Over the last few weeks the 2011 accident rate data has been coming out. On January 5th, Aviation International News headlines read:

1. Recent Period Safest for Airlines in Modern History
2. Year Ends with Significant Increase in Bizav Accidents

The headlines would suggest a significant change in business aviation and commercial aviation accident rates.  In actuality, the statistical differences are rather small.

In a report provided by Robert E. Breiling Associates Inc., the total fatalities, of U.S.-registered business jets and turboprop operations, nearly doubled from 19 to 35 in 2011, while the number of incidents increased from 90 in 2010 to 101 in 2011.

As dramatic as these headlines seem, the plotting of statistical data for accident rates, has been a generally flat line for the last 4 decades.  Since 1979, the fatality rate has been less than 2 per 100,000 flight hours.

In my perspective, the data is saying, to improve the accident rates we will need to do a better job of managing safety processes.

For more information about safety management systems, visit AirSafetyGroup.com or contact Jeff Whitman.

In my blog “Lessons from the Yak crash that killed the hockey team,” one could infer that the blame for the accident belongs to Yak Service and not the pilots.  Granted, the responsibility for the safety of flight operations belongs to Yak Service, but shifting the blame for the accident to management still focuses on who is at fault, rather than why it happened.

Asking why addresses where the process is broken, not who is at fault.  The emphasis is on the organization’s overall goals, not doling out punitive actions.

Prevention or blame?

Most organizations, like most individuals, have a strong bias for blame. Looking for the causes (why) rather than a single cause (blame) requires a cultural shift for most companies.  If something goes wrong in your organization, and the first question is who, then you have a blame culture.

For example, you go to the drive up window of your favorite fast food restaurant and order a cheeseburger, fries, and a drink.  After leaving the window you reach into the bag to grab a fry and discover there are no fries in your bag.  What’s your first thought?

If you are like most people, your first thought is a variation of, “the (*#*!)  didn’t give me my fries!”  Does blaming the window attendant solve the problem?  Of course not.   The order and delivery process is still broken.

Would punishing the window attendant or requiring remedial training fix the problem?  Maybe for that employee, but what about their replacement?   What affect would this individual solution have when you visit a different restaurant?  If the solution doesn’t address all the scenarios, the process is still broken.

During an evaluation or investigation, organizations that require high reliability examine operational processes to discover what may be broken.  They realize that identifying multiple causes provides greater opportunity for mitigation, which increases the reliability of the organization.

High reliability organizations understand, when something goes wrong, asking why provides more information than asking who.

For more information about safety management systems, visit AirSafetyGroup.com or contact Jeff Whitman.

In September 2011, a Yak Service Yak-42, carrying a professional ice hockey team, crashed on takeoff from Yaroslavl-Tunoshna Airport in Russia, killing 44 of the 45 occupants. The world was shocked and saddened by the news. Obviously something had gone terribly wrong. This week, crash investigators made public their findings. The reason: Pilot error.

Surprising?  No.  Preventable?  Yes.   The pilots clearly made errors.  But the sad truth is that the crash was preventable.  How?  To answer that we must dig deeper and go beyond the “who” is to blame and turn our focus to the “why.”  That is how we’ll uncover the underlying problems – the real reasons for the crash – and determining a way to solve them.

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This article is a continuation of; “I have an SMS, now what do I do with it,” which is located at:

http://proairman.com/i-have-an-sms-now-what-do-i-do-with-it

The fourth question I am addressing is; “What is my daily job?  Do I..”

This question clearly indicates the organizational management lacks the fundamental understanding of the processes of the SMS, or failed to provide the requisite guidance.

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Progressing To the Next Level of Safety Management

This article is the third in a series of articles that takes a closer look at the aviation safety management system. The entire series can be found here.

In the previous article; “The Shifting Focus of Safety Management,” I made the statement; “In order to progress to the next level of safety management, a performance based approach is required to assess the actual performance of activities against organizational controls.”
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The Shifting Focus of Safety Management

This article is the second in a series of articles that takes a closer look at the aviation safety management system. The entire series can be found here.

Historically, aviation safety management has been based of regulatory compliance.  There is no argument that regulatory compliance is an important part of safety management, although it is impossible to provide rules for every operational situation.

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The NTSB is amending its regulations concerning notification and reporting requirements regarding aircraft accidents or incidents, which will become effective March 8, 2010.

The final rule herein codifies the addition of five reportable incidents, the reporting of which the NTSB believes will improve aviation safety.

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Do you need an SMS

This seventh and final article is a series to simplify the understanding of the SMS processes. The entire series can be found here.

It is not about the ICAO deadline

Many operators are hung up on ICAO dates for determining when or if they need an SMS. The primary factor in determining the requirements for an SMS is the regulatory requirement of your country of registration and your area of operation. The ICAO deadline is applicable only in absence of a regulatory agency.

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An Industry Sponsored Alternative for SMS Compliance

This article is the fifth in a series to simplify the understanding of the SMS processes. The entire series can be found here.

The previous article addressed the current dilemma for operators of States without guidance for safety management system (SMS) implementation.  For those who operate across International boundaries red flags ought to be flying high.

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The Fair Treatment for Experienced Pilots Act (H. R. 4343), which became law (Public Law No: 110-135) on December 13, 2007, extended the federal age standard for pilots of large commercial aircraft from 60 to 65 years of age.  A provision of the act requires the U.S. Government Accountability Office (GAO) to report, no later than 24 months after its enactment, the effect, if any, of the change on aviation safety.

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