. g. in relation to matters such as the dissemination of proprietary or confidential information).

In addition to the documentation and tracking of actions associated with each single event, a systematic compilation of actions should be made to provide a historical information base of lessons learned. When these actions are compiled and sorted on the basis of the systems affected or the safety issues raised, they can serve as solutions for similar problems that could arise in the future at the plant or at other plants. 6. 1. The IAEA Safety Requirements for Operation [2] states in para. 23 that “…operating experience shall be carefully examined by designated competent persons for any precursors of conditions adverse to safety, so that any necessary corrective action can be taken before serious conditions arise”.

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