Industry Best Practices to Counter Critical MOC Faulure Modes

Industry Best Practices to Counteract Critical MOC Failure Modes

MOC continues to recognized as a vital PSM element for accident prevention.  Yet, industry incident experience reveals that are several areas where MOC design, roll-out, execution and monitoring still challenge even the best companies.  This paper will address critical MOC failure modes and ways to address them to prevent repeating other company's accidents:

• Not recognizing change
• People going around the MOC system
• Temporary changes
• Organizational changes
• Inadequate hazard review
• Inadequate communication of changes

This paper and presentation will present each critical failure mode, a specific incident example, technical /cultural causal factors, and industry best practices to make an MOC system fault-tolerant to these problems.