- The checklist has been changed from "CDI calibrated" which was deemed to be a poor cue to ensure it was connected to the circuit, to CDI connected to circuit.

- It was reported to other members of the team to highlight the potential of its omission -some had made a similar mistake previously.

- The department is looking at a way of improving in-house problem solving and reporting after this incident. The department are currently using apps on mobile devices where if anything challenges the normal work flow it can be logged via phone in a word or two in a matter of seconds. This allows for increased visibility for all and for the safety team to follow up any events.