Safety Management

Safety Management

Safety – Different Approaches (IFATCA, 2013)

The safety approach of the industrial age until the closing years of the 20th century was founded on the notion that safety is defined by its opposite: by what happens when safety is missing. This means that safety is measured indirectly, not by its presence or as a property in and of itself, but by its absence or as Hollnagel (2012) describes it, the consequence of its absence. This approach is preoccupied and focused with what goes wrong and improved safety performance is achieved by determining the causal factors(s) that led to the event, incidents and accidents, errors, failures and other inadequacies within socio-technical systems and then removing or mitigating these same causal factors. This reduces the socio-technical system behaviour (which is often complex) to one of a simple cause and effect relationship, intrinsically linear.

Historically speaking therefore, accidents and incidents explained by such a simplistic cause and effect relationship – irrespective of the simple or complex nature of the system itself – reduces or decomposes the safety problem space to a vignette and we no longer notice the implicit model behind our thinking.

Three prominent and widely used models of this perspective of safety science are:

  • The “Barrier Model” (Heinrich)
  • The ‘Iceberg’ Model’ (Heinrich)
  • The ‘Swiss Cheese’ model (Reason)

A number of methods have been developed that provide the means to describe and assess systems behaviours to determine hazards e.g., fault tree, bow tie, SAM, Human Reliability Analysis and Tripod, just to mention a few. These have all have been developed on the principal that systems fail because of the combination of multiple small failures which are each individually insufficient to drive a complex system to fail in some way. This analysis then yields to the quantification of risk and assumes mitigations to these risks. Frequently it is observed that such analyses use the human component as the mitigation strategy to manage this identified risk. This approach is often called the linear model.

Over the last two decades the linear model has come under increasing pressure, primarily because it has been unable to account for more and more complex accidents.

To cope with the more complex system behaviours, i.e. accidents and incidents we face, the systemic model has emerged as an alternative. Instead of decomposing system behaviour into events over time, the systemic approach focuses on systems as a whole – holistically. This approach assumes that system properties can only be treated adequately in their entirety, taking into account all facets relating the social to the technical aspects (Ramo and Simon, 1973) and their emergent properties. There is no or little separation of humans, technology, organisations and society.

Systemic models assume that failure and success stem from the same sources and that its component parts can rarely, if at all, describe socio-technical systems. As the often-unchallenged principal that more technology is the key to more production drives the systems we control, environmental and economic efficiency. They become ever more complex and it becomes very difficult to identify linear cause-effect relations. Paths of system behaviours may be invariant to linear interactions or trajectories. This means that it is not possible to observe incidents and accidents in isolation, if we want to improve the systems we try to control. If this assumption is correct it asks for a more holistic view on safety and the systemic approach requires us to understand the system as a whole instead of by its parts.

 

DEFINITION OF SAFETY MANAGEMENT (ICAO, 2020)

According to ICAO, a safety management system (SMS) is defined as a systematic approach to managing safety, including the necessary organizational structures, accountabilities, policies and procedures. SMS requirements are addressed in Annex 19 — Safety Management.

Training in SMS is defined as training which focuses on the role that the individual play within the SMS and how their contributions fit in the bigger picture of safety management at the overarching organizational level. The goal of this training is to ensure that personnels are trained and competent to perform their duties within the SMS. The amount of training required and the topics that must be covered depend on each individual’s involvement in the SMS.

More information on SMS and developing SMS training can be found in the following document:

Safety Management Manual (SMM) (Doc 9859).

 

ICAO Safety Management Panel – Objectives

IFATCA is represented on the ICAO Safety Management Panel (SMP). The objectives of the panel are, inter alia (ICAO, 2020):

  • Analyzing the needs of the aviation stakeholders (States and Service Providers) with respect to the collection, analysis, sharing and exchange of safety data and safety information.
  • Contributing to the ongoing development of the Safety Management Manual, (SMM) (Doc 9859) which provides guidance on the high level requirements contained in Annex 19 – Safety Management.
  • Identifying, developing and validating practical examples and tools in support of the ongoing understanding and use of data and information collection, analysis, sharing and exchange, including examples and tools submitted to ICAO for posting on the Safety Management Implementation website.
  • Ensuring proper liaison takes place with other ICAO Expert Groups where there is a need for co-ordination on safety data and information collection, analysis, sharing and exchange related issues.
  • Supporting the aviation Industry in practically implementing the Annex 19 SARPs in relation to safety data and information collection, analysis, sharing and exchange, that meets the intent of the language and effectively measures and improves safety performance amongst the aviation industry.
  • Ensuring the effective use and implementation of these SARPs will allow for the vision of Safety Management to be realized, with a mature aviation system that can proactively and predictively manage safety risk, leveraging advances in computing technologies and increased data availability.
  • Developing proposals for the amendment of Annex 19 and future revisions of the ICAO SMM that improve aviation safety without creating a regulatory burden for Service Providers.
    Identifying appropriate material that is consistent with ICAO provisions to support all stakeholders with respect of the collection, analysis, sharing and exchange of safety data and information to support effective Safety Management.

For more information, visit one of the following WIKIFATCA pages:

Safety Management 92

  1. A Better Understanding of the Linear versus the Systemic Approach to Safety
  2. A Just Culture in Safety Reporting
  3. A Review of the Policy on the ATM Safety Monitoring Tool
  4. AAS 1.13 DETERMINING OPERATIONS READINESS OF NEW ATM SYSTEMS
  5. Aerodrome – Review ICAO Manual on the Prevention of Runway Incursions
  6. Aerodrome – Review Provisional Policy on Future ATM Concepts for the Provision of Aerodrome Control Service
  7. Air Safety Reporting Systems
  8. Air Traffic Control Separation Monitoring Tool (ASMT)
  9. Airport Infrastructure Development
  10. Airspace Design and Procedures Controller Involvement
  11. Ambient Workplace Recording
  12. ANNEX A – Safety Management Strategy
  13. ANSP Key Performance Indicators (KPIs)
  14. ATCO Performance
  15. ATS 3.13 MIXED MODE OPERATIONS
  16. ATS 3.15 SYSTEM DEFENCES DURING PLANNED SYSTEM DEGRADATION
  17. ATS 3.36 RECATEGORIZATION OF AIRCRAFT FOR WAKE TURBULENCE
  18. ATS 3.43 CRISIS MANAGEMENT
  19. ATS 3.44 MOVING TO A NEW FACILITY
  20. Clarification of Sector Manning Principles
  21. Crisis Management
  22. Critical Incident Stress Management – Guidance Material
  23. Determining Operations Readiness of Automated ATM Systems
  24. Develop Policy on System Defences During Planned System Degradation
  25. Educational Issues on Distraction (Guidance Material)
  26. Evaluating Team Resource Management Implementation within ATC and to Define the Practice for IFATCA
  27. Human Factors in Accident and Incident Investigation
  28. IFATCA/ Eurocontrol Prosecutor Expert Course
  29. Incident Reporting Responsibilities throughout the Whole ATM Domain
  30. Investigate Minimum Safe Altitude Warning Systems (MSAW)
  31. Investigate Runway Incursions
  32. Investigate the Mechanisms for Dealing with a Critical Incident/Accident
  33. Investigate the Professional Aspects of the Difference between Intrinsic and Tactical Safety in the Aerodrome Domain
  34. Investigate the Subject of Computer Virus
  35. Just Culture
  36. Just Culture Revisited – Guidance Material for Member Association
  37. LM 11.2.1 JUST CULTURE, TRUST AND MUTUAL RESPECT
  38. LM 11.2.2 EXEMPTION FROM DUTY
  39. LM 11.2.4 PROTECTION OF IDENTITY
  40. LM 11.2.5 REFERENCE CARD
  41. LM 11.2.6 USE OF RECORDED DATA
  42. Management of Mixed Mode Operations
  43. MED 9.2.4 CRITICAL INCIDENT STRESS MANAGEMENT
  44. Monitoring Institutional Framework in ATM
  45. Moving to a New Facility
  46. Normal Operations Safety Survey – NOSS
  47. Performance Measurement in ATC
  48. Performance Targets in Air Traffic Management
  49. Position Paper on Remotely Operated Towers
  50. Produce a Definition of Controller Tools
  51. Protection of Safety Information
  52. Protection of Safety Information Sources
  53. Protection of the Identity of ATM Staff Involved in Serious Incidents / Accidents
  54. Quality Management Systems in ANSPs and the Relation with the SMS
  55. Radar Recording in ATC Systems – Technical and Professional
  56. Relief from Operational Position after an Occurrence
  57. Remote Control Towers
  58. Report Writing and ANSP Procedures for Serious Incidents or Accidents
  59. Resilience and a New Safety Approach – Do We Have the Right Model to Learn from Past and Future Events?
  60. Review Accident and Incident Investigation Policies in view of the “Just Culture” Philosophy
  61. Review IFATCA Technical and Professional Manual on Technical Policy Statements related to Mixed Mode Operations
  62. Review of LM (Legal Matters) – Professional Policy of the TPM
  63. Review of Part IV – Professional Policy of the TPM
  64. Review of Provisional Policy – ATM Safety Monitoring Tools (ASMT)
  65. Review of the IFATCA Vision Document
  66. Review of the Legal Section Relating IFATCA’s Just Culture Policy
  67. Review of WC (Working Conditions) – Professional Policy of the TPM
  68. Review on Just Culture and IFATCA’s Technical and Professional Manual Update
  69. Review Policy on Mixed Mode Operations
  70. Review the Use of Safety Cases
  71. Safety
  72. Safety Auditing of Air Traffic Services
  73. Safety Management Policy Work Plan
  74. Safety Management Systems (SMS)
  75. Sectorless ATM
  76. Study Land and Hold Short Operations
  77. Study Reporting of TCAS RAs
  78. Study the ICAO Manual on the Prevention of Runway Incursions
  79. The 2004 Cagliari Accident and the European Court of Human Rights Decision
  80. The Reality of Just Culture – A Roadmap for the Changing Landscape of Just Culture
  81. The Use of Safety Nets in ATM
  82. Transgression in Service Providers
  83. Update of Accident and Incident Investigation Policy
  84. Use of Area Recordings
  85. WC 8.1.8 PERFORMANCE INDICATORS
  86. WC 8.2.10 SHORT TERM CONFLICT ALERT (STCA): HUMAN FACTORS / LEGAL ASPECTS
  87. WC 8.2.12 ATM SAFETY MONITORING TOOL
  88. WC 8.2.7 WORKING WITH UNSERVICEABLE OR INADEQUATE EQUIPMENT
  89. WC 8.7.2 NORMAL OPERATIONS SAFETY SURVEY
  90. WC 8.7.3 SAFETY MANAGEMENT SYSTEMS
  91. WC 8.7.4 INTRINSIC AND TACTICAL SAFETY
  92. WC 8.7.5 RESILIENCE AND LINEAR VS SYSTEMIC APPROACH TO SAFETY

Last Update: September 19, 2020  

October 27, 2019   433   superman    WIKI  

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