cheese slices [9]. The idea attracted Reason, then working on a new SCM version
for the British Medical Journal ([8], Fig. 3). This was a landmark article (quoted
3442 times) and in 2003 Reason was appointed Commander of the British Empire
for his work on patient safety. The SCM was born. Its simplicity and empirical
pragmatism made it the vector of a new paradigm of Safety: the organizational
accident.
Fig. 2 a The accident causation model published in 1990 explicitly introduced the defense in
depth concept. b A more complex representation showing the interactions between human and
technical dimensions of the system
264
J. Larouzée
for the British Medical Journal ([8], Fig. 3). This was a landmark article (quoted
3442 times) and in 2003 Reason was appointed Commander of the British Empire
for his work on patient safety. The SCM was born. Its simplicity and empirical
pragmatism made it the vector of a new paradigm of Safety: the organizational
accident.
Fig. 2 a The accident causation model published in 1990 explicitly introduced the defense in
depth concept. b A more complex representation showing the interactions between human and
technical dimensions of the system
264
J. Larouzée