The Los Alamos National Laboratory’s (LANL) corrective action program does not properly address the root causes of problems at the facility to prevent recurrence and fails to close corrective action records at the appropriate time, resolving some before completion and leaving others open long after, according to a Feb. 25 Department of Energy Inspector General (IG) audit report.
Of the 460 items recorded in the lab’s issues management tracking system between 2009 and 2014, 196 were identified as high significance and featured “significant weaknesses in areas such as analysis and documentation of root causes for issues,” the IG said. Seventy-three percent of those high-significance issues were “unsatisfactorily addressed” and not effectively closed, the audit found, while 36 percent were closed before the completion of corrective actions and 35 percent did not include causal information regarding the incident in question, the audit noted.
Roughly 46 percent of the high-significance issues were closed before the lab could address the root cause of the event, the IG found. It noted an incident in which corrective actions following an August 2010 chemical spill and hazardous material cleanup at a lab waste management site did not include the procedure changes necessary to prevent recurrence. “While the procedure was revised, the revisions did not address the specific handling and packaging issues that LANL determined contributed to the spill,” the IG said.
The IG said deficiencies in LANL’s corrective action management program create an inefficient system in which certain problems – rather than the underlying issue – are repeatedly corrected. LANL began tried to improve its corrective action process in 2014, the IG said, but staffing reductions delayed those efforts. The IG recommended that LANL meet the requirements to properly process high-significance deficiencies “by identifying root cause, determining extent of problem, and ensuring effectiveness of corrective actions,” and develop procedures to address timely issue closure. The National Nuclear Security Administration agreed to address the recommendations by Sept. 30.
