**4. Organizational knowledge and learning model**

The next paragraph contains the empirical development of research, which has designed a model of knowledge acquisition based on analysis and evaluation of operational experience and has developed an organizational learning system that has been brought to practice successfully in Nuclenor, company that manages the operation of the nuclear power plant of Santa María de Garoña in Spain. Following are commented the background and organizational context in which the work has been developed, are characterized the organizational roles involved in the model and are described the activities of the process of analysis of operational experience and acquisition of knowledge, to finalize presenting learning model developed using workflow nets as a technique of specification.

#### **4.1 Background and organizational context**

Currently the development of policies of continuous improvement in the organizations can be achieved through the implementation of organizational learning processes and the evaluation of operational experience, according to the phases of detection, communication, evaluation and, correction and improvement of findings, events or incidents reported.

Following is presented a methodology for the acquisition of knowledge and learning based on experience, this methodology is been used to improve the efficiency in Nuclear Power Plants, which for the strict and rigorous control that they are subjected, can provide the basis for other industries.

The Nuclear Security Council in Spain carried out periodically a review of the security of Nuclear Power Plants, through the evaluation of the operational experience required to the holders of energy production plants. It must demonstrate that the power plants maintain a

Assessment of Operational Experience as Strategy

(execute) them and within what time.

when was necessary.

consider the following roles:

is executed, giving the incident by closed.

**4.2 Organizational roles of the process** 

evaluation (BuUnCoor. Resp. Eval.).

the events and incidents detected.

responsible for the following functions:

for Knowledge Acquisition and Learning in Organizations 139

actions that prevent the future recurrence of the condition or adverse trend that carries again to the event occurs. In this sense, it will record the set of actions to be performed, indicating if they involve the correction or improvement of some aspect, their priority and the training to give when appropriate, establishing the business unit that will implement

The actions to be executed by each business unit are communicated to the unit responsible, starting then the implementation phase of the actions; process that ends when the last action

Likewise, the general coordinator of the process will carry out in parallel form the tasks of control and monitoring of the process on those events that are in evaluation or open (in phase of implementation of actions). The monitoring of the actions being executed will be recorded, indicating the date on which it is tracking, the evolution in the implementation of the action (difficulties, delays incurred, etc.), which may give rise to coordination actions

The process of knowledge acquisition and learning based on operating experience of the organization requires the coordination of the various business units and the participation of their staff. To implement this process in a satisfactory way in the organization it is necessary

*General Coordinator of the Process* (GeCoorPr): is responsible for managing the program of


*Business Unit Coordinators* (BuUnCoor): the coordinators of each business unit are


*Coordinators of business units responsible for evaluation* (BuUnCoor Resp. Eval.): in this case the



*Coordinators of business units responsible for execution* (BuUnCoor Resp. Exec.): will be the

*Personnel of the organization and external* (PerOr-Ex): any person who while performing their job detects an incident, must inform the coordinator of the unit providing the necessary data




operational experience, including the following tasks (PG-017, 2007):

responsible for the performance of the following tasks (PCN-A-039, 2010):

generated by their unit, completing the report of the event.

business unit coordinator has the following functions:

units of the organization to correct the incident.

referred to above, including the evaluation report.

executing and closing the corrective actions assigned.

to determine if applies record and evaluate the event.

high level of efficiency and operational safety, through an adequate system of acquiring knowledge from the experience, so that the existence or the development of potentially dangerous states of the structures, systems and components will be detected and analyzed exhaustively taking measures and corrective and improvement actions which will be more suitable (GS-1.10/08, 2008).

An event is defined as any unwanted and unintentional sequence of occurrences that results or could potentially give rise to consequences in different areas of the organization as plant operation or safety, (PCN-A-039, 2010). While there may be various types of events according to their degree of importance and characteristics, much of the events can be categorized as minor incidents, that is, unexpected results, errors or incidences in the activity, conditions that detects any service of the organization, which is considered to have had or could have an impact on security, reliability of the installation, organizational efficiency, risk and the health of people, industrial plant equipment or environment.

The detection, correction and prevention of incidents are carried out mainly through two different processes: the analysis of operational experience and the probabilistic security analysis which works with historical data. In this paper we focus on the first process because it works on abnormal or unexpected events that correspond to situations that occur during the daily activity in the industrial installations. These events are unique opportunities to detect, analyze and correct imperfections of the organizational practices and human error.

The implementation of an organizational learning process of these characteristics, based on the analysis of the operational experience, requires to define the set of activities to follow in a methodological form, to carry out the evaluation of the events occurred in the organization, since these are detected until the actions to correct them are executed: record of the event, communication, evaluation and definition of actions to take, execution of these and close of the event. The aim of this process is to ensure that the appropriate actions are taken to increase the security and reliability of the industrial plant, and the efficiency in the management of the organization, taking into account for the future the recommendations and lessons learned issued from this analysis.

This learning process includes all the activities guided to compare the functioning of processes and activities of an organization with the established expectations. The activities and issues that must be corrected or improved are derived from the comparison between the results and expectations.

The working method employed, allow tracking of each situation and know the status of the events in its different phases; propose actions to take, and get reports for both the enterprise and other organizations. The aim pursued is to identify, document, analyze and evaluate inadequate trends, and adopt the actions to resolve the nonconformities detected.

The first phase in the evaluation of an event is to describe and record the circumstances that have surrounded the incident, which may occur as a result of inappropriate actions in the design, maintenance, non-fulfillment of procedures and practices, inappropriate communications or lack training (PG-017, 2007).

Once registered and documented the event, first the direct cause is analyzed, that is, the failure, action, omission or condition which immediately produces or leads to the occurrence of the event.

It then proceeds to perform the process of evaluation properly speaking, which starts by analyzing the root causes, that is, the fundamental causes that if are corrected will prevent the repetition of the event or adverse condition, and continues determining the corrective

high level of efficiency and operational safety, through an adequate system of acquiring knowledge from the experience, so that the existence or the development of potentially dangerous states of the structures, systems and components will be detected and analyzed exhaustively taking measures and corrective and improvement actions which will be more

An event is defined as any unwanted and unintentional sequence of occurrences that results or could potentially give rise to consequences in different areas of the organization as plant operation or safety, (PCN-A-039, 2010). While there may be various types of events according to their degree of importance and characteristics, much of the events can be categorized as minor incidents, that is, unexpected results, errors or incidences in the activity, conditions that detects any service of the organization, which is considered to have had or could have an impact on security, reliability of the installation, organizational

The detection, correction and prevention of incidents are carried out mainly through two different processes: the analysis of operational experience and the probabilistic security analysis which works with historical data. In this paper we focus on the first process because it works on abnormal or unexpected events that correspond to situations that occur during the daily activity in the industrial installations. These events are unique opportunities to detect, analyze and correct imperfections of the organizational practices

The implementation of an organizational learning process of these characteristics, based on the analysis of the operational experience, requires to define the set of activities to follow in a methodological form, to carry out the evaluation of the events occurred in the organization, since these are detected until the actions to correct them are executed: record of the event, communication, evaluation and definition of actions to take, execution of these and close of the event. The aim of this process is to ensure that the appropriate actions are taken to increase the security and reliability of the industrial plant, and the efficiency in the management of the organization, taking into account for the future the recommendations

This learning process includes all the activities guided to compare the functioning of processes and activities of an organization with the established expectations. The activities and issues that must be corrected or improved are derived from the comparison between the

The working method employed, allow tracking of each situation and know the status of the events in its different phases; propose actions to take, and get reports for both the enterprise and other organizations. The aim pursued is to identify, document, analyze and evaluate

The first phase in the evaluation of an event is to describe and record the circumstances that have surrounded the incident, which may occur as a result of inappropriate actions in the design, maintenance, non-fulfillment of procedures and practices, inappropriate

Once registered and documented the event, first the direct cause is analyzed, that is, the failure, action, omission or condition which immediately produces or leads to the

It then proceeds to perform the process of evaluation properly speaking, which starts by analyzing the root causes, that is, the fundamental causes that if are corrected will prevent the repetition of the event or adverse condition, and continues determining the corrective

inadequate trends, and adopt the actions to resolve the nonconformities detected.

efficiency, risk and the health of people, industrial plant equipment or environment.

suitable (GS-1.10/08, 2008).

and human error.

results and expectations.

occurrence of the event.

and lessons learned issued from this analysis.

communications or lack training (PG-017, 2007).

actions that prevent the future recurrence of the condition or adverse trend that carries again to the event occurs. In this sense, it will record the set of actions to be performed, indicating if they involve the correction or improvement of some aspect, their priority and the training to give when appropriate, establishing the business unit that will implement (execute) them and within what time.

The actions to be executed by each business unit are communicated to the unit responsible, starting then the implementation phase of the actions; process that ends when the last action is executed, giving the incident by closed.

Likewise, the general coordinator of the process will carry out in parallel form the tasks of control and monitoring of the process on those events that are in evaluation or open (in phase of implementation of actions). The monitoring of the actions being executed will be recorded, indicating the date on which it is tracking, the evolution in the implementation of the action (difficulties, delays incurred, etc.), which may give rise to coordination actions when was necessary.
