In this episode of the Pipeliners Podcast, Russel Treat is joined by Mike Mercer from the High Reliability Group to explore what it means to be a high-reliability organization (HRO). The conversation covers how leadership, culture, and standardized processes contribute to safety and performance in high-consequence industries like nuclear and pipeline operations. Listeners will gain insight into how deliberate leadership behaviors can build more resilient teams and better prepare organizations to manage the unexpected.

Leadership in the High Reliability Organization Show Notes, Links, and Insider Terms

• Dr. Mike Mercer is a Senior Consultant at High Reliability Group, LLC. Connect with Mike on LinkedIn.
  • High Reliability Group LLC is a management consulting firm specializing in High Reliability Organization (HRO) principles. Drawing from the operational standards of the U.S. Nuclear Navy, the firm helps clients improve safety, consistency, and performance through proven HRO practices. Its consultants bring decades of real-world leadership experience across high-risk industries.
  • Learn more about the HRG Leadership Program
• High-Reliability Organization (HRO): An organization that operates in high-risk, high-consequence environments while maintaining a strong safety record through structured processes, culture, and leadership.
• Nuclear Navy: A branch of the U.S. Navy operating nuclear-powered submarines and ships, known for its rigorous safety culture, structured procedures, and high standards, largely shaped by Admiral Hyman Rickover.
  • Admiral Rickover: The founder of the U.S. Navy’s nuclear propulsion program. His leadership principles emphasized strict adherence to standards, deep technical knowledge, and accountability, setting the foundation for high-reliability culture.
• Watch Team Backup / Forceful Watch Team Backup: A deliberate practice in HROs where team members actively monitor one another’s actions to prevent errors, regardless of hierarchy. Also referred to as Deliberate Team Backup.
• Stop Work Authority: The ability for any team member—regardless of rank—to halt operations if something appears unsafe or incorrect, reinforcing accountability and safety.
• Questioning Attitude: A core behavioral trait in HROs that encourages team members to continually challenge assumptions, raise concerns, and ask questions, even in routine operations.
• Knowledge and Learning: Foundational behavior in high-reliability systems combining technical expertise (explicit knowledge) with field application (experiential knowledge) to support safe, effective performance.
• Integrity: In this context, integrity refers to each individual’s full contribution to team safety and performance, including the courage to speak up, own mistakes, and act transparently.
• Normalization of Deviance: A phenomenon where repeated exposure to nonstandard or unsafe practices leads them to be perceived as normal, eroding safety over time.
• Circle X Method: A formal, step-by-step procedure execution method used in the Nuclear Navy, involving reading, verifying, executing, and marking each step with verbal confirmation, often using grease pencils and sheet protectors.
• Procedural Rigor: The degree of structure and discipline applied when following procedures; tailored based on task complexity, risk level, and personnel experience.
• Cognitive Diversity: The range of perspectives, experiences, and thinking styles among team members that contribute to effective problem-solving and decision-making in HROs.
• Psychological Safety: A cultural condition in which individuals feel safe to voice concerns, ask questions, and admit mistakes without fear of punishment or ridicule.
• Scholar-Practitioner: A professional who applies academic research and theoretical frameworks in practical, real-world settings—especially in leadership development.
• Managing the Unexpected: A leadership capability in HROs that enables teams to adapt quickly to abnormal operating conditions by fostering awareness, decision-making readiness, and trained responses.
• Abnormal Operating Conditions (AOC): Unexpected or off-nominal situations in operations that require deviation from normal procedures and pose elevated safety or operational risks.
• SQUAD Analysis (S1–S4): A multi-layered framework used by HRG to evaluate organizational performance, including:
  • S1 – Self: Individual-level factors such as bias, leadership style, and psychological safety.
  • S2 – Situation: Environmental context, including physical, psychological, and personal (relational) factors.
  • S3 – System: Governance, policy, procedure, and organizational structure.
  • S4 – Surroundings: External influences such as regulatory bodies, public perception, and industry pressures.
• Transactional vs. Transformational Leadership: Two contrasting styles where transactional leadership focuses on rule-following and performance, while transformational leadership emphasizes vision, inspiration, and cultural development.
• Psychological Environment: The mental and emotional conditions influencing decision-making, especially under stress or during crisis events.
• Normalization of Deviance: A gradual erosion of safety norms as deviations become tolerated and eventually accepted as normal practice.
• Dramatic Rehearsal: A proactive mental simulation or scenario planning exercise where leaders visualize potential emergencies to prepare responses in advance.
• Bellingham Incident: Refers to the 1999 Olympic Pipeline explosion in Bellingham, WA. A landmark event in pipeline safety history, which led to regulatory reforms and broader implementation of Pipeline Safety Management Systems (PSMS).
• PHMSA (Pipeline and Hazardous Materials Safety Administration) is responsible for providing pipeline safety oversight through regulatory rulemaking, NTSB recommendations, and other important functions to protect people and the environment through the safe transportation of energy and other hazardous materials.
• NTSB (National Transportation Safety Board) is a U.S. government agency responsible for the safety of the nation’s major transportation systems: Aviation, Highway, Marine, Railroad, and Pipeline. The entity investigates incidents and accidents involving transportation and also makes recommendations for safety improvements.
• API (American Petroleum Institute): Since its formation in 1919 as a standards-setting organization, API has developed more than 700 standards to enhance industry operations. Today, it is the global leader in convening subject matter experts to establish, maintain, and distribute consensus standards for the oil and natural gas industry.
• API Recommended Practice 1173established the framework for operators to implement Pipeline Safety Management Systems (SMS). A significant part of this recommended practice is a training and competency aspect.
  • PipelineSMS.org is a useful resource with various safety tools that was developed by pipeline operators to help other operators enhance safety in their operation. Read the website resources or email pipelinesms@api.org with inquiries.
  • The Plan Do Check Act Cycle (Deming Method) is embedded in Pipeline SMS as a continuous quality improvement model consisting of a logical sequence of four repetitive steps for continuous improvement and learning.
• Regulatory Oversight: The process by which agencies like PHMSA ensure compliance with safety and operational standards through inspections, audits, and enforcement.

Leadership in the High Reliability Organization Full Episode Transcript

Russel Treat: Welcome to the “Pipeliners Podcast,” episode 399, sponsored by EnerSys Corporation, providers of POEMS, the Pipeline Operations Excellence Management System, operations and compliance software for the pipeline operator to address safety program management, control room management, and field operations. Find out more about POEMS at enersyscorp.com.

[background music]

Announcer: The Pipeliners Podcast, where professionals, bubba geeks, and industry insiders share their knowledge and experience about technology, projects, and pipeline operations. Now your host, Russel Treat.

Russel: Thanks for listening to the Pipeliners Podcast. I appreciate you taking the time. To show that appreciation, we give away a customized YETI tumbler to one listener every episode. This week, our winner is Brandi Good with Enbridge. Congratulations, Brandi. Your YETI is on its way. To learn how you can win this prize, stick around till the end of the episode.

This week, we speak with Mike Mercer with the High Reliability Group about leadership in the high-reliability organization. Hey, Mike. Welcome to the Pipeliners Podcast.

Mike Mercer: Hey, Russel. Thanks for having me.

Russel: Before we dive in, I always like to ask the guest to do a little bit of an introduction. If you would, tell us a little bit about yourself, your background, and what you do.

Mike: I am a Senior Consultant for the High Reliability Group. We are a group of consultants. Most of us, pretty much all of us, are retired Navy nukes who worked for Bob Koonce, who is a retired or former nuclear submarine captain. He took the idea of an inspection team in the Navy. Every year, we would get inspected to make sure we were safe to operate nuclear reactors.

He took that idea and is applying it to high-reliability organizations, so high-risk, high-consequence, and making sure that those same safety principles that have led to 75-plus years of safe reactor operations, that those are the kind of principles that we’re applying to the high-reliability organizations.

That’s what we do. We go in, and we do an assessment. We offer them feedback and also coaching and been doing that since 2016. I’ve been with the team since October. My background, I’ve been really focusing in on the leadership.

Post-Navy, I really been focusing or pursuing leadership academically all the way through my doctorate in executive leadership. I was brought in to build a leadership development program. That’s what I’ve been focused on. That’s a little bit about me and HRG.

Russel: What did you do in the Navy?

Mike: I was a submarine nuclear-trained electrician, but please don’t ask me to do any of that electrical work. I don’t even like to change light bulbs anymore.

Russel: [laughs]

Mike: Too many of those.

Russel: That’s funny. I have a number of friends…In fact, one of our employees is former nuclear Navy. I have friends, back when I was in the Corps, at Texas A&M that were on Navy scholarships and had plans to go into the nuclear Navy. Some of them made it to captains of nuke boats. That’s a big deal.

The way that that program works, starting with the way that the candidates get trained and selected, is unique. I guess that’s the word I would use. It’s just the way they approached it was different than what a lot of organizations do. It’s just unique.

Mike: For sure. I’ll say, my biggest takeaway from my time in the Navy and on submarines, it was really about the team and the culture. There’s a right way to do business and to do maintenance and to do operations.

That is what we have taken and what we’re applying in HRG and what we’re sharing with these high-reliability organizations, what we’re building in the leadership development program, that’s the secret sauce. That’s what it’s all about.

Russel: That’s a great segue. I was going to ask you to define what is a high-reliability organization, but I think what I’m going to do is I’m going to talk a little bit about my take on it and then listen for you to tell me what I got right, what I got wrong, if that makes sense.

We, as pipeliners, we operate what I might call high-consequence organizations, meaning when we don’t get it right, things happen that have significant adverse consequences. I think you could say the same thing about the nuclear navy. If you don’t operate a nuclear reactor correctly on a boat, submerged, then that has very significant consequences.

Mike: That’s 100 percent right.

Russel: A high reliability organization is somebody who can operate a high-consequence operation in a reliable way that

Mike: I think that’s a great way to put it.

Russel: I would say that the thing that makes an organization a high reliability, there’s several elements, but one of the key elements is leadership. That leadership doesn’t mean what I tell people to do. It has to do with the culture that I deliberately create that can operate in a high-reliability way. Have I got that right?

Mike: Absolutely. John Maxwell, who’s a big leadership guru, I guess you could say, boils it down to, “Leadership is influence. Nothing more, nothing less.” It’s out of who we are and our giftings. That’s how leadership flows. It’s the culture that you create in the teams that you lead.

It’s not about telling people what to do, but how you set them up for success. How you run your day-to-day, that will either set them up for success or set them up for failure.

Russel: Exactly. One thing you did say, though, is you said Maxwell says it comes out of your gifting. I think there is some truth to that, but I do think that leadership can be learned. It is not something you’re born with. Like anything else, it’s a learned skill.

Mike: For sure. I completely agree with that.

Russel: But it’s learned in a laboratory. It is not learned out of a book. It’s more like riding a bicycle.

Mike: It is a combination of the two, because there’s a thing called the knowledge spiral, and it combines experiential knowledge with explicit.

Like in the nuclear navy, we had our reactor plant and steam plant manuals. We would read the book, and we learned the technical knowledge, and then we went and we applied the knowledge, and that became our experiential knowledge.

Then we would write down our lessons learned after we went and did an evolution. Those lessons learned now became formalized as we wrote our standing order. It’s like this ongoing cycle of experiential and explicit knowledge. You see what I’m saying?

Russel: Yeah. That’s the PDCA cycle in safety management, right?

Mike: For sure.

Russel: But the point I’m making is the leadership attributes, the things that leaders need to do to create and facilitate a culture of learning and a culture of ownership, and those things, that those are learned skills, but they have to be practiced to be fully learned.

Mike: Absolutely.

Russel: You don’t learn them without practicing them.

Mike: 100 percent. Which is why I like the fact that my terminal degree is a scholar practitioner and not a — not that there’s anything wrong with a PhD — but mine is a scholar practitioner because I had to demonstrate through several different projects the outcomes because leadership is demonstrated, not just talked about. I completely agree with you.

Russel: To this point, I want to elaborate a little bit about the nature of what that leadership looks like. You shared some information where you compared traditional military culture to Rickover’s nuclear culture.

For those that are listening to the podcast that are not nuclear folks, Admiral Rickover was the founder, creator, mentor owner of the nuclear navy pretty much until his death. If you didn’t do it the Rickover way, you didn’t do it in his nuclear navy. That’s how that is.

He was a really fascinating guy and very forward-thinking. He really took military leadership and spun it on its ear. I have personal experience of people who I was in the Corps at A&M with that were applying for the Nuclear Navy that got thrown out of Rickover’s office more than once. They would try to say that I know leadership and he’d be like, no you don’t. Does that resonate for you?

Mike: It really does. There’s even a great story of President Jimmy Carter and his experience with the Admiral. Being asked by the Admiral, did you do your best? He had to sit there and think and admit to the admiral that he hadn’t done his best.

I think that gives us all pause to really consider in any given situation, have we really done our best. The Rickover standard which is the Nuclear Navy standard. I would say the longer we go on, it’s important that we don’t forget who the admiral is and what he did.

We have to take ownership of that standard for ourselves. we can’t keep saying that’s the Admiral Standard, because that is the standard. When we think about traditional military culture versus the nuclear culture, follow orders, just do what you’re told versus have a higher level of understanding that is the standard when it comes to nuclear versus, or higher reliability, right?

We have a higher level of understanding because if we don’t, if we just do what somebody tells us to, without thinking. There’s consequences to that.

Russel: We have to know enough about the process to be able to question when things are not normal.

Mike: Right. It’s finding that balance between, there’s a formality in executing procedures, whether we’re talking about actually doing a circle, an X in the procedure. Depending on the difficulty, the complexity of that procedure.

Sometimes you’re actually merging two and three different procedures. You’re bouncing between them because of the complexity of that procedure. we would use a method we call Circle X, where we have actually put sheet protectors and we’re using a grease pencil, and we’re actually, we circle the step, we read the step.

There’s a verbatim repeat back in the communication. That step gets executed. It’s repeated that it’s completed, and then it gets marked off, and then you do the next step, right? That formality in the procedure, in the communication.

Then if something doesn’t seem right, we question it, right? Not because there’s no trust, but because there’s accountability. In traditional military culture, never challenge your superiors. That’s not how it is. We expect that you will challenge in a respectful manner, right?

Even if you just say stop, right? That’s not disrespectful. Now you have to understand, when you say stop, you have to understand the plant conditions. Because you can’t say stop in the middle of some sort of transient condition because you have to be in a safe condition.

Russel: You’re talking a lot from a nuclear kind of power plant perspective. If I try to take this to pipelining, there’s a couple things you’re saying that I would think would resonate and a couple things that would be a bit I’m not sure that we want to do that.

The idea of, I read a procedure, I communicate a procedure, somebody executes a procedure, you confirm the execution. That level of rigor in a process, most pipeliners would go, that’s crazy, right? On the other hand, if I’m doing a weld or I’m doing a pipe fusion, in plastic pipe or something like that. There is an appropriate level of rigor and communication to make sure I follow the procedure.

That’s really what you’re getting at, right? Is what’s the appropriate level of rigor and procedure.

Mike: For sure and I would say the next level down from what I was talking about is where maybe you read a couple of steps and you go execute those two steps, right? Then the next level down of that is you read the procedure. then you go do it.

Then the next level down from there is you’ve done the procedure, you know the procedure, and there’s not a lot of concern for safety. It’s an everyday procedure.

Russel: It’s also, if I use again, a pipeline or example, it’s the difference between a senior pipeline controller and their level of qualification and somebody who’s brand new still in training. They’re…

Mike: To a degree. It really, again, depends on the what it is. The safety…

Russel: Getting a little out of the details of just talking about what is high reliability and what’s a high reliability approach is there is a presupposition of a high level of understanding, and part of the leadership is to make sure that everybody has the highest possible level of understanding. The other thing is that we’re going to formalize the way we execute procedures so that we all do it the same way every time.

Mike: That is so important.

Russel: Yeah. That I would argue in pipelining is we don’t do nearly a good enough job of that. I think we’re getting better as an industry, but I think we got a lot of ground to cover to get better. You need that level of consistency across the entire organization. Somebody doing a pipe fusion in Texas is the same thing as somebody doing a pipe fusion in or in Arizona.

Mike: If you think about it, that makes sense because number one if you don’t have a standard of way of doing it, how do you anticipate what the next step is? How do you question it if it doesn’t look right, sound right, feel right?

Russel: That’s really the key thing. If I don’t have a standard process and I don’t have a standard way of executing and communicating about the process, I don’t have near the ability to develop instinct around are we doing it correctly or is there something going on that I haven’t seen before, I don’t know about?

Mike: HRG, when we come on site, that’s all we want to do is just observe what you’re doing and provide you that insight. Hey, here’s an opportunity to standardize what you’re doing, because this is how it’s going to help you. This is where it’s going to make you safer.

This is where it’s going to help you be more efficient. It’s going to increase your watch your team backup. This is never about what you’re doing wrong. This is about how you can be more safe.

Russel: It’s all about process and team performance.

Mike: A hundred percent. We are much more about coming alongside and doing almost some shoulder to shoulder coaching as we’re evaluating. We’ve gotten really good feedback on that process. Because again, we’ve been there. We’ve been there, we’ve done it. We’ve been assessed.

Russel: There’s a lot of corollaries for this in the pipeline control room. There’s also a lot of corollaries for this in the field work that occurs in pipelining. You list, in the materials you gave me, some key behaviors. Number one being knowledge and learning. We’ve talked about that. Number two being formality. Talked about that.

Number three being a questioning attitude. I call that wondering, like always having a childlike wonder about what’s going on, what’s operating, what’s occurring, and then communicating what you’re seeing. Number four is forceful watch team backup. Can you explain what that is?

Mike: Yes. Forceful watch team backup, especially in the nuclear navy, this is definitely where, regardless of rank title or whatever, if you see somebody getting ready to take an incorrect action — and this is where that knowledge and learning comes first, you have to have that solid baseline knowledge of the plant and understanding.

Because if you see somebody getting ready to take an incorrect action, being willing to vocalize that, “Stop,” or, “Take your hand off the panel,” or whatever it is to give that very commanding order regardless of who they are, that’s forceful watch team back up.

Russel: That’s the person looking over your shoulder trying to make sure you don’t make a mistake.

Mike: That could also be…

Russel: That’s not necessarily a deliberate thing as much as is the teamwork thing.

Mike: I guess it depends on how you look at it, because the way that I’ve written it now in the curriculum for the leadership program is I actually call it deliberate team backup because it is intentional.

It means that everybody in the space is paying attention to what’s going on. There’s no silos because it could be the panel operator on the other side of the room who is paying attention and saying, “Wait.” Recommend doing this or asking that question. “Have we done A, B, C?”

Russel: No, I get it. I’m thinking of a baseball analogy. If the ball’s hit sharply to the shortstop, the left fielder’s coming up to back him up. That’s all situational because if it’s hit sharply and there’s somebody on first, then…

Everybody understands that this is the condition we’re in, and this is the play or the operation we’re going to perform. I know, based on current state operation I’m going to perform, what is my role and who am I backing up.

Mike: Anybody, from senior to most junior, has that what you call stop work authority. Anybody on a team…

[crosstalk]

Russel: That’s commonly understood. What’s not commonly understood is putting some formality and structure around how you’re putting people in place to actually do stop work. Sometimes, it’s not stop work as much as it says, “Pause, this is correct work.” Stop work tends to mean shut everything down.

Mike: This forceful watch team backup is just on a normal day. We’re standing watch. We’re in the control room. We’re wherever in a unit.

You can ratchet that up if we’re doing a controlled evolution. Now, you’re adding a layer. You’re putting specific people, extras, supervision in place over that shoulder to specifically watch and make sure that they don’t take wrong action.

Russel: A lot of times, that manifests in the way a multi-person procedure is operated, and how multiple people collaborate. How they work together and collaborate in a process. The last one you have in this list of five behaviors is integrity. I think I know what that means, but I’m going to ask. What do you mean by integrity?

Mike: Integrity is like the…Was it the one ring that rules them all, if you will? I always think about integrity like structural integrity.

Russel: Here’s what I would think that it means. What it means is every person on the team is fully contributing to get to the outcome in a safe way.

Mike: I love that.

Russel: What that means is the biggest failure in high reliability organizations around this is what I would call withholding. It’s failure to say or communicate something that you think is material. There’s all kinds of reasons that we as humans do that. That guy knows more than me. That guy has a more senior position than me. It’s not my place to speak up. I’ll let somebody else speak up. That sort of thing.

Integrity is I am going to say what I see and I’m going to say what I believe to be true. Now you want to do that in a respectful and proper way, but I’m going to contribute my part. That’s integrity.

Mike: I agree. I just didn’t want to give the, do what’s right when no one’s looking. Because I feel like it’s more than that. It’s…

Russel: Yeah, it’s that too. It’s really don’t withhold. That’s the human failure that I think you tend to see in these kind of things. One of the other things in the materials you sent me was this idea of managing the unexpected in a high reliability organization.

I don’t know that we got time to fully unpack that, as I was reviewing that material, so we’ve been talking about watch, we’ve been talking about structure and process and procedure and questioning attitude and all that.

Ultimately what we’re trying to do is we’re creating the capacity to effectively manage the unexpected, what we in planning would call abnormal operating conditions. In a general way, what’s important in terms of leadership in order to have the capacity to do this?

It’s all about how the organization or the team makes decisions, right? How does it take in new information and how does it make decisions? Then there’s a whole bunch of like common human failures that contribute to the outcomes we’re not looking for, right?

Things like I want to defer to rank versus expertise. Another one would be I’m always thinking about what could go horribly wrong. I’m preoccupied with adverse outcome. Another would be, I don’t want to simplify it. I’m going to make it more complex.

It’s interesting. Engineers and operators in this kind of thing tend to want to make things more complex, because we’re focused on all the little bitty details. Those kinds of things, and being able to lead people to operate in a way that they don’t fall into standard human traps.

Mike: For sure.

Russel: That is not a simple thing, by the way. That is a very complex thing.

Mike: No, and it takes an intentionality by leaders to. To not make it more complex, to not fall into do it because I said to, or, all those things that you talked about. That’s why I love referencing managing the unexpected. Especially when you are in the, you could call it the fog of war, when you’re in the fight if you will.

You have to think about those things ahead of time and I’ve heard it called dramatic rehearsal. It’s like literally, what do I do when. Think about it all the way through so that when you’re in that situation, you’ve already put yourself there, you’ve already thought about it.

Because once you’re there as a mentor of mine says, once the time of execution is upon you, the time of preparation is over.

Russel: That’s right. You’ll fall into one of two behaviors. You’ll fall into whatever your human nature takes you to, or you will fall into your training. It’s one of those two extremes. You fall into one of two. If you have the right training, if you have the right leadership, then you’re going to fall into your training. If you don’t have the right leadership, you’re going to fall into your human behavior

Mike: A hundred percent.

Russel: If you study incidents that the human factor is always a material part of the incident, and normally it’s not a single failure, a single human doing a single thing. It’s a set of things that come together and operate to give you an adverse outcome.

It’s not normally a single person or a single decision. It’s more of a systematic thing, but it all relates to the human element in the organization.

Mike: Absolutely.

Russel: I wanted to wrap up. You did a little bit of an analysis of the Bellingham, and you did what you guys call an S-quad Analysis. We’ll start with the self, and let’s unpack that a little bit. What is that evaluation, and how would you analyze Bellingham?

Mike: When we talk about the self-cognitive diversity is always a good place to start because that is that’s everything that makes a person a person. That’s their diverse perspectives. That could be specifically when we’re talking about Bellingham, that’s their diverse perspectives on pipeline safety, on risk management.

Maybe it was limited, maybe that led to some overconfidence in existing protocols. It’s looking at their leadership style. Maybe it was a transactional versus transformational leadership style.

Emphasizing maybe more direct compliance with existing procedures that could have discouraged innovative safety measures. Or critical questioning of pipeline integrity.

At the S1 level, we’re also looking at individual bias. How did that personal bias impact decision-making that could have hindered proactive identification of vulnerabilities in the system. Sometimes you have a lot of, “Well, that’s the way we’ve always done it.”

You become blind to problems. That’s the normalization of deviance, if you will. Then you also have some psychological safety going on. If you have a lack of that, that could have played into that at the S1 level as well.

Russel: Yeah. I noticed in the materials you provided me that you’re looking at this from two perspectives. One is the initial response, and the other is a secondary response.

I’m looking at how you scored that. It’s interesting because just in terms of the entire S-quad assessment, the initial response is generally not effective, but the secondary response is somewhat more effective. That tells me that the incident caused them to learn something.

Mike: True. Now if you’re looking at the self, you’ll see that the self is actually somewhat effective and then highly effective. They actually, at the self-level, they learned quite a bit.

Based on the Likert scale, and now take this at the subjective level, because this is based on the prompts that I put into taking the S-quad Analysis, taking the incident report, putting it into an AI, whether that’s Copilot or ChatGPT, or whatever. There’s some element of my own bias, because the first time it came back, it said that they were somewhat effective.

I’m like, “People died.” I’m like, “How are they effective?” I’m like, “Rerun the analysis. And don’t be afraid,” is what I told it. I said, “Don’t be afraid to be more critical because there were fatalities. When it came back, it was definitely more critical. Take it for what it’s worth. If nothing else, no model is perfect, but it…

Russel: We also have to take into account that this is a third party who’s not a pipeline or using a NTSB report, which is public domain and may not include all the information that’s available, and doing kind of an analysis.

Mike: The whole purpose of the S-quad is it gets you to look at a bigger picture. What did we miss? Have we thought about…?

Russel: You got situation, which is looking at the decision-making, the resource allocation, and the pressures that were operating. There were some significant pressures in Bellingham around implementing some changes and some field work that was going on, and other things. That’s interesting. If I walk this up a little bit…

Mike: If I could, at the S2 level, you’re really looking at three sub-environments. That’s the physical constraint, the physical environment, you’re looking at the psychological environment, and you’re looking at personal environment.

Any kind of relational issues, that could be peer-to-peer, that could be supervisor to subordinate. Psychological, that could be preexisting psychological, that could be in the middle of the casualty, psychological. Then, like I said, the physical constraints of, if I was in the shipyard and we were behind on schedule.

There’s a lot of things, and these aren’t linear. These are complex, and they’re all happening at the same time. How does that influence the decision-making that’s happening in real time? You have S1, which is the supervisor, the cognitive diversity, the biases, and all that.

Now, you’re putting them inside of a situation with three sub-environments, all complex, and now you’re going to put them inside of S3, which is your governance, your policies, your procedures. Then, hopefully driven by your mission, vision, values, what did you see in S3 in the system?

Russel: What’s interesting to me is I don’t know what the actual production performance drivers were around Bellingham. I know a lot about the actual causal events, but not about…What occurs to me is I don’t know a lot about that.

I know that one of the findings was inadequate regulatory oversight, and that the whole pipeline safety framework that we now operate under in the US came directly out of Bellingham.

There was a systematic failure from a regulatory oversight perspective that caused material change. That’s interesting. It’s interesting. Then the S4 is the surroundings. That was kind of talking about surroundings there, the regulatory part.

What’s interesting to me as I look at this is I always love a structured way to put information together, particularly information that might otherwise be thought of as subjective.

What this is doing is it’s structuring a way to capture information, some of which we might think of as subjective, but that just really means it’s a human factor. It’s a little bit harder to quantify and identify.

I like the structure. The thing that’s really interesting to me is it just says the initial response was ineffective. It just didn’t work. Then the secondary responses were maybe effective. You could argue that certainly been a lot of pipeline safety performance improvement in the industry since Bellingham.

It’s an interesting kind of mechanism. I think it ties together the conversation we’ve been having in that this human factor, you have to understand how it’s operating and what’s needed or required in the organization from a leadership and capabilities, capability to overcome that.

Mike: For sure, and being able to take the outcome of this analysis and then turn it into almost like an audit tool is we take the lessons learned and then it’s, OK, how do we now, we’re not Bellingham we’re Morgantown or whoever. How do we go look at ourselves? How do we take these lessons learned and we turn this into a checklist?

It’s not comprehensive. This is not the only thing we’re going to go look at. It gives us an idea of the things that we should go look at. That’s one of the things that I love about the S-Quad analysis is, again, we’re using today’s tools, which AI is one of them.

Is now I’m taking the lessons that I learned from the analysis and I’m saying, “OK, now based on these lessons learned, give me an audit checklist to go and assess what things should I go look for? Then I go and I take those right?

Russel: Yeah, no I think this is really excellent. It certainly creates some structure around things I know to be true from a leadership perspective. I think it creates some…One of the key principles in pipeline safety management is leadership, but this begins to put some structure, clarity and depth around what that means or what that could mean for an organization.

Mike: For sure.

Russel: Look, this has been a great, this has been a great conversation. We’re running a little longer than I normally do. That’s all good. For the listeners we’ve been talking about a PowerPoint. There’s a lot more information in this PowerPoint on this subject. We will make that available through the website. Just go find episode 399 on the Pipeline Podcast Network website.

You’ll be able to download the PowerPoint we’ve been talking about. There’s a bunch more information in here. We’ll also link up information so if you’d like to get in touch with the High Reliability Group and explore what they can do, that’ll be available to you as well. Listen, Mike. Really appreciate your time. It’s been a great conversation. I’ve certainly learned some things. I got some ideas. I appreciate you, man.

Mike: Thanks for having me, Russel. I had a blast. This has been so much fun. Really appreciate the time and the opportunity.

Russel: I hope you enjoyed this week’s episode of the Pipeliners Podcast and our conversation with Mike. Just a reminder before you go, you should register to win our customized Pipeliners Podcast YETI tumbler. Just visit pipelinepodcastnetwork.com/win and enter yourself in the drawing.

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Russel: If you have ideas, questions, or topics you’d be interested in us talking about, please let me know on the Contact Us page at pipelinepodcastnetwork.com, or reach out to me on LinkedIn. Thanks for listening. I’ll talk to you next week.