Topic Learning Guide Aviation Safety Systems TOPIC 2 SAFETY MANAGEMENT SYSTEMS Safety Management Systems in the Aviation Industry Introduction This topic area covers the second and third sessions.
Now that some of the basic terms and concepts associated with safety management systems and risk management have been discussed, it is important to outline what a safety management system encompasses, and the benefits it can bring when implemented and maintained within an organisation such as an airline.Not only must organisations be aware of operational issues such as scheduling, crewing, and administration, but all staff members must be made aware of the importance of implementing measures to identify, analyse, and monitor safety concerns. Within these sessions, the elements of a Safety Management System will be discussed, as well as the regulatory environment safety must be practiced within. Prior Learning Time Participants must have a sound understanding of the terminology used to describe safety management systems.You will need a minimum of 12 hours to complete this section.
Learning Outcome 1 Performance Criteria 1. 1 Performance Criteria 1. 2 List the common elements of a safety management system Define a safety management system in the context of aviation operations. Discuss the benefits of developing and implementing a safety management system within an organisation. Outline some of the elements in a successful safety management system. Performance Criteria 1. 3 Learning Outcome 2 Describe the impact the regulatory framework has on development of aviation safety management systems.Study the international and national regulations important when establishing safety management systems.
List some associations and foundations promoting safety practices within the aviation community. Performance Criteria 2. 1 Performance Criteria 2. 2 Aviation Safety Systems Learning Outcome 3 Discuss examples of how safety management systems have been developed for specific organisations. Describe at least four methods used by various organisations to manage safety within their environment.
Apply principles described in these examples to develop a safety management system for a small aviation operator.Performance Criteria 3. 1 Performance Criteria 3. 2 Assessment Table Assessment All Learning Outcomes All Performance Criteria All Aviation Safety Systems References Australian Government, 1920, Air Navigation Act 1920, http://www.
scaleplus. gov. au [accessed November 2001] Airservices Australia. 2002, Airservices Vision, http://www.
airservices. gov. au [accessed January 2002] Airservices Australia, 2001, Airservices Australia Online Action Plan August 2001, http://www. airservices. gov. au [accessed November 2001] Arbon, E.
R, Houden, L. H, and Feeler, R. A. 1993, The Practice of Aviation Safety; Observations from Flight Safety Foundation Safety Audits, Flight Safety Foundation Publications. Australian/New Zealand Standard (AS/NZS 4804:2000), Occupational Health and Safety Management Systems – General Guidelines on Principles, Systems, and Supporting Techniques, Standards Australia International, Sydney. Australian Transport Safety Bureau, 2001, The INDICATE Safety Program; Implementation Guide, http://www. atsb. gov.
au [accessed November 2001] Aviation Safety Foundation Australia, Safety Guideline Questionnaire and Gap Analysis for Aviation Organisations, available through ASFA.Boeing, 1996, Safety Program Model, presentation. Civil Aviation Safety Authority, 1998, Aviation Safety Management; An operators guide to building a safety program, Goanna Print, Australia Department of Transport and Regional Services, 2001, Aviation information, http://www. dotrs. gov. au/aviation [accessed November 2001] Federal Aviation Administration, FAA Safety Systems Handbook,http://www.
faa. gov [accessed November 2001] Flight Safety Foundation, 1996, Aviation safety: Airline management selfaudit, Flight Safety Digest, November, pp. -6. Flight Safety Foundation, 2000, Consensus on need for FAA guidance helps propel era of director of safety, Flight Safety Digest, January, pp. 125. Flight Safety Foundation, 2002, Flight Safety Foundation organizational chart, http://www.
flightsafety. org [accessed January 2002] GAIN Programme, 2000, Operators Flight Safety Handbook, ASFA Safety Management Program Resource Pack. Maurino, D. , Reason, J.
, Johnston, N. and Lee, R. 1995, Beyond Aviation Human Factors, Avebury Aviation, England Aviation Safety Systems References Mein, D. T. E. 001, Employing safety management systems as part of a performance-based regulatory regime, Air Traffic Management, July/August, pp. 22-26 Nav Canada, 2001, Corporate Safety Plan 2001-2002, http://www. navcanada.
ca [accessed January 2002] O’Connor Airlines, 1999, OASIS Fieldbook; Airmanship Resource Management, Operations Manual OFB-005, Australia Reason, J. 1998, Managing the Risks of Organizational Accidents, Ashgate, England Royal Aeronautical Society, 2002, About the RAeS, http://www. raes. org. uk [accessed January 2002] Shell Group of Companies, 1999, Aviation Safety Management Policy, Shell International Limited, London Wood, R.H.
1997, Aviation Safety Program; A Management Handbook, Snohomish, Washington Resources ADDITIONAL READINGS http://www. scaleplus. gov. au – all Australian legislation, as well as court case results are available on this site in full.
Assessment Progress The information presented within this session, as well as the handouts, are the foundation for the first assessment. The elements listed as being important to incorporate into a safety management system will provide the criteria for which the report to management can be based on. Author Details © RMIT University 2007.Author/s: Aerosafe Risk Management Pty Ltd Date: October 2007 Modified by: Graham Matthews Date: January 2009 END OF TOPIC 2 COLLEGE OF SCIENCE, ENGINEERING AND HEALTH (SEH) School of Aerospace, Mechanical and Manufacturing Engineering POSTGRADUATE BY COURSEWORK Aviation Programs Aviation Safety Systems Topic 2: Safety Management Systems Section 1: Introduction “…the dynamic commercial environment has led to the recognition that safety must be managed as any other business imperatives are managed; purposefully, with targeted performance goals, and demonstrated results that can be measured.The emphasis is on performance; safety performance” Mein, 2001 Managing safety is imperative to the success of any organisation, and especially ones that depend heavily on technology such as aircraft. The above quote reflects the fact that safety should be approached as any other business goal is, and therefore should be allocated the appropriate resources and time that other aspects of the organisation are.
Unfortunately, in many cases the only time safety has been provided with the attention it requires is in the case where something has gone wrong.This type of reactive approach is not a long term solution. There are many safety considerations to integrate into a safety management system; Occupational Health and Safety requirements, maintenance, personnel management, security, ground operations, commercial considerations, and a number of other elements. Managing safety adequately means making an active effort to consider all of these elements, and factor decision-making on the information provided by the different departments and areas within the organisation.It is not simply about an aircraft in flight, because there are many other elements that can undermine the safety of an organisation’s operations than just mechanical failures. Therefore, the essence of safety management lies within its proactive nature.
In order to achieve this, safety management systems are developed and implemented. These systems are what they sound like; a set of policies, procedures, and other practices that are developed to manage safety issues within the organisation efficiently and thoroughly.The material covered within this topic spans two sessions. These sessions provide an introduction to safety management systems. The following topics will be covered; Safety management systems – an overview o o Objectives of establishing and maintaining a safety management system, and The elements of a successful safety management system Safety and the regulatory environment o o o International regulations, National regulations; The role of the DOTRS, ATSB, CASA, and Airservices Australia, and Safety associations, foundations, and societies. Aviation Safety SystemsEight examples of safety management systems within organisations. o o o o o o o o The ATSB INDICATE Safety Program, The CASA Aviation Safety Management Operators Guide to building a safety program, The Boeing Safety Program model, The FAA System Safety Handbook, OASIS – O’Connor Airlines, Shell Aviation Safety Management Policy, The GAIN Safety Manual, and MESH – British Airways.
The Aviation Quality Database, ICAO Accident Prevention Manual, NAV CANADA Safety Management Program, ASFA Safety Guidelines Questionnaire. Other Safety Management references o o o o An Overview Good safety management is more than just a legal and moral requirement. Around the world, there is a growing recognition that safety programs can improve a company’s operating performance and profits as well as its safety defences.
” This statement was taken from CASA’s Aviation Safety Management operators guide (1998), and reflects the fact that Safety Management has further benefits than the improvement of safety measures. Objectives of Establishing and Maintaining a Safety Management System The integral component of any safety management system is that it is proactive in its nature.The CASA Handbook also states that the outcome of their implementation is to allow an organisation to identify and track hazards to ensure that action is taken to either eliminate them, or mitigate their effects. There are four general principles to follow; management is to set the safety standard, the company needs to maintains these standards, hazards are to be reported in a timely manner, and action needs to be taken to resolve hazards. How these points are actually to be achieved will be discussed in the following section.As will be outlined in further sessions, the cost of implementing and maintaining theses systems can be high.
However, when a comparison is completed on the costs that can be incurred as a result of there not being adequate safety measures in place, the cost of safety management can be justified. The CASA Handbook (1998) mentions some of the following direct and indirect costs that can arise from not having adequate safety measures. The direct costs are more obvious, as they are generally encompassed in the physical damage that results from a safety failure.The indirect costs include; Loss of business and damage to the reputation of the organisation, Legal action and damages claims, Surplus spares, tools and training, Increased insurance premiums, Loss of staff productivity, Aircraft clean-up and recovery, Cost of internal investigation, Loss of use of equipment, and Cost of short-term replacement equipment. Aviation Safety Systems There are further ramifications due to the publicity that accidents and other safety breaches receive, and a strong social cost that occurs when accidents in particular occur.It is estimated that the industry/social cost of accidents can be as high as $76 million per year (CASA Handbook 1998). Over one third of this is due to the loss of productivity of the victims involved in accidents. Therefore, the incentives for implementing solid safety management systems are high.
Although there is no one straightforward way that can be advocated for developing and implementing a safety management system, there are a series of considerations that can be incorporated into the policies, support networks, training courses, reporting systems, and other operations within an organisation.The Elements of a Successful Safety Management System The following elements have been drawn from a number of safety management systems used worldwide and then summarised into the latest ICAO Safety Management Manual SMM (2008). The ways to actually implement these elements will not be discussed until the final two sessions of the course, but it is important to have a good understanding of the scope in which safety management systems need to be developed under before listing the tools used to implement one. 1.Safety policy and objectives 1. 1 – Management commitment and responsibility 1. 2 – Safety accountabilities 1.
3 – Appointment of key safety personnel 1. 4 – Coordination of emergency response planning 1. 5 – SMS documentation 2. Safety risk management 2. 1 – Hazard identification 2. 2 – Risk Management 3. Safety assurance 3. 1 – Safety performance monitoring and measurement 3.
2 – The management of change 3. 3 – Continuous improvement of the SMS 4. Safety promotion 4. 1 – Training and education 4. 2 – Safety communication 1.
SAFETY POLICY AND OBJECTIVES 1. 1 Management commitment and responsibility Securing the dedication of management within an organisation is the only way that safety will be addressed properly, depending on the structure of an organisation, the CEO, Chairman, President, and Directors maintain the final accountability for safety. The organisation must define the organisation’s safety policy which shall be in accordance with international and national requirements, and which shall be signed by the Accountable Executive of the organization.The safety policy must reflect organisational commitments regarding safety and needs to include a clear statement about the provision of the necessary resources for the implementation of the safety policy; and must be communicated, with visible endorsement, throughout the organisation.
The safety policy should include the safety reporting procedures; clearly indicate which types of operational behaviours are unacceptable; and include the conditions under which exemption from disciplinary action would be applicable.The safety policy should be periodically reviewed to ensure it remains relevant and appropriate to the organisation. 1. 2 Safety accountabilities The organisation shall identify the Accountable Executive who, irrespective of other functions, shall have ultimate responsibility and accountability, for the implementation and maintenance of the SMS. The Positive Safety Culture Aviation Safety Systems organisation shall also identify the accountabilities of all members of management, irrespective of other functions, as well as of employees, with respect to the safety performance of the SMS.Safety responsibilities, accountabilities and authorities should be documented and communicated throughout the organisation, and include a definition of the levels of management with authority to make decisions regarding safety risks tolerability. 1.
3 Appointment of key safety personnel In addition to the safety accountabilities in section 1. 2, the organisation needs to identify a safety manager to be the responsible individual and focal point for the implementation and maintenance of an effective SMS. . 4 Coordination of emergency response planning The organisation should ensure that an emergency response plan that provides for the orderly and efficient transition from normal to emergency operations and the return to normal operations is properly coordinated with the emergency response plans of those organizations it must interface with during the provision of its services. This is discussed as part of the accident and incident investigation, and the security lesson.However, it is important to note that planning for emergencies such as accidents, security breaches, and other dangerous situations is a secondary safety measure, as it is reactive rather than proactive in its approach. However, safety breaches cannot be eliminated, and therefore emergency plans are important so that all personnel within an organisation are aware of their responsibilities and role in such circumstances. This is an important part of any safety management plan, and must be completed to ensure that all contingencies are covered.
. 5 SMS documentation The organisation should develop an SMS implementation plan, endorsed by senior management of the organization, that defines the organisation’s approach to the management of safety in a manner that meets the organisation’s safety objectives, and maintain SMS documentation to describe the safety policy and objectives, the SMS requirements, the SMS processes and procedures, the accountabilities, responsibilities and authorities for processes and procedures, and the SMS outputs.Also as part of the SMS documentation, the organisation should develop and maintain a safety management system manual (SMSM), to communicate its approach to the management of safety throughout the organisation.
2. SAFETY RISK MANAGEMENT 2. 1 Hazard identification The organisation should develop and maintain a formal process that ensures that hazards in operations are identified. Hazard identification shall be based on a combination of reactive (incident investigations), proactive (reporting) and predictive (change management and project risk assessments) methods of safety data collection.
To establish what type of hazards exist within the industry as well as the specific organisation, methods need to be established to firstly provide all personnel within the organisation to report any hazards, as well as analyse them. As will be discussed in detail as part of the accident and incident investigation lesson, a confidential reporting system must be established so that hazards, safety breaches, and any incidents that occur can be reported to a designated Safety Officer to be actioned.This type of measure is both proactive and reactive in its methods, and must remain confidential. 2. 2 Risk Management The organisation should develop and maintain a formal process that ensures analysis, assessment and control of the safety risks in its operations. This is discussed further in the next two topics. 3.
SAFETY ASSURANCE 3. 1 Safety performance monitoring and measurement The organisation should develop and maintain the means to verify the safety performance of the organisation and to validate the effectiveness of safety risks controls.The safety performance of the organisation shall be verified in reference to the safety performance indicators and safety performance targets of the SMS. Aviation Safety Systems Safety action groups or safety committees need to be conducted so as to provide a forum for safety issues to be discussed on a regular basis and with all those responsible for safety present. The CASA Safety Management Handbook (1998) advocates that these action groups must occur at least four times a year for large aviation operators. . 2 The management of change The organisation should develop and maintain a formal process to identify changes within the organisation which may affect established processes and services; to describe the arrangements to ensure safety performance before implementing changes; and to eliminate or modify safety risk controls that are no longer needed or effective due to changes in the operational environment.
3. Continuous improvement of the SMS The organisation should develop and maintain a formal process to identify the causes of weaknesses in the SMS, determine the implications of weak performance of the SMS in operations, and eliminate or mitigate such causes. Assessment and improvement of the SMS can be done through Auditing. Auditing and other assessments can be completed internally and externally. Internal uditing is an important part of the safety management program of an organisation, and should be carried out by the key safety personnel, or a representative of the safety action group (CASA Safety Management Handbook, 2000).
An annual assessment plan should be drawn up as part of the preparation for the implementation of a safety management system, then a checklist drawn up that is a translation of all the performance indicators established by management. External audits are useful for providing an objective opinion about organisations’ safety practices and internal auditing procedures.The Flight Safety Foundation have completed numerous audits over the past decade, and have created a list of the areas that they study for all airlines they audit (Flight Safety Foundation, 1990); For safety management audits, the following areas are reviewed: Management’s policies and practices relative to safety, Organisation for safety, Management emphasis in safety, Training, Managerial and supervisory qualifications, Personnel safety, and Employee morale.The other areas of the organisation that are observed include: Operational Policies and Implementation, Flight Operations, Observation and evaluation of typical flights, Aircraft maintenance, Aircraft support equipment, Airport, hangar, ramp, and facilities, and Security. Aviation Safety Systems The Flight Safety Foundation then collates and publishes this information (not naming specific airlines due to confidentiality agreements).
These reports can be found as part of their Flight Safety Digests that are available on their website.They are extremely useful for observing trends within the industry, identifying areas that other airlines have had problems in, and applying this information to one’s own operations. Auditing is one way of reviewing the success and the progress of the safety management system. Consultation of the performance indicators drawn up as part of a safety management policy will also provide another way of regular reviewing. The Australian/New Zealand Standard for OH&S management systems (AS/NZS 4804:2000) provides some solid guidance as to how reviewing and evaluation can take place.It advocates the review of all business practices rather than just those pertaining to safety. The convening of a safety action group is one way that regular reviews can be conducted, as is the scheduling in of regular internal and external audits. The results of these reviews must be communicated back to all employees to ensure they receive feedback on their progress, as well as feedback on any weak areas.
4. SAFETY PROMOTION 4. 1 Training and education The organisation should develop and maintain a safety training programme that ensures that personnel are trained and competent to perform the SMS duties.The scope of the safety training shall be appropriate to each individual’s involvement in the SMS. Hazard reporting, identification, and analysis are important for establishing what measures to implement, and one of the main ways to do so is through training.
Discussed in further detail in the last two sessions, the most important elements of training include the following: Conducting a training needs analysis – conducting a TNA involves the study of an organisations’ current procedures, practices, and existing training to determine where the pitfalls are, and what is currently successful.Being able to analyse is assisted by the use of the hazard reports, as they will point to some of these pitfalls. This will also be assisted by reading regulations pertaining to safety, attending professional development workshops, and working with management to set training priorities.
Establishing learning objectives – Like the ones that appear at the commencement of each lesson, learning objectives must set the criteria for the conduct of training. Participants in training courses are expected to be able to complete the learning objectives with the resources provided to them within the training.The target audience and standards of acceptable performance must also be considered when establishing learning objectives.
Delivering effective training to personnel requires the following considerations to be made: Choosing the right trainer – The FAA Handbook (2000) recommends that trainers need to be aware of the relationship they establish with the participants on a course. The trainer should act as a facilitator to the learning process rather than being a teacher as such.Recognising the participant’s objectives for the training – certain methods of training may need to be considered, such as the type of environment that is best for learning, providing participants with an understanding of the ‘big picture’ behind why they are receiving this training, the acknowledgement of the participant’s knowledge base, and allowing for participants to choose how they learn (i. e asking whether the group wants to complete a certain exercise together or in smaller groups). Establishing good training delivery methods – to conduct effective training, consideration needs to be given to how the information is delivered.
Information can be received either passively or actively. Passive learning includes the provision of manuals or books, watching a video, or hearing a lecture. Active learning is completed by holding workshops where the input of all individuals is required, such as responding to a scenario, performing experiments, or role-playing. Aviation Safety Systems After the training has been conducted, it is then important to review the results that it produces. This can be conducted via the use of surveys to course participants immediately after the course, and then again after a certain period of time.Auditing procedures also assist it this process. 4.
2 Safety communication The organisation should develop and maintain formal means for safety communication, that ensures that all personnel are fully aware of the SMS, conveys safety critical information, and explains why particular safety actions are taken and why safety procedures are introduced or changed. Establishing a Positive Safety Culture The topic of culture and safety are discussed in more detail as part of future sessions, but it is important to note that the above elements of a safety management system will not succeed to the same degree without a good safety culture.The following information provides a good overview of the types of elements that contribute to this; “The main elements of a safety culture and their various interactions are previewed below: • An ideal safety culture is the engine that continues to propel the system towards the goal of maximum safety health, regardless of the leadership’s personality or current commercial concerns. Such an ideal is hard to achieve in the real world, but it is nonetheless a goal worth striving for. The power of this ngine relies heavily upon a continuing respect for the many entities that can penetrate and breach the defences. In short, its power is derived from not forgetting to be afraid. In the absence of bad outcomes, the best way – perhaps the only way – to sustain a state of intelligence and respectful wariness is to gather the right kinds of data. This means creating a safety information system that collects, analyses and disseminates information from incidents and near misses as well as from regular proactive checks on the system’s vital signs.
All of these activities can be said to make up an informed culture – one in which those who manage and operate the system have current knowledge about the human, technical, organizational and environmental factors that determine the safety of the system as a whole. In most important respects, an informed culture is a safety culture Any safety information system depends crucially on the willing participation of the workforce, the people in direct contact with the hazards. To achieve this, it is necessary to engineer a reporting culture – an organisational climate in which people are prepared to report their errors and near misses.An effective reporting culture depends, in turn, on how the organisation handles blame and punishment.
A ‘no-blame’ culture is neither feasible nor desirable. Small proportions of human unsafe acts are egregious (for example, substance abuse, reckless non-compliance, sabotage and so on) and warrant sanctions, severe ones in some cases. A blanket amnesty on all unsafe acts would lack credibility in the eyes of the workforce. More importantly, it would be seen to oppose natural justice.What is needed is a just culture, an atmosphere of trust in which people are encouraged, even rewarded, for providing essential safety-related information – but in which they are also clear about where the line must be drawn between acceptable and unacceptable behaviour. The evidence shows that high-reliability organisations – domain leaders in health, safety and environmental issues – possess the ability to reconfigure themselves in the face of high-tempo operations or certain kinds of danger.
A flexible culture takes a number of forms, but in many • • • • • Aviation Safety Systems ases it involves shifting from the conventional hierarchical mode to a flatter professional structure, where control passes to task experts on the spot, and then reverts back to the traditional bureaucratic mode once the emergency has passed. Such adaptability is an essential feature of the crisis-prepared organisation and, as before, depends crucially on respect – in this case, respect for the skills, experience and abilities of the workforce and, most particularly, the first line supervisors. But respect must be earned, and this requires a major training investment on the part of the organisation. Finally, an organisation must possess a learning culture – the willingness and the competence to draw the right conclusions from its safety information system, and the will to implement major reforms when their need is indicated” (Reason, 1998) Management or any Safety Officer cannot set out to establish a sound safety culture without considering the above elements, because as well as relying on a good safety culture, the help contribute to one. A brief overview of the elements that contribute towards a successful safety management system have been presented.This is not the definitive list, but it provides an overview of how to initiate the management of safety, and the types of considerations that need to be made if it is to be of value to the organisation. Quality management has been established in many segments of the aviation system for a long time. Many aviation organisations have implemented and operated quality control (QC) and/or quality assurance (QA) for a number of years.
QA systems can define and establish an organisation’s quality policy and objectives. They ensures that an organisation has in place the elements necessary to improve efficiency and reduce service-related risks.If properly managed, a QA system ensures that procedures are carried out consistently and in compliance with applicable requirements, that problems are identified and resolved, and that the organisation continuously reviews and improves its procedures, products and services. QA should identify problems and improve procedures in order to meet corporate objectives. The application of QA principles to safety management processes helps ensure that the requisite system-wide safety measures have been taken to support the organisation in achieving its safety objectives.However, QA can not, by itself and as proposed by quality dogma, “assure safety”.
It is the integration of QA principles and concepts into an SMS under the safety assurance element, that assists an organisation ensuring the necessary standardisation of processes to achieve the overarching objective of managing the safety risks (Safety Management Manual SMM 2008). Section 2. Safety and the Regulatory Environment Although it is obvious to most why safety measures need to be implemented, it is most likely that safety records worldwide would be different if there were no regulations to advocate the use of certain safety procedures.
A short list of the most important regulatory documents have been included below, including those that are used in an international context, and nationally within Australia. Some of the associations, institutes, and foundations that assist in the promotion of flight safety are also discussed. International Safety Regulations The International Civil Aviation Organisation is the regulatory body for international civil aviation, as stated in the Chicago Convention.Their aims as an organisation include; to develop the principles and techniques of international air navigation, and to foster the planning and development of international air transport so as to ensure a number of different aims, one of which being the safe and orderly growth of international civil aviation throughout the world. A Contracting State of ICAO is a State which has adhered to the Chicago Convention on International Civil Aviation, whether or not it is a member of the United Nations (UN) and/or any of its other Agencies, e.
. Switzerland. A non-Contracting State of ICAO, on the other hand, is a State which has not signed and does not adhere to the Chicago Convention, Aviation Safety Systems but which is a member of the UN and/or any of its other Agencies. There is a third category: that of States which are not signatories to the Convention on International Civil Aviation and which are not members of the United Nations nor of any of its Agencies. Very few States belong to this category, which has not been given a specific name.For purposes of planning and facilitating the follow-up of implementation of the required air navigation services and facilities, States have been categorized into two main groups: those which are geographically situated within the region or have territory in that region, and those which are not located in the region but have air carriers on their registry which conduct international air traffic operations in the region. The States belonging to the first group are essentially those which are responsible for the provision of the services and facilities required in the region and are, for purposes of brevity, referred to as ‘provider’ States.The States of the second group are usually referred to as ‘user’ States.
There are 190 contracting sates as of December 2007 (Memorandum on ICAO n. d. ). Australia was an inaugural member of ICAO and was elected to the Interim Council in December 1944. Australia has been an ab-initio supporter of ICAO and is currently elected to the 33 member ICAO Council as one of the ten “States of Chief Importance in Air Transport” (ICAO ICDB Working Council Paper 2007). The Contracting States who are entitled to take part in ICAO meetings and vote upon the many standards that ICAO draws up relating to aviation.These standards appear as part of the convention that also saw the formation of the organisation; the Convention on International Civil Aviation (the Chicago Convention of 1944), which includes a number of Annexes that relate to specific areas of aviation such as licensing, operation of aircraft, airworthiness, ATC, aerodromes, environmental protection, security, and dangerous goods (ICAO website, 2008). There is no one specific Annex that advocates that safety must be practiced; all of ICAO’s documentation is geared towards this aim.
Nations who have ratified this treaty, and the many others that ICAO has had a part in binding, are obliged to implement these standards throughout their national aviation industry. Paragraph 3. 2.
4, Part I, Annex 6 of the Chicago Convention states that from January 1st 2009, Member States of ICAO shall require operators to implement acceptable safety management systems (SMS) for their flight operations The European Aviation Safety Agency (EASA) became operational in 2003 on the basis of a European Parliament and Council Regulation (216/2008 or Basic Regulation).As an independent EU body under European law, EASA is accountable to the Member States and the EU institutions. A Management Board with representatives from the Member States and the European Commission adopts the Agency’s budget and work programme. The aviation industry is actively involved in the Agency’s work through a number of consultative and advisory committees which is similar to CASA. There is also an independent Board of Appeal. EASA is based in Cologne, Germany, the Agency already employs over 400 professionals from all Member States.EASA currently provide regulation for maintenance and airworthiness, however airspace control and operator related regulations still reside with the individual National Airworthiness Authorities. National Safety Regulations Every nation has their own national regulations regarding aviation.
The Civil Aviation Safety Authority (CASA) was established on 6 July 1995 as an independent statutory authority (previously operating as the Civil Aviation Authority CAA). Under section 8 of the, Civil Aviation Act 1988, CASA is a body corporate separate from the Commonwealth.CASA’s principal function is to conduct the safety regulation of civil air operations in Australia and the operation of Australian owned aircraft overseas. It is also required to provide safety education and training programmes, cooperate with the Australian Transport Safety Bureau, and administer particular features of Part IVA of the Civil Aviation (Carriers’ Liability) Act 1959.
Aviation Safety Systems The Civil Aviation Regulations 1988 (CAR) and the Civil Aviation Safety Regulations 1998 (CASR), made under authority of the Civil Aviation Act, provide for general regulatory controls for the safety of air navigation.The Civil Aviation Act and CAR 1988 empower CASA to issue Civil Aviation Orders (CAO) on detailed matters of regulation. The CASRs 1998 empower CASA to issue Manuals of Standards (MOS) which support CASR by providing detailed technical material.
Part 28 of the CASA Civil Aviation Act (1988 p32) requires an operator to ensure “the organisation has suitable procedures and practices to control the organisation and ensure that the AOC operation can be conducted or carried out safely”.This is the head of power for CASA to hold operators responsible for safe operations. Civil Aviation Order 82. 3 Amendment 1 (2009) applies to AOC holders for RPT operations in the category “other than high capacity aircraft” and Civil Aviation Order 82. 5 Amendment 1 (2009) applies to AOC holders for RPT operations in the category “high capacity aircraft”. The amendments add in the requirement for the operators to have an implementation plan for a safety management system by April 1st 2009.
The amendments list the SMS element requirements and list a requirement for the AOC holders to have a Human Factors and Non-Technical skills training program. CASA CAAP SMS-1(0) (2009) – Safety Management Systems for Regular Public Transport Operations describes the safety outcomes and the key elements of a SMS. It is based around the SMS Framework recommended by ICAO.
The CAAP specifies the components and elements that need to be in place for RPT operations to meet the requirements of CAO 82. 3 and CAO 82. 5 for an SMS program.CASA CAAP SMS-2(0) (2009) – Integration of Human Factors (HF) into Safety Management Systems (SMS) – This CAAP describes the integration of HF into the SMS provides a managerial and organisational framework to ensure the systematic identification and analysis of relevant HF issues, and the application of appropriate tools, methods and measures to address such issues.
CAO 82. 3 and CAO 82. 5 require RPT AOC holders to ensure that an SMS is established in their organisations and that HF is integrated into their SMS processes.The practical and methodical application of HF within an SMS is essential to ensure compliance and to optimise human performance within their systems. CASA CAAP SMS-3(0) (2009) – Human Factors (HF) and Non-Technical Skills (NTS) Training for Regular Public Transport (RPT) Operations – This CAAP provides advice and guidance for developing Human Factors (HF) training and associated Non-Technical Skills (NTS) assessment for Flight Operations Safety-Critical Personnel.
Other legislation affecting CASA in the exercise of its powers include the: • Air Navigation Act 1920 – This Act outlines all regulations pertaining to air navigation such as the freedoms of the air, laws for international flights, accident investigations, and aviation security Commonwealth Authorities and Companies Act 1997 Auditor-General Act 1997 Ombudsman Act 1976 Freedom of Information Act 1982 Privacy Act 1988 Administrative Appeals Tribunal Act 1975 Administrative Decisions (Judicial Review) Act 1977 • • • • • • Aviation Safety Systems The Chief Executive Officer manages CASA, and is responsible to the Minister for Infrastructure, Transport, Regional Development and Local Government (About CASA n. d). There are many miscellaneous Acts and regulations which further outline the regulatory requirements for Australian aviation. These can be found on the CASA website (www. asa. gov. au) Department of Infrastructure, Transport, Regional Development and Local Government (DITRD&LG) have an Aviation Division, who role is to “advise on international and domestic aviation issues; regulate international airline operations; and manage Australia’s participation in the work of the International Civil Aviation Organisation (ICAO).
It also manages the continuing relationship between the Government and Australia’s airlines; with the aviation safety organisations – particularly Airservices Australia (Airservices) and the Civil Aviation Safety Authority (CASA); and publishes Australia’s international and domestic air-service statistics. The Division also develops and administers aviation security standards” (Department of Transport website, 2001). The Australian Transport Safety Bureau (ATSB) is another government body responsible for the investigation of aviation accidents and incidents, and investigations into any other possible safety concerns with regards to transport.Their responsibilities are bound by Annex 13 to the Chicago Convention. As a result of completing investigations and their subsequent analyses, safety recommendations that must be complied with are made. The ATSB is an operationally independent bureau within the Australian Government’s Department of Infrastructure, Transport, Regional Development and Local Government. Under the Transport Safety Investigation Act 2003 (TSI Act) the ATSB is responsible for the investigation of transport safety matters including the aviation sector.Their primary focus is the investigation of fatal accidents and serious incidents, and other serious safety matters concerning commercial passenger carrying operations.
CASA and the ATSB have signed a Memorandum of Understanding (MoU) that sets out safety objectives and underlying values to guide the ongoing relationship between the two organisations. The MoU is intended to maximise aviation safety outcomes and enhance public confidence in aviation safety.The MoU sets out safety objectives and values to guide the working relationship between CASA and the ATSB (Memorandum of Understanding CASA & ATSB 2004).
While CASA is responsible for the control of Airspace, Airservices Australia is a government-owned corporation providing air traffic control management and related airside services to the aviation industry) constitute a tripartite structure for providing safe aviation in Australia, each with separate and distinct functions, working together as an integrated system.Airservices Australia is responsible for the management of all Australian airspace through the provision of air traffic services. Their stated vision is to “be the global leader in air traffic management and the provision of related information and safety services through: • • • • • • keeping safety first, best practice environmental management, the pursuit of operational excellence, creating value for our stakeholders, growing our business, and skilled and committed employees” (Airservices website, 2002)Their services include the following (Table 2. 2): Service En-route air traffic services Arrival and approach air traffic services Airport air traffic services including flight Customers Airlines and other aircraft operators Airlines and other aircraft operators Airlines and other aircraft operators Aviation Safety Systems information Airport rescue and fire fighting services Engineering services Maintenance services Environment services Provision of aeronautical informationAirlines, other aircraft operators, and airport owners External aviation industry customers External aviation industry customers Other customers and stakeholders including government agencies, airport owners, and community groups Airlines, other aircraft operators, and airport owners Table 2. 2 2001) Range of services offered by Airservices Australia (Source Airservices action plan, They are required to liaise with aviation operators, airports, other government bodies such as CASA and the ATSB.In recent years they have been responsible for the implementation of the Australian Advanced Air Traffic System (TAAATS), the Tactical Flow Management System (TFMS), Central Traffic Management System (CTMS), and Controller-Pilot Data Link Communications (CPDLC). Therefore, there are four defined bodies that are responsible for the development of policy and regulations, and for the implementation of these regulations for the purpose of securing the safety and efficiency. This has not been without its problems occasionally, and improvements can always be made to the way Australian regulations are implemented and communicated.
However, many of these organisations are now implementing their own safety management systems, thus promoting their use more visibly. Safety Associations, Foundations, and Societies As well as the regulatory bodies, there are hundreds of associations, clubs, societies, foundations, and boards who promote aviation safety, and assist their members and the public in raising their awareness of issues and possible solutions. On an international scale, these other bodies include; 1) The International Air Transport Association (IATA) – IATA is a trade association for airlines worldwide.There are 280 airlines that are currently members, and its head office is in Montreal, Canada. Further information can be found on http://www.
iata. org. The Flight Safety Foundation – Based in the United States, The Flight Safety Foundation conducts research, safety audits, training, and produces publications (such as their monthly Flight Safety Digest), all of which are focused on aviation safety. With sister organisations in West Africa, Japan, Taiwan, Europe, and Australasia, the Foundation is far-reaching in its influence on international aviation safety practices.Some of their achievements include: Spurred acceptance of flight data recorders, anti-collision lights, aircraft rescue and fire fighting training, and standardisation of pilot training, Initiated the first international, safety-oriented and anonymous pilot-reporting system for civil aviation, which became the model for similar programs throughout the world, Completed the first international agreement to exchange aviation safety information with a nongovernment U. S.
S. R. (now the Commonwealth of Independent States) foundation, Fostered U.
S. implementation of flight operational quality assurance by use of onboard digital flight data recorder information, Studied the benefits of head-up guidance systems to reduce landing accidents, and Conducts annually three safety seminars — the International Air Safety Seminar, the European Aviation Safety Seminar and the Corporate Aviation Safety Seminar (Source; Flight Safety Foundation website, 2002). 2) Aviation Safety Systems Further information can be found on their website http://www. flightsafety. org. ) The International Federation of Airline Pilots Association (IFALPA) – “The Mission of IFALPA is to be the global voice of airline pilots, promoting the highest level of aviation safety worldwide and providing services, support and representation to all of its Member Associations” (IFALPA website, 2002). They provide a daily news service, publications, training courses, and hold annual seminars. Further information is available on their website www.
alpa. org. The Royal Aeronautical Society (RAeS) – Based in the United Kingdom, the RAeS have branches worldwide. They are “the one multidisciplinary professional nstitution dedicated to the global aerospace community”.
The RAeS is the world’s only professional body which caters for the entire aerospace community (Royal Aeronautical Society website, 2002). With a wellestablished network of members, and a well-recognised reputation worldwide, the RAeS services the aviation community by providing monthly seminars, three journals per month, publications, conferences, and has also established 20 specialist groups to represent every facet of the aviation industry. It also awards medals to their outstanding members. Further information can be gained from the main website, http://www.
aes. org. uk, or on the Australian website, http://www. raes.
org. au. The Aircraft Owners and Pilots Association (AOPA) – This association has branches in the US, UK, Switzerland, Italy, South Africa, and in Australia. As well as publishing a regular magazine that is distributed to its members, its committee members are often called to be representatives on boards discussing safety and other operational issues. They state that their aim is to allow for people to have the freedom to fly responsibly, and this is voiced when disagreements arise over the validity of regulations that are to be introduced, or are in place.They have also been instrumental in advocating that amendments occur to the Civil Aviation Act in Australia.
The International Society of Air Safety Investigators (ISASI) – Further information can be found on their website, http://www. isasi. org.
1) 2) 3) Some of the Australian bodies include; 1) The Australian Transport Council – There is an Air Transport Council for each State, who is responsible for the implementation and oversight of the regulations within the Air Transport Act. Formed in 1987, it also advises the Minister for Transport on all air transport matters that will affect the State.The Aviation Safety Foundation of Australia (ASFA) – ASFA was established for the purpose of promoting air safety, the coordination and facilitation of independent air safety resources in Australia, and establishes standards of practice within the industry.
Members are able to attend seminars, receive communications from other members, coordinate the provision of resources such as the OASIS safety management system, and provide safety awards to members. Members are from a wide range of areas within aviation; commercial aircraft operators, maintenance crew, legal practitioners, and aviation medical professionals.Further information can be found on their website www. asfa. com. au. The Australian Aviation Psychology Association (AAvPA) – Their primary objectives are to promote the exchange of information and advancement of knowledge in the fields of aviation psychology and human factors, and to thereby expand their contribution to the safety and efficiency of the aviation industry in the Asia Pacific region (AAvPA website, 2001).
Again, the association conducts seminars and conferences, papers, and other resources.Further information can be found on their website http://home. vicnet. net. au. The website contains some helpful links to other websites involved in aviation psychology, safety, and accident investigation. 2) 3) Aviation Safety Systems Aviation Safety Systems Eight Examples of Safety Management Systems To clarify what a safety management system is and how it is implemented within an organisation, the following information is to provide some examples of how particular organisations have established their own safety management system.
The ATSB INDICATE Safety Program The Bureau of Air Safety Investigation (the ATSB’s predecessor) developed a program entitled Identifying Needed Defences In the Civil Aviation Transport Environment (INDICATE) in consultation with the Australian regional airline industry so to provide aviation operators with guidelines for the development of their own safety management program. The aim of the program is to promote the reporting of safety hazards and other safety concerns in the workplace.They advocate that all or some of the following activities should be included to ensure this occurs (CASA Safety Management Handbook, 2000): The appointment of an operational Safety Manager or Safety Officer who is available to staff as a confidant for safety related issues, Conducting a regular series of staff meetings to identify safety hazards within the operation, Establishing a confidential safety hazard reporting system, Conducting monthly safety meetings with management, Establishing a safety information database, and The distribution of safety information regularly.A software package accompanies this program which has the capability to record the nature of hazards, record the action taken on the hazard, and can generate a recommendation for management or appropriate aviation authorities. Trials in implementing this program have been completed, whereby five elements within organisations were studied to determine whether the program was successful; airline safety culture, staff risk perception of aviation safety hazards, staff willingness to report hazards, action taken on identified safety hazards, and staff comments about safety management within the airline.The trials found that in general, staff confidence in how safety management has been improved, as well as their willingness to report hazards. The communication between departments and external agencies had also improved.
The CASA Aviation Safety Management Operators Guide to Building a Safety Program The material for the CASA Handbook has been quoted throughout these sessions and others, as it is a good summary of information regarding aviation safety management. This guide is designed to provide just that; an overview about safety management programs for aviation operators.Rather than being a manual as the ATSB program is, it provides a number of case studies of aviation accidents and incidents, as well as describing some other safety programs used worldwide. The Boeing Safety Program Model Designed for use by ramp, maintenance, and flight operations, the Boeing Safety Program Model outlines the reasons for having a safety program, as well as the tools required to implement it (CASA Safety Management Handbook, 2000).
Some of the material covered includes investigation techniques, depth of inquiry of investigation, error types, corrective action, and safety philosophies.The program is presented as a two-day course. The program is better put to use in larger aviation operations, as small aviation operators would find the detail required for the program to be unsuitable for their requirements. Aviation Safety Systems The FAA System Safety Handbook The Federal Aviation Administration developed their System Safety Handbook to be used by their employees, supporting contractors, and others involved in safety throughout the FAA. Because the FAA is primarily responsible for civil aviation safety within the United States, it is important for their internal safety procedures to be correct.In 1998 the FAA issued their safety risk management policy, and the Handbook is designed as a ‘how to’ for the departments to implement system safety engineering and management, as well as risk management practices.
Rather than being a guide to the establishment of a safety management system within an aviation operation, it describes in detail the way to ensure that safety is weaved through all areas of an organisation from a technical perspective. It is a good source of information on safety analysis techniques, training, and operational risk management.OASIS – O’Connor Airlines The Operational Aviation Safety Integration System (OASIS) was produced by O’Connor Airlines, with the material based on the original concepts of Dr Tony Kerns and Professor James Reason. The OASIS Fieldbook is a one part of another extremely large document, which is a template for a Safety Policy and Program made available through the Aviation Safety Foundation of Australia (ASFA) for any aviation operators. Originally designed by O’Connor Airlines, Southern Airlines, and Strategic Air Services Ltd, the document is n excellent guide for the ‘how to’ of safety management systems. It covers topics such as the establishment of safety committees, accident and incident reporting, safety audits, safety information distribution, and safety analysis, and is useful for both small and large aviation operators. Shell Aviation Safety Management Policy Shell has often been recognised as having some of the best practices in safety management. This document describes their approach to air transport contract safety.
Due to their requirement to contract out many of their business functions, they have developed a ‘checklist’ of requirements that is provided to each one of their potential contractors, whom have to comply with this standard. In general, the following provisions need to be followed to be considered for a contract with Shell: The provision of a Safety Case, The provision of a Health, Safety, and Environment Management system that is acceptable to Shell, The establishment of Shell Standards for the purposes of developing best-practice for air transport contract, and A Safety Interface document drawn up between the contractor and Shell.What is required within each of these documents are described in the subsequent document that Shell provides. It proves to be an interesting example of how organisations manage not only their own safety issues, but those of any contractors they may use. The GAIN Operators Flight Safety Manual The Global Analysis and Information Network (GAIN) manual was developed by the GAIN “Aviation Operator’s Safety Practices” working group in the United States, and adapted from the Airbus Flight Safety Managers Handbook so to make it more generic.It is designed to assist aviation operators establish a flight safety function within their organisation. It is a good starting point for any organisation, and can be tailored to meet the requirements of individual aviation operations.
It covers topics such as Aviation Safety Systems management and their structure, safety program activities, human factors, emergency response and crisis management, and risk management. MESH – British AirwaysManaging Engineering Safety Health (MESH) is a proactive safety program developed by Professor James Reason (CASA Safety Management Handbook, 2000). The program has been tailored for use in many industries, one of which being Tripod-DELTA used by Shell International. The purpose of the program is to measure an organisations ‘safety health’ in terms of human fallibility, technical and procedural shortcomings, and local hazards. The methods used to measure these elements are quantitative in their nature, and there is a software package that is used in conjunction with the program.The advantages of this system is that it involves the staff in safety further, it directs safety resources where they are most needed, and it encourages better communication between management and staff.
Aviation Safety Systems Other Safety Management References There are several other helpful resources regarding safety management. Some of these include examples of how to establish a safety management system, and provide further ideas about the elements that should be considered in the programs. The Aviation Quality Database (AQD)The Aviation Quality Database was developed in New Zealand with the assistance of the New Zealand CAA. It is designed to provide a means by which aviation operators can be made compatible with the CAA’s computer data for incident and accident reporting, quality deficiency tracking, and analysing safety trends within the industry. Further information about the Aviation Quality Database can be found within the CASA Safety Management Handbook. ICAO Accident Prevention Manual This manual is provided to member states of ICAO.As outlined in the Chicago Convention of 1944, it is a requirement for all member states to have a safety program, and within that outline how accidents are to be dealt with. The Accident Prevention Manual therefore outlines how this can be done in terms of ‘safety theories’, roles and responsibilities, accident prevention concepts, and strategies to mitigate some of the elements that lead to accidents.
NAV CANADA Safety Management Program Nav Canada is the equivalent of Airservices Australia, and they too have also developed a Safety Management Program for use within their organisation.The CASA Safety Management Handbook outlines some of the details of this program, including the six essential components of the manual; 1) 2) 3) 4) 5) 6) A detailed company safety policy, The integration of risk management principles, Giving ownership of the safety management system to management and staff and making them responsible and accountable for risk management, The systematic planning and reporting of risk management activities, The ongoing assessment and evaluation of the effectiveness of the planned risk management, and The measurement of risk management activities.Some of these concepts are outlined in their Corporate Safety Plan for 2001-2002. It lists the following goals that were set for the year, and reported on their progress; Goal 1 – Operate a fully integrated safety management system, Goal 2 – Manage the safety risks associated with implementing the strategic initiatives, Goal 3 – Systematically apply human factors in NAV CANADA operations, Goal 4 – Operate a safety management program, Goal 5 – Plan and manage the safety risks associated with introducing key technical systems, Goal 6 – Promote aviation-wide system safety initiatives, and Goal 7 – Actively promote a positive safety culture.
Aviation Safety Systems Aviation Safety Foundation Safety Guidelines Questionnaire and Gap Analysis for Aviation Organisations The ASFA Safety Questionnaire was provided to members of the Foundation, which contains some general questions that assist in prompting the reader to consider certain elements for their safety management system. Conclusion An overview of what a safety management system is, the elements that must be included, why it must be completed, and how to do so have been presented within these sessions.As will be seen from the following sessions, many of the practices and procedures are the same as those of risk management, and the two are inextricably bound by their common objectives; to improve the safety and efficiency of an organisations’ operations. References About CASA n.
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