Effective risk management requires the elimination of risk-taking
behaviors. These behaviors result in human error, the largest single
component of mishaps.
First-line supervisors are in the best position to help eliminate
human error. They are aware of day to day events and stressors that affect
the way people perform and can intervene by counseling individuals.
Questions are designed to assess behavioral factors and indicators
that are related to human error mishaps. They range from biographical
factors and work performance to risk-taking behaviors. One point is given
for a "yes" or "no" answer. A maximum of 26 points can be scored. The
higher the points, the greater the risk.
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IRA OFF-DUTY SELF ASSESSMENT FORM |
| I. BIOGRAPHICAL FACTORS |
Yes/No |
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SINGLE |
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MALE |
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E-5 OR BELOW |
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AGE 18-25 |
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II WORK PERFORMANCE FACTORS |
Yes/No |
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COUNSELED FOR POOR JOB PERFORMANCE |
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PERFORMANCE EVALUATION BELOW STANDARD |
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IGNORED SOP'S TO SAVE TIME |
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ARRIVED LATE OR DECLARED UA |
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LOW ADVANCEMENT EXAM AND PQS SCORES |
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III PERSONAL FACTORS |
Yes/No |
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IMPULSIVE DECISION-MAKER |
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FINANCIAL DIFFICULTIES SUCH AS BAD CHECKS,
LATE PAYMENTS |
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FAMILY ADVOCACY PROBLEMS SUCH AS SPOUSAL ABUSE |
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ALCOHOL/DRUG ABUSE PROBLEMS |
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RECENT SERIOUS FAMILY ILLNESS |
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RECENT BREAK-UP OR PROBLEMS WITH IMPORTANT PERSONAL RELATIONSHIPS |
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JUDICIAL OR NON-JUDICIAL PUNISHMENT |
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IV. RISK-TAKING FACTORS |
Yes/No |
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PARTICIPATES IN ACTIVITIES WITHOUT APPLYING RISK MANAGEMENT PROCESS |
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INVOLVED IN RECENT ACCIDENT OFF-DUTY |
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CONSUMES ALCOHOL BEFORE OR DURING ACTIVITY |
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BULLET-PROOF MENTALITY |
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DOESN'T USE PERSONAL PROTECTIVE EQUIPMENT SUCH AS SAFETY GOGGLES OR LIFE JACKET |
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|
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V. LEAVE/LIBERTY FACTORS |
Yes/No |
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PLANS TO SWIM IN AREAS WITHOUT LIFEGUARDS |
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PLANS TO BEGIN WORK UNDER VEHICLE WITHOUT ADEQUATE SUPPORTING EQUIPMENT FOR LOAD |
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PLANS TO JOG OR BOAT DURING BAD WEATHER |
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PLANS TO PARTICIPATE IN HIGH-RISK SPORTS
SUCH AS SCUBA DIVING AND OFF-ROAD RIDING |
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PLANS TO CAMP WITHOUT SUFFICIENT FOUL WEATHER GEAR OR KNOWS TERRAIN |
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TOTAL POINTS: |
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(TOTAL POSSIBLE POINTS: 26) |
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