The Operating Experience Program

The HS-30 Operating Experience Program manages and shares operating experience data from across and outside the DOE Complex in order to share good work practices and prevent adverse events. Occurrence Reports that have been filed from all DOE sites during the previous 24 hours are analyzed daily and assigned keywords before being entered into the Occurrence Reporting and Processing System (ORPS), a central, searchable database.

The Requirements

DOE’s Occurrence Reporting Program sets forth the minimum set of occurrence reporting requirements for Departmental Elements, including the National Nuclear Security Administration (NNSA), and contractors responsible for the management and operation of DOE-owned and DOE-leased facilities. These requirements include categorizing occurrences related to safety, environment, health, or operations (Reportable Occurrences); notifying DOE of these occurrences; and developing and submitting documented follow-up reports. These occurrence reporting directives further require that the notifications be timely in accordance with the significance of the occurrence, and that the written reports contain appropriate information describing the occurrence, significance, causal factors, and corrective actions. No exemption to this minimum set of occurrence reporting requirements is permitted.

In addition, DOE analyzes aggregate occurrence information for generic implications and operational improvements. The Occurrence Reporting Program, including the Occurrence Reporting and Processing System (ORPS), is described in DOE O 231.1A, Environment, Safety and Health Reporting, and its associated Manual, DOE M 231.1-2, Occurrence Reporting and Processing of Operations Information. Other related documents are DOE G 231.1-1, Occurrence Reporting and Performance Analysis Guide, and DOE G 231.1-2, Occurrence Reporting Causal Analysis Guide.

Getting the Information to the Field - DRAFT

Safety Bulletins, Safety Alerts, Lessons Learned, and the Operating Experience Summary are readily accessible on the DOE Website in order to reinforce the core functions and guiding principles of Integrated Safety Management. Bulletins and Alerts are published soon after a particular event of note. The Operating Experience Summary, on the other hand, is a compilation of articles written about recent events in the Complex, commercial nuclear, and industry, both national and international, and so is published on a periodic basis. The target audience is first-tier supervisors, work planners and craft personnel for distribution DOE-wide.

Lessons Learned and Best Practices
DOE Corporate Lessons Learned (LL) is a web-based tool designed to facilitate information sharing in a consistent and timely manner among headquarters elements, contractors, and subcontractors. It is updated daily, compiled after subject matter expert review of DOE LL reports submitted from across the DOE complex. Sharing lessons learned can potentially reduce risk, improve efficiency and performance, and enhance the cost effectiveness of DOE processes and operations, since it is meant for facility management’s use in defining and planning work, promoting continuous improvement, and correcting hazardous conditions.

The DOE lessons learned program also provides a feedback mechanism for the job planner for selected types of work, and during hazard analysis and work planning activities.

Safety and Health Alerts, Safety Bulletins
DOE quickly disseminates publications after an event, using actionable information that has a high potential to impact safety and health at DOE facilities. Most of the publications listed below are available at http://www.hss.energy.gov/CSA/specialreports.html

Special Operations Reports (SOR) are issued by the Deputy Secretary of Energy to initiate management actions in response to events whose subject matter represents significant Department safety concerns. SORs are disseminated through formal correspondence to the National Nuclear Security Administration (NNSA) and the Program Secretarial Offices (PSOs) for action and further dissemination to field elements and formal submittal to contractors for action. Topics have included electrical safety and laser eye safety.

A Safety Alert (SA) is issued by the Office of Health, Safety and Security (HSS) to inform the DOE Complex or affected sites of potentially significant safety issues that can adversely affect operations (for example, an immediate conduct of operations problem, suspect/counterfeit parts or defective items that require immediate action). SAs are disseminated by formal correspondence from HSS to NNSA Deputy Administrators and PSOs requesting their action and further dissemination to DOE field elements and formal submittal to contractors for action. Topics have included defective scaffold clamps and respirator filter recall.

A Safety Bulletin (SB) is issued when analysis of operating experience data shows a trend that warrants senior Headquarters, field manager, and contractor attention. SBs are disseminated by formal correspondence to NNSA Deputy Administrators and the PSOs recommending their action and further dissemination to DOE field elements and formal submittal to contractors for action. Topics have included silica dust exposure, automated external defibrillators (AEDs), and counterfeit square D circuit breakers.

A Safety Advisory is written on an as-needed basis when analysis of operating experience data shows a trend that warrants senior Headquarters, field manager, and contractor attention but is of less significance than would merit producing an SOR, SA or SB. Advisories are disseminated by being posted to users of the DOE Corporate Lessons Learned Database or are posted on the Lessons Learned web page. Topics have included beryllium exposure awareness, coping with post-traumatic stress, and an OSHA update to electrical installation.

A Just-in-Time Operating Experience Report is issued to communicate brief examples of problems and mistakes encountered in actual cases and to present points to consider for avoiding similar occurrences by compiling lessons learned from review of common (i.e., frequently performed) work activities for an audience that includes program managers, field representatives, work planners, first line supervisors, and workers.