Abstract
Abstract
Designed systems inevitably rely to some degree for their protection on organizational artefacts. These are rules, procedures, instructions, authority structures and so on that are designed, like physical devices, but have organizational rather than physical functions. An analysis was conducted of maritime accidents to investigate how these organizational artefacts were implicated in failure, and a method was then developed to help system designers to perform a failure modes analysis of these artefacts. The proposal is that analyses of failure modes in physical devices should be accompanied by parallel analysis of failure modes in organizational artefacts.
