Thursday, January 21, 2021

Human Factors 7 Ways

 Human Factors 7 Ways

By Catalina9

There are several principles applied to the Safety Management System (SMS) and human factors, or human behavior is one of them. Human behavior is predictable and reliable with common cause variations, but also includes an element of special cause variation, or adaptability, which is often assigned as a common cause variation. Human behavior adapts to how things are done on the job, or what is an expected job performance outcome. In aviation, human error or pilot error was over the years determined to be the root cause of all incidents and an accepted system to eliminate human behavior. When pilots became the root cause all written processes, procedures and checklists were deemed to be infallible within an infallible operations system itself. With pilots as the root cause and their deviation form a perfect system, they became the special cause variation which caused the incident. In the mind of every accident analysts and air operator, they had solved the problem until another unreliable person would show up as a pilot. When human behavior is determined to be the root cause, the root cause analysis took a wrong turn at the crossover point on the infinity path, bypassed several stops and went directly from plan to act. 

An effective Safety Management System is operational infinity.
With the implementation of the Safety Management System the PDCA circle was transformed into the infinity path by the addition of just culture. In addition to Plan – Do – Check – Act, the Just Culture path added Trust – Learning – Accountability – Sharing. This overall path allows for incremental safety improvements by the just culture path and safety improvement oversight by the administrative path. 

With the Just Culture path arrived the seven SMS principles of successful human behavior for a desired outcome in operations. 

The first is the principle of control, or an SMS principle of personnel involvement. A person feels positive about themselves to the degree they are in control of their own destination or their sense of coherence. A person in control of their activities feel happy, are engaged and at peace with themselves. Their contribution to safety on the infinity path comes from within, or internal locus of control. On the other hand, a person feels negative about themselves to the degree to which they feel they are not in control of their own future. A person with an external locus of control feels that other people are in charge of their job performance, such as their boss or their customers. A person with an internal locus of control makes their decision with accountability and within a just culture system.  An interesting point to remember is that a person can give away control to the boss or customers, but they are still responsible for the outcome of their actions. Control begins with thoughts which determine the feelings which then determine actions. When emergencies happen, a pilot who feels scared while flying will make a different decision than a pilot who enjoy flying.

It is not by accident that older airplanes are still flying.
The second is the principle of accident, or an SMS principle of objectives and goals. The principle of accident is completely opposed to the principle of control. We say failing to plan is planning to fail. Since objectives and goals are established a person living by this principle expect goals to happen by accident and that their actions do not affect the outcome. A person living by this principle is apathetic, has lost interest in their job performance, and 

complete their tasks because they have to, and not because their actions affect the outcome. A person living by this principle believes the cards are stacked against them because who other people are or what other people do.  The greatest enemy of human success, or safety in aviation is passivity and when personnel feel passive and helpless. Airports and airlines are very good at setting goals, but then they operate without a goal achievement plan.  Remember, a ship without a rudder drifts completely by the force of the sea, while a ship with a rudder sails straight and true to its destination through any type of sea.

The third is the principle of cause and effect, or an SMS principle of monitoring safety. This principle is that for every effect in operations, there is a specific cause. Everything that happens for a reason even if the reason is unknown. Both success and failure in aviation safety are not accidents but have specific causes. A great rule is that when an airline or airport plan incremental safety improvements is to do what others have done to achieve their goals. Success leaves tracks and when and airline or airport learn what other successful operators did and then do the same thing you, they will eventually get the same result. This principle is nature’s unbiased principle. Nature just says here is the principle, this is the playing field and here are the rules of the game. When the game is played by the principle the outcome is success, but if the principle is ignored, there is failure in aviation safety. An important application of this principle is that thoughts are causes and conditions are effects. Thoughts is a primary moving force in operations, they create the conditions and are affected by communication inputs.   

The fourth is the principle of belief, or an SMS principle of incremental safety improvements. When a person emotionally believe they need to hurry with their tasks, they will hurry and when they believe hurrying will cause errors, they will make errors. Whatever any person believes with emotions, or with intensity, it becomes a reality because that person act on the basis of their beliefs. The more intensely a person hold their belief to be true, the more the belief becomes true. Many things we believe about aviation safety is not true at all. However, once a person has decided to believe certain things are true, they do not see, or accept anything that contradicts it. A blind spot is created. Obstacles to aviation safety are self-limiting beliefs, or that time to perform tasks is a limited factor. Within an effective SMS system any person performs tasks with an unshakeable belief and expectation that they are performing tasks successfully with accountability.

The fifth is the principle of expectations, or an SMS principle of preparation for safety improvements. The principle of expectation are expectations of operational outcome and becomes a self-fulfilling prediction since there is a tendency for human factors to take the path of least resistance to their expected outcome. When the flight crew expects a flight will be successful their attitude towards operations focuses on tasks required for a successful outcome. When their focus is on other things than the successful outcome of their flight, safety critical functions may be left unattended. An airline or airport operator must never consider anything else but to expect the best job performance of themselves and all other personnel and show this by their actions. 

   The sixth is the principle of attraction, or SMS     principle of a clear commitment to safety. The   principle of attraction is a living magnet, and you   attract into your life the people and the 
 circumstances that are in harmony with your   dominant thoughts. The attention of an SMS 
 manager is drawn to aviation safety issues, while the   attention of an aircraft mechanic is drawn towards   improved tools or repair processes. On the other   hand, achievements of an SMS manager or aircraft   mechanic are elevated for other likeminded to be   attracted to. When driving a vehicle, the colors of   other vehicles are seldom noticed. However, the day you bought a red car, you all of a sudden noticed how many red cars there are on the road. When someone thinks negative thoughts, they will attract negative people into their environment and when thinking positive they will attract positive people. This has become apparent in social media postings where negative thoughts and post are extremely successful. The more emotion that is attached to a thought the greater is the intensity of attraction. An airline or airport striving to be successful achieve success by becoming more like other successful airlines or airports. Major airlines are successful today because they thrived on positive values. Success in airline and airport operations is to attract personnel with a positive attitude. 

The seventh is the principle of correspondence, or an SMS principle of promoting the safety policy. The principle of correspondence is as within so without. A person’s outer world is a mirror and reflects what is going on in the inner world. This becomes apparent in the relationship with operational processes. When compliance and performance is removed from within, it is also removed from the outside world, or how the job is done. This makes human factors, or human behavior a common cause variation as opposed to a special cause, where outside distractions interfered with the tasks. Common cause is fully integrated within the organization and their expectations. Reading, thinking, planning, visualizing, with all these things you can create within your mind a mental equivalent of what you want to enjoy on the outside. Promotion of the safety policy by the accountable executive is an invaluable tool to instill awareness with incremental changes of the world within. A person becomes what they think about most of the time. Everything in the material world began with a thought in the mind of a person and that thought turned into a goal which turned into a plan which began to take physical reality. 

The principle of correspondence is crucial for safety improvements of human behavior, to manage thinking within a just culture and to reduce common cause variations within human factors. 


Friday, January 8, 2021

Run Aviation Safety The Same Way As COVID Safety

 Run Aviation Safety The Same Way As COVID Safety

By Catalina9

You would think it should work and be safe to run aviation safety the same way as COVID safety is run and managed. The public trust COVID processes completely and without concerns. We do not ask questions about experts’ qualifications and we demand that our leaders lead us down the safe path with their proven COVID safety processes. 

A successful process may be applied to other safety concerns and generate a safety outcome. A process that is used to operate a vehicle on icy roads can also be applied to icy runways or icy airplanes wings. The process is the simple plan – do – check – decide – act/adjust process. 

Plan is to establish an objective, which is for the public to feel safe or healthy. Do is to carry out what needs to be done to meet the objective. Check is to analyze data from the previous phase. Decide is to make an objective decision at the fork-in-the-road, based on collected datapoints. Decide is to make an objective decision at the fork-in-the-road, based on collected datapoints. Act, or adjust is to make changes to improve the process. The objective is for the public to feel safe by travelling on a road or runway surface that will provide friction, while it is the opposite for an aircraft wing. The do-phase is to apply the plan and conclude with a check or test of the result. After this data is analysed there will always be a fork-in-the-road, and when arriving here an educated decision is made. As the path continues one direction or another, adjustments or action may be applied to improve the road surfaces or quality of de-icing. The corrective action my be different in these examples, but all processes are the same. Gravel may be put on icy roads, chemicals on icy runways and de-icing fluid on an aircraft. At the end of the day the public feel safe and willing to drive the road or enter an aircraft departing from an icy runway relying on laws of nature to transport them safe to their destination. 

The onset of COVID surprised everyone and there was little or no data available to understand how react to the virus. In aviation there could also come a time when an unexpected or unknown event would take place. An aircraft cold for no apparent reason become uncontrollable, or a runway could be covered by a swarm of insects within a few minutes. 

Parking an airplane is a safety tool to eliminate a risk to aviation.
When COVID hit, everything came to a halt. Applying the same safety principle to aviation when an unknown event hits all flight stops, which was the reaction on September 11, 2001. Within a few days and after the risk was reduced all airplanes were flying again. If an aircraft for no apparent reason becomes out of control, the immediate action could be to stop all flights, since all aircraft are relying on the same laws of physics. When these catastrophic events occur and applying the COVID principle, the next step would be to plan, or define an objective. 

Since the objective is for the public to be safe, continue to keep all runways closed and aircraft parked is accepted by the flying or travelling public since it was widely publicized that there were no other reasons but for their own safety that these corrective actions had to be implemented. This also parallels the plan phase of the COVID attack. Since there is always a hazard involved when an object or person is moving, or moving close to each other, 100% safety was achieved by stopping all activities.   

The do-phase is to apply the plan, which is to communicate to teach the public that it is dangerous and unsafe to be a passenger on an aircraft since the cause or cure has not yet been defined. Time goes on and the flying and travelling pubic accept these conditions as true and stay put. This phase also parallels the COVID process.   

The next phase is the check phase where data collected is analyzed in a statistical process control software. Since there are no flights, the data shows that the applied corrective action works without any other incidents. The experts let the public know that parking the aircraft has been successful for the safe operations of an aircraft. However, since the flying and travelling public were unable to fly, they drove the highway, which resulted in an increase of fatal accidents. Since several of these accidents were cause by passengers who normally would fly, the fatalities were contributed to airline travelers. Since airline passengers now were causing highway accidents, severe restrictions were imposed on vehicle owners and secondary highways were closed. The major highways remained open without restrictions. 

Bird travel routes were not changed after several birds took an airliner down.
At this time about a year had gone by since the first out of control aircraft crashed. Pilots in remote areas had been flying under the radar, but since a policy stated that flying was unsafe a decision needed to be made as to what new safety actions should be. The decision makers had arrived at the fork-in-the-road where a decision of action was forced upon them. Still, without a cure or solution for the out-of-control aircraft it would be a defeat to their integrity if they allowed airplanes to fly again.

The final stage of the process is to act or adjust for continuous safety improvements. A decision was made to continue down the path of compliance enforcement, since it had been successful in preventing aircraft accidents. Enforcement actions would be taken against any pilot flying since there is a possibility that the aircraft could be involved in an accident. It was also decided to enforce penalties if a person who normally would be travelling by air was operating a vehicle on any roads. This final stage also paralleled the COVID process in that enforcement actions are taken against groups of people gathering. 

When applying this process to aviation safety an aircraft would never fly again since the aviation industry and the safety of the flying public is only safe when all aircraft are parked. 

When a root cause is unknown or there is no cure for the failure, two options become available. One is to do nothing, and the other option is to overreact and take extreme actions. The most logical safety option is to overreact to ensure safety. It is easer, less stressful, less work to say no and transfer the risk to someone else than accept responsibility and take measures to mitigate. None of these two options are steps to fulfil the purpose of the objective. What is missing in the equation is a third, but hidden option, which is to assess residual consequences and new hazards by doing nothing or taking extreme measures.  


Friday, December 11, 2020

Santa At Recovery

 Santa At Recovery

By Catalina9

This year had been a quite different experience for Santa. In addition to complete the productions of all gifts requested, Santa had to implement several changes to the operation, which included change management processes, or safety-case actions. For centuries Santa had successfully delivered gifts to every household on the globe. On the same date every year, over a 24-hour period, every corner of the world received a visit from Santa delivering gifts that both kids and grownups had requested. This year was not any different than previous years with gift requests from all corners of the globe. 

Santa scouting out the new place.
    What was different was that Santa needed to move the manufacturing plant due to competition by a previously little known of the genetically altered reindeer Randolph and the crew. While Randolph had been active for a test-run some years ago, and at that time Rudolph hand to run, run, run to stay ahead. These reindeer had inhabited one of the most sparsely and remote areas of the globe since Glacial Lake Missoula flooded the West. Santa needed to move South to somewhere around the 60th parallel to be able to compete with these strong, but unpredictable reindeer. The isolated North Pole was a perfect place for other reindeer to infiltrate Rudolph’s crew, infiltrate the elves, and spread invisible poisonous particles onto the gifts. Santa’s ancestors had spoken about these reindeer several times, but Santa did not believe it was possible or that they would become an actual threat to their very successful gift delivery process. For centuries Santa had been the world’s super-supplier of seasonal gifts all over the globe and Santa had no plans for that to change

Santa had developed the Streamlined Mission Service, or SMS, for delivery of gifts and to reduce roof-top incidents and excursions. Initially, Santa was appointed the AE (Accountable Elf), but that didn’t work out since Santa was busy with the production, reading letters and the annual training of reindeer. Mrs. Santa was therefore appointed AE and to have final authority of streamlined operations, oversight resources and approval of elves. Since the implementation of SMS, Santa had noticed that there were several areas that were in need of operational safety improvements. Over time Santa’s SMS evolved into the core business solution center. Every decision now hits the SMS first before it enters anywhere else into the organization. 

Roof-top excursions and unstable approaches were reduced drastically compared to the pre-SMS days. Santa discovered the secret of training, communication and expectations. Rudolph, the lead reindeer and all the other reindeer were assigned specific roles and responsibilities tailored to their functional area in the operations. As the lead reindeer, Rudolph was responsible for planning and executing approaches and departures, while other reindeer were responsible for ATC (Around The Clock) communication, approach slope guidance, airspeed, local phenomena observations, being on the lookout for conflicting traffic, including DRONES (Delivery Resources On Nearby Estates and Surfaces), or on the lookout for other aeronautical obstructions. In addition, Santa applied SPC (Santa’s Professional Calculator) control sheets to assess operational processes. Santa was all set to get ready for the 2020 deliveries, but then the genetically altered reindeer and their Virtual Santa showed up. The only option was to move operations to a different place to be competitive. 

Santa submitted a proposal to the AE to initiate the move to a new location the day after all 2019 deliveries were done to be ready for the 2020 season in time. Normally, since Santa is capable of delivering gifts to billions of people during a 24-hour period the move should be a simple task. However, with all the capacity of Santa, if this move didn’t follow a plan, it could end up in a disaster. Since the beginning of time Santa had operated out of the North Pole and current processes were designed to be effective at that location. 
Over the last few years Santa had noticed an increase in UAV (Universal Autonomous Vessel) deliveries. Santa also took advantage of this service by allowing for the UAV’s to overfly the sleigh and pick up the gifts on the fly for delivery. Santa’s new place was also planned to be close to the UAV production location. 

Secret picture of Santa doing winter training in the summer
Santa was worried, but Mrs. Santa had for years planned for an unplanned move in the near future. Since the beginning of their SMS, Mrs. Santa had designed several Safety Cases for use in the future. Mrs. Santa’s Safety Cases included operational safety, regulatory compliance, compliance with standards and compliance with Santa’s SMS Policy. When preparing for unknown locations, Mrs. Santa had prepared each Safety-Case for locations with snow and ice, rain and fog and the desert with hot sun. In addition, each Safety-Case came prepared with an emergency preparedness plan and an operations contingency plan while on the road

Santa selected a location where reindeer training and their flights could be accessed any time of the year. Since one half of the gift deliveries are in locations without snow, there was a requirement for a location where non-snow training was available. In addition, Santa was looking for a place where the runway could be simulated with ice and snow during the summer months. After much research and drawing from centuries of data, Santa, with Mrs. Santa’s approval selected a location around the 60th parallel where there was a runway that recently was extended and paved, there was a lake at the end of one threshold for water landings training, including training for unexpected events if ditching should be necessary. The lake is a great place for winter training with ice and snow to simulate the North Pole. The runway is located in a narrow valley between tall mountains. This is perfect for departure and arrival training and for Rudolph and the crew to train for mountain flying with extreme winds and to exercise to gain strength to blast away from any place on the globe. In addition, there was heavy-water available for Santa to generate short-field takeoff power.  

Santa At Recovery was a success. The production plant was moved, and delivery operations were in place in time for the first departure. Recovery is the opposite of being reactive. Recovery is to be proactive.  An airport, airline or Santa at recovery is to be proactive to stay on the path with forward-looking accountability and forward-looking recovery while operating within a 3D environment. When driving down the road the driver is constantly in a recovery mode. It’s not a reactive recovery to recover from the ditch or to be towed out of a lake, but it’s to adjust how the vehicle travel 3D, which is time (speed), space (location) and compass(direction) to arrive at the fork in the road, at home, at Santa’s new place, or at the SMS goal set by the SMS Policy. 

Of course, this is a true story, and a blog wouldn’t be anything else. It’s true in that when drastic, or sudden unplanned changes becomes necessary for continued operations there is not even a tunnel somewhere to be found to look for the light at the end of the tunnel. Airlines and airports are now in a time period with a golden opportunity for aviation since the first flight in 1903 to accept the gift of Santa and Mrs. Santa’s to move forward and never look back. Santa and Mrs. Santa had faith in their hard work and SMS preparations. Without doubt, without knowing and without seeing the future, or being able to visualize or comprehend what was in store for their operations Santa and Mrs. Santa were prepared.  

A secret picture of Santa’s new location.
    Their success in the move, and their exception to exceed previous years customers’ confidence level and satisfaction, was contributed to their preparations, which becomes stored as a latent condition until needed. It was contributed to their just-culture and it was contributed to their vision to extend their SMS Policy (Streamlined Mission Policy) and their No Bucking Antlers Policy (Non-punitive Policy) to all their customers. It was crucial for Santa’s operations to accept the sudden changes without looking back and to move forward with a plan to achieve their objective to servicing their customers to their satisfaction. Someday Santa may move back to the North Pole, but then it will be a simple task because the move activated their Emergency Preparedness Plan as a Full-Scale Moch Disaster Exercise.  


Monday, November 30, 2020

How To Set SMS Goals

 How To Set SMS Goals

By Catalina9

Goals within a Safety Management world are derived from data collected, or borrowed, or just picked out of thin air. After a decade or so operating within an SMS world, airlines and airports have collected thousands of datapoints to be recorded in the hazard registry. The SMS process for both airports and airlines have enough inhouse data to design useful goals. 

Make sure your shoes are ready for the first goal-setting step    
    The goalsetting process is a decision process based on data collected and entered in the hazard registry. When data is transformed to numerical or alphabetical values they turn into information. Information consumed generate knowledge and with when knowledge is processed it becomes comprehension of one or multiple integrated systems. Data is the foundation for goalsetting, but just the data in itself is an unuseful tool to generate practical goals until each datapoint applied have completed the comprehension process. It is a simple task to set a goal based on events or a currency value. However, it is a comprehensive task to set goals that affect the outcome of events or values. SMS is hard work and will never change. Data comprehension is very different than an emotional opinion about a datapoint. Comprehension is intelligence, it’s neutral and it’s the law of cause and effect, while an emotion is artificial intelligence, judgmental and an opinion.   

There is a 14-day step process in a professional and effective goalsetting process and to design effective goals. Each step may be assigned to one goal or multiple goals. The 14-day goal process are comprehension steps to assign a goal-value. The value of a goal is measurable in either events or currency. A simple goal is to “be safe.” This goal is not measurable and is not attached to events or currency. To “be safe” is a safety-card goal to eliminate responsibilities. SMS is not only hard work, it’s also roles and responsibilities. Take a minute and write down how each person in your organization can “be safe”. One of the first answers that comes to mind is often what the person cannot do. E.g. do not cross a runway when airplane is landing, or do not land if a vehicle is crossing a runway. The 14-day process looks at what you are doing to achieve the goal and not what you are not doing to achieve the goal. 

Stay on track.
  Another trap that is easy to fall into is to    set a goal that safety is the
  number 1  priority. A general definition    of safety is the condition of being     protected from or unlikely to cause   danger, risk, or injury. When safety is   the  number 1 priority any action taken   by a person must be to protect a person   form danger, risk, or injury. The   simplest  way to achieve this is to do   nothing. However, when safety become   paramount, or the supreme goal, doors   are opened for safety in operations. 

The first of the 14-steps is to think. Think about your airport or airline as it is now and write down the things that are most important to you in your daily operations. Review your hazard registry and think about what outcome each hazard generated. Think about how each hazard was discovered, if was by active hazard search, hazard research, incident report or a report from the public or a contractor. 

The second step is to Imagine. Imagine that you could wave a magic wand and make your airport or airline perfect in each area of your operations. What would it look like? Imagine what snow-clearing would look like, what FOD removal would look like, what a perfect departure or arrival would look like, or what a magic wand could do to take the pressure of your mind. 

The third step is to write. Write It down using your thoughts from Day 2, write down each goal you’d like to achieve for your ideal airline or airport operations. Make your description clear and detailed in every sense. When you write it down use an old-fashion pencil and paper to reinforce yesterday’s imaginations. 
The fourth step is to decide upon your objective, or major definite purpose. Ask yourself if any goal on this list could be achieved within 24hours, which one goal would have the greatest positive impact on your airline or airport operations. Base your decision on operational comprehension as an airport or airline operator rather than a wish of what would be nice to achieve. 

Step number five is a deadline. Think of a reasonable date for you to achieve your goal. If your goal is big enough, set sub-deadlines. Without deadlines and defined completion dates a goal is nothing else but a virtual reality dream. 

The sixth step is to identify any obstacles, or hazards. Identify any potential obstacles that you will have to overcome to achieve your goal. Determine how to overcome each of them. If your airport or airline has worked within an SMS world for a decade or so all your answers are in the hazard registry records. If you are new to SMS, borrow data, research data, or simply pick it out of thin air. 

The seventh step is to Identify. Identify knowledge and skills you’ll need. What one skill, if you developed and did it consistently, in an excellent fashion, would help you the most to achieve your most important airport or airline goal. Within an SMS world all your answers are in the SMS training component. Data collected is a tool to identify skills that helps you the most for each role and responsibility in your airport or airline operations. 

The eight step is to make a list. Make a list of everything (each and every step) you will have to do to achieve your goal. Sine your operations has worked with SMS for several years, use the process assessment tool assigned to your operations. Track the process backwards, from the end result (goal) to a fork in the road where you find step number eight. 

The ninth step is to organize. Organize your list into a plan. Organize your list into a series of steps from the beginning all the way through to the completion of your goal. Goals does not happen by accident but by applying active tasks to each step of the process. Without a list of steps there is an opportunity that an incorrect task is applied to the correct step. 

Write your plan down in your own words
    Step number ten is to write your plan down. Write your   plan down in the Safety Management System records. Write   down each phase of your plan all the way through   completion of your goal. Plan each day, week and month in   advance. Follow the step in you Safety Management   System  (SMS) Manual.

    The eleventh step is to determine your support system.   Your support system is already defined in you SMS Manual   with roles, responsibilities and accountability. Make a list of   every person in your life that you will have to work with or   work around to achieve your goal. These are admin   personnel, pilots, airside workers, vendors, contractors, the SMS Manger, Airport General Manger, QA Manager, Director of Operations, Maintenance Manager and others listed in the SMS Manual. 

The twelfth step is to make your goal public. Tell others what goal you intend to achieve and by when, especially those in your support system. Post it on the SafetyCorner, in paper format or electronically. Follow the process in you SMS Manual. 

The thirteenth step is to practice visualization of your goal. Create clear, vivid, exciting, emotional pictures of your goals as if they were already a reality. Review your goal in a virtual 360 experience. Use virtual reality animation to see what your goal looks like in a perfect SMS world, but also accept the fact that human factors, supervision factors, organizational factors and environmental factors affect the actual outcome of your goal. Visualizations is a common part of flight training in simulators and virtual reality in airport operations also available. 

The fourteenth step is the toughest part. It’s to get started. Take the first step no matter what the step is. Goal setting is like skydiving when the first step is the point of no return. On this last day of the challenge, complete the first task you’ve outlined for yourself and get started on the path to a successful SMS in airport and airline operations. 


Sunday, November 15, 2020

Safety vs Profit

Safety vs Profit 
by Catalina9

One misconception in the aviation industry is that there are major conflicts between safety and profits. Conventional knowledge is that one cannot operate with an effective profit-margin system while at the same time operating with an effective safety system. Let’s for a moment assume that this is true and that for each safety system implemented there is huge reduction in profit and the profit margin. 

When the safety-card is played the SMS nucleus is unbalanced.

When the safety-card is played there are no opposition to their choice of corrective action plan. Nobody wants to argue against safety. When someone wants a specific result, they use the safety-card to get what they want, and they draw root-cause solutions from an emotional data base rather than a hazard registry or an analytic data base. The safety-card is played in the aviation industry, it’s played in the long-haul transportation industry, it’s played to protect public safety and it’s played when nobody has a true answer for their solutions to the issue or event other than a safety scare. The safety-card is a virtual tool without a major definite purpose and where the safety nucleus is unbalanced. 

A major definite purpose is defined as the one goal that is most important to you personally for incremental safety improvements of Your Amazing Airport or Airline. It is usually the one goal that will help you to achieve more of the other goals than anything else you can accomplish. The first part of a major definite purpose is something that you personally really want. Your desire for this purpose must be so intense that the very idea of achieving your major purpose excites you and makes you enjoy the associated projects. The second part it that it must be specific an explained clearly. It’s better to explain it clearly than cleverly. The third part is that it must be measurable. The only quantity to measure is in monetary value. A return on investment safety formula must be answered by dollar signs. The safety result is not that we got away with only one accident this year, but if the return on investment was in the black or in the red. The fourth part is that a major definite purpose must be both believable and achievable. It is a simple task to believe, or wish for an outcome, it’s hard work to achieve it. The fifth part of your major definite purpose is that it needs to come with a high probability of success. If you set a low or medium probability of success, there is little or no incentive to access tools for success. When you set your major definite purpose today it might look overwhelming and unachievable, but it is the only thing that keeps you moving forward at incremental steps to reach each goal to build a path to your objective. A final part of your major definite purpose must be in harmony with your other goals, and the Safety Management System (SMS) Safety Policy. In addition, it must also be in harmony with your sub-goals and congruent with the organizational just culture. The safety-card cannot be the major definite purpose since it does not state specific objectives or goals, but is a tool to generate vague visions, strong wishes, opinions, and reactions without directional control. A safety-card organization is recognized by their wishes to prevent accidents and eliminate damage or injury.

When looking at safety improvements from a safety-card organizational view, their statement is true that safety cost too much and is not practical to implement. In an organization without a major definite purpose the only solution available is to allocate more cash to the solve the problems. Since airports and airlines are safe already and flying being the safest mode of transportation, any additional cash-outlays are not required to maintain current level of safety in operations. Any accident free day is money saved and safety becomes an unnecessary expense. 

SMS is a compass to navigate the turbulent
seas while monitoring drift.

A Safety Management System (SMS) comes with a built-in major definite purpose, which is to design a just culture that is compatible with the safe operation of an airport or aircraft. An airport or airline establishing this as their main definite purpose has unlimited options available to operate within an acceptable safety margin. The safety-card only look at tangible improvements, while the SMS, in addition, looks at intangible solutions. Since intangible solutions are unable to be touched or grasped, there is no physical presence or visual clues, they are unpopular to implement.

The SMS is the human factors system, or human behavior. When looking safety from the SMS perspective as a capital investment of human behavior it becomes the major influencer of the return on investment. Safety in an SMS world is project solutions leadership motivation. Projects are established, solutions are implemented, leadership is dynamic, and motivation is to maintain goal-oriented behaviors. Within the SMS, the safety culture, or just culture, is measured in cash value and return on investment. Simply said, it is expected that a pilot uses the brakes when a taxiing aircraft is approaching behind a stopped aircraft. It’s expected that a pilot on approach stay on approach slope and it is expected that an airport operator has trained personnel to work airside. This is what SMS is all about. When applying SMS processes to operations there is no additional cost to complete these tasks, or other tasks. Every safety measure taken within the SMS is an action of human behavior within the human factor system where safety does not become an opposition to profit but a contributor.   


Monday, November 2, 2020

Building A Winning SMS Team

Building A Winning SMS Team
By Catalina9

Building a Winning SMS [Safety Management System] Team begins and ends with you. You are the person who holds the keys to open doors of data, information, knowledge, and comprehension.  Building a Winning SMS Team is to clear a path of least resistance within a hazard environment. While building the team is to clear a path of least resistance, designing the path is to incorporate a conglomerate of tasks and to navigate insurmountable hazards. A Winning SMS Team operates at a 95% confidence level that your human factors system is in control.  The difference between a 95% confidence level and a 100% confidence level that operational processes are in-control, is that there is no room for safety improvements at the 100% safe operational level.    

A Winning SMS Team is filled with energy.
 Building the Winning SMS Team started with a   blank   sheet of paper and a pencil on a cold October   12th day.   Designing a Safety Management System 
 is beyond any task of designing other types of   systems. SMS is a  team of human factors, human   behaviors and human  interaction which reacts   emotionally to interference  from outside sources.

 The first task when building the team is to design a   path where emotional reactions are acceptable.   During the pre-SMS times the aviation industry   conventional wisdom was that a pilot could make   emotional decisions for the safe operations of an aircraft. It was expected of pilots to have super-natural powers to make rational decisions to avoid hazards and manage hazardous operational conditions. Two prime examples that pilots were expected to have these powers, are the 1977 Tenerife Island disaster and the 1989 Dryden disaster. In both accidents the finding was that the pilots failed one or more tasks in one way or another by making emotional decisions rather than following procedures. Any person experiences an unexpected condition instantly has an emotional reaction to that event. The reaction could be undetected by the pilots or others, or they could be obvious to anyone. The story goes that in a single engine propeller airplane the propeller is a fan to keep the pilots cool…because they will sweat if it stops. 

The second task when building the team is to design a path where variations are acceptable. In the pre-SMS days, it was expected that all pilots operated an aircraft exactly the same way, that they identified hazards without individual deviation, that they all reacted exactly the same way with their hazard avoidance actions, and that the outcome of their reaction would always be incident-free. Airlines operated with a 100% confidence level that they were 100% safe 100% of the times. When operating with this as facts, as opposed to opinions, air travel became the safest mode of travel. Whenever major accidents occurred, they were brushed away as pilot errors by a renegade pilot who willfully disrespected expectations that airliners do not crash. Variations comes from common cause variations and special cause variations. A common cause variation is always present in the process. An example is the migratory bird seasons, where birds seasonally travel, causing a common cause variable in the spring and fall. A special cause variation is not present in the process but is an unexpected event which occurred at an unexpected location at an unexpected time. When special cause variations are acceptable is when root cause analysis management becomes available. In and SMS environment, special cause variations are forced by virtual reality in operations [training] or simple brainstorming sessions [virtual testing]. The fact that one person in an enterprise had decided on what process or procedures were operational safe did not ensure safety, but rather transferred human factor elements from pilots to process designers.  When variations are acceptable is when variations management, or root cause analysis becomes available.

The third task to build the team is to accept a just culture. A just culture are expectations of human behaviors within an organization. In the pre-SMS era, a just culture was what was considered by management what was just to their positions. 

Just Culture is to consider decisions from the past.
Management’s just-culture task became a task to protect their image and decisions which were contributing factors to the disaster. The task after an accident did not always become a fact-finding mission, but rather it became an accident motive-finding mission. When building a Winning SMS Team, a just-culture is what is just for the traveling public, what is just for customer service, and what is just for you. In a just-culture environment there is trust, learning, accountability, and information sharing. Without any of the four just-culture principles there is anarchy in operational safety.  

The fourth task to build the team is to accept learning, education, refresher, and training as pillars for continuous safety improvement. During pre-SMS times training was viewed as a task required to repair lack of knowledge, qualifications, or skills. Yes, it is true that pilots received recurrent training, but the intent of training was to discover and repair deficiencies rather than build on individually current job-performance skills to improve these skills beyond regulatory requirements. Within an organizational culture that embraces training, training becomes a non-punitive reaction to unintended operational events. E.g. if a pilot taxi across taxiway lights because the turn was missed, in a non-training environment a recurrent training due to the incident becomes the punitive action that a pilot does not appreciate. While the same scenario in a training-accepted environment, the refresher training becomes a welcome task for continuous job performance improvement. 

The fifth task to build the team is to accept personnel involvement or initiative. A person who is actively involved comprehend safety in operations at a higher level that a person who passively must accept demands from management to maintain their job. Involving a person is to actively involve the five senses of sight, sound, smell, taste, and touch. If one or more of these senses are removed from the involvement equation, there is an increase in organizational hazard level. 

The sixth task to build the team is to accept job-performance variances between individuals. Job performance variances are discovered by conducting non-disqualifying operational audits where individual review their findings for possible self-adjusting behaviors. 

Within these numbers are all answers to be discovered.
The seventh task to build the team is feedback    from you and feedback to you. Feedback         comes in all shapes and forms and is more 
 than a standardized feedback answer. Feedback is interaction between personnel, interaction within the enterprise environment, interaction with policies, interaction with project solutions and interaction with leadership motivation. Feedback is the Nucleus within an Enterprise   where positive and negative emotional charges       are balanced as sensed by the five sense. When      emotional charges are balanced an Enterprise    is operating within a user-friendly Safety Management System scaled to size and complexity of the Enterprise.

The beauty of a Winning SMS Team is their generous output of project solutions and motivational management. 


Monday, October 19, 2020

SMS Works

 SMS Works

By Catalina9

COVID19 affected air travel and airport operations to a degree never seen before. Major airports went down to 10% of normal movements and the airlines parked thousands of airplanes at these same airports. COVID19 was a disaster for the aviation industry with little or no hope to recover back to 2019 levels for several years. 

An effective Safety Management System (SMS) could not have prevented this disastrous outcome and would not have made one difference for safety in operations. However, what any airport or airline would have in place with an effective SMS, is a recovery tool unlike any other tool. 

A positive attitude is a prerequisite for recovery in aviation.
When a hazard is discovered for the very first time, or a special cause incident occurs for the very first time, three corrective action plan (CAP) options are available. Option one is the extreme to cease operations, or the other extreme to do nothing. The CAP solution when arriving at the fork-in-the-road and holding on to a previously unidentified hazard, is not to develop a CAP to attack the hazard, but it is of vital importance to turn in the direction of least residual risk (leftover hazards) and the least substitute risks (new hazards). When a new hazard is introduced into the SMS system and this is a hazard without prior known CAPs it is impossible to design a CAP that will resolve the risks. The risk has become an inherent risk that needs to be mitigated. 

A couple of examples of a the introduction of a new hazard is the Hudson River landing, where the probability of an all-engine failure was considered a likelihood to be inconceivable and times between intervals to be imaginary, theoretical, virtual, or fictional. Another accident example is MH370 incident where it also was inconceivable that an airliner could just vanish into thin air. When COVID19 hit airports and airlines with an SMS contingency plan for recovery executed their plan and became the leaders of recovery at airport and airlines. A recovery does not imply getting back to 2019 levels, but to recover from a prior unknown hazard. No one could ever imagine that a virus could prevent 3-4 billion passengers to travel. In 2019 the global airline industry reached over 4.54 billion people. Not long-ago IATA published an article that 1.2 billion people had travelled the first nine months of the year, or about 25% of 2019 levels. 

Airlines and airport took it upon themselves at an early stage of the hazard identification to apply the principle of SMS and ensure that customer service became their number one priority. Airlines and airports leaders understood that the public expected them to make changes and that they needed changes that the travelling public would accept as their hazard protection. 

Their first step was to design and implement a Safety Policy. In general, this policy stated that only COVID19-free passengers could board an aircraft for travel. Not only did they distribute their policy to all personnel, but they also expected the policy to be adhered to by the travelling public, airport operators, check-in agents and flight crew. Airports installed sanitizing gates and airlines sanitized each aircraft prior to boarding new passengers. In addition, check-in agents checked all traveller’s health condition prior to boarding. The first SMS step was completed, which was a short-term corrective action to separate data into two categories. 

The second step was to implement a non-punitive reporting policy. Anyone who observed a hazard, i.e. that a person might be affected by the COVID19 virus was encouraged to report it without fear of repercussion, or for fear of being kicked-off the flight. The non-punitive reporting policy became the second level of safety to separate data into the correct category. The beauty of the non-punitive reporting policy is that there is no requirement for the person reporting to have all the facts or to provide a solution, but to report what in their mind is a hazard. It’s for the experts, SMS Manger or Director of Safety in an organization to establish the validity of the claim. 

The third step was to establish definite guidelines and roles and responsibility for all personnel. This includes what actions to take and the reporting hierarchy. The crucial test for the airline industry had become to ensure that the same approach was applied on all seven continents: Africa, Antarctica, Asia, Australia, Europe, North America and South America. Applying the CAP with regional differences was expected to cause an unstable recovery. 

The fourth step was to communicate to the travelling public and to both internal and external organizations. The communication process needed to be simple and accessible, and social media became the main preference for communication source. Airlines and airports conducted surveys to learn how the travelling public felt about departure, or arrival delays. 

I am the Confidential Advisor to the AE.
The fifth step was safety planning for travelers to maintain a confidence level that air travel is protecting them from the hazard. Goals and objectives were established and included spacing passengers seating and design seat separators. Face masks were also required during the flight to contain any large droplets within a personal space. Airlines were already equipped with a comprehensive air filtering system as an additional layer to ensure customer satisfaction. 

comprehensive air filtering system as an additional layer to ensure customer satisfaction. 

Step six was performance measurements. Just as passenger’s heath conditions data were documented upon boarding, data was also collected upon deplaning. This data was entered into a hazard registry, analyzed, and compared to pre-boarding screening. 

Step seven was to review all data for effectiveness. IATA article published that 1.2 billion people had travelled by air the first 9 months of 2020. Out of the 1.2 billion travelers 44 cases were contributed inflight COVID-19 transmission, which is five COVID19 transmission per month. Let’s say that an average airliner seats 150 passengers. For 150 passengers to reach 1.2 billion travelers, they would be required to travel 8,000,000 trips. Out of these 8 million trips, 44 passengers would be infected. One person would have to travel 181,818 trips in 9 months to reach a high probability level to be one of these 44 receiving an in-flight transmission of COVID19. 

It is impossible to see what the future holds. It is impossible to state that without applying CAPs, mitigations, and SMS principles more than 44 cases would have occurred during air travel. However, when comparing to the general population of 7.8 billion people worldwide and 40,369,270 cases; this is about 1 of every 200 being infected by COVID19. If applying the same 1:200 ratio to the air-travelling public, 6,217,616 would have been infected. 

Based on this data form the World Health Organization and the International Air Transport Association, a Safety Management System is the profit generator, the effective business tool, and the superior tool in customer satisfaction. 

Recovery in aviation and recovery at airports is to dedicate your Amazing Airport or Airline to continuous improvements. Train your SMS to increase your revenue one-tenth of one percent daily. This amounts to one half of one percent more productive each week, or two percent each month and 26% increased revenue each year. 


Human Factors 7 Ways

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