1. Purpose of feedback
During the operating phase, the purpose of the feedback process is to take note of any abnormal elements that fall outside the scope of the prescribed rules, and to carry out a detailed analysis to identify their causes and sequences, and define the corrective measures needed to prevent them from recurring.
The "feedback" approach consists of systematically and organizationally listening for "signals" coming from the plant, and seizing on any accident, incident or anomaly to learn as much as possible from it. It is a response to the "intransparency" of complex systems.
This approach leads us to strongly question the real effectiveness of the pile of instructions and procedures that results from the vain hope that, "by forcing ourselves to write down everything we do", we would exhaust the totality...
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Purpose of feedback