In August, government and industry joined forces in a workshop that identified ways to improve the integration of human factors and safety management systems. Dr. Bill summarizes the activity and outcomes.
The Opportunity
Maintenance organizations, large and small, have formalized their safety management with safety management systems (SMS). Many embrace SMS and the benefits because it is a regulation. However, by regulation or not, organizations appreciate that SMS enhances not only the safety benefits but also economic efficiency. Early identification of hazards and addressing risk means that costly errors, worker injury, flight delays, and more, are minimized. Knowing that human error is the most likely cause of negative maintenance events, an SMS must consider human factors. The workshop defined the “Pain Points” related to integration human factors into SMS. The ultimate goal was to recognize current best practices and to write a specification for new tools and processes that help ensure HF-SMS integration.
Delegates
The Federal Aviation Administration, the Office of the Secretary of Transportation–Transportation Safety Institute, and the Aircraft Electronics Association were the workshop co-sponsors. This mix of organizers ensured the participation of large and small airlines and MROs from the Americas and Europe. Airline maintenance organizations were American, United, and Avianca (Columbia). Maintenance organizations (MROs) included Lufthansa Technik (Germany), Summit Aviation, Flightstar, and Brant Aero (Canada). Boeing and the Thales Group provided a manufacturer’s perspective. Of course, Dr. Bill had a reasonable cast of industry and government human factors practitioners on hand. Everyone attending was active in corporate safety, SMS, and/or human factors. It was an ideal group to fulfill the workshop goal.
“Pain Points”
The medical doctor often starts a patient interaction by asking your general condition. Then, the doc may continue a diagnosis by asking “Does anything hurt”? Do you have any pain points? Are you too heavy or light weight? Are you exercising and eating properly? Is health near the top of your priority list? How can you improve your health? That way the medical practitioner can react to your current condition, offer proactive advice to continue good health, and even predict the risks in your current life style. That’s what an SMS does. That’s what we did on the first day of the three-day meeting. Many delegates presented the status of their current safety management efforts. Then the group collaborated to list the pain points. Many of the general “pain points” were derived from a group-created listing of common post-maintenance discrepancies. See Tables 1 and 2.
Table 1: Example Listing of Common Post-Maintenance Discrepancies
• Inspection/test not completed
• Lock-out/tag-out error
• Loose fittings/lines
• Paperwork not complete
• Improper parts installed
Table 2: Example HF-SMS Pain Points
• Obtaining high value data from frontline maintenance workers
• Insufficient root cause analysis (RCA) before addressing contributing factors
• Need for standardize RCA tools
• Corrective actions are too often individual centered rather that organizational-centered
• Sufficient resources for event investigation
• Enhance the shared culture between management and labor
• Understanding and cooperation between different labor groups (Example: pilots-mechanics, trainers-engineering)
The Day 1 deliberations showed that many of the post-maintenance discrepancies and pain points were identical, but of different scale, between the airline and the general aviation organizations. That was an indication that many of the solutions are likely to be generic but must be adaptable to different organizations.
Best Practices
On the second day of the workshop, delegates discussed the human factors-related practices that worked well. There was some deliberation on the best practices to address the Day 1 post-maintenance discrepancies. An example is the creation of tool accountability programs and technology-based tool identification to prevent “tools left in aircraft.” However, general best practices were more suitable to the workshop goal. Table 3 offers some of the best practice examples. The Day 2 deliberations showed that the integration of HF information into SMS is already well on the way. It is not a novel concept. It can be continued and enhanced.
Table 3: Example Best Practices for HF-SMS integration
• Peer-to-peer assessment like maintenance line-operations assessment (LOSA)
• A “Respect the Aircraft” program focused on preventing a drift away from procedures
• A program for increased management presence on the front line of maintenance
• New attention toward fitness for duty, especially fatigue
• Application of the PEAR model to simplify understanding of HF in an SMS
• A SMS information workflow system that all can understand
• The importance of frontline empowerment
• Use a “floor model” to offer daily safety information data to the workforce
• Use of daily, weekly, or monthly newsletters for frontline employees
The HF-Maintenance SMS Tool/Process Specification
Day 3 had the goal of summarizing the presentations and discussions to list specifications for a tool and process(es) to enhance/integrate human factors into a safety management system. The deliberations during the first two days made this a manageable task. Table 4 offers examples of “Support needed.”
Table 4: Example Specifications to Enhance HF-SMS Integration
• Create a dynamic “floor model” to communicate safety management data to frontline maintenance workers
• Create means/motivation for frontline employees to offer solutions to address hazards and related risk
• Create means for training departments to provide SMS-oriented examples and solutions
• Be sure that SMS data is relevant to frontline workers
• Promote the concept of many HF-champions within the workplace, to include managers
• Encourage peer-to-peer observation and interactive feedback
During the discussions, on all three days, it was surprising that maintenance organizations share many of the same challenges integrating human factors into SMS, regardless of size. It is also very encouraging that everyone, at all organizational levels, seems to understand and appreciate the value of attention to human factors in all aspects of work and safety management. No one needs to be convinced!
The critical next step must be to capitalize on the data from SMS. That data can help formalize and communicate the best practices to identify hazards and risks associated with human factors in maintenance organizations.
Workshop Follow-up
This article offered quick summaries of extensive deliberations. The next step will be a detailed report, published in cooperation with the three hosting organizations. That will chart a path of applied research and development. The deliverable shall be focused on operational SMS practitioners of all sizes. Stay tuned.
Thank you to D Smith (OST-TSI), Ric Peri (AEA), and Ashley Awwad (FAA-CAMI) for critical partnership in planning, executing, and documenting this workshop.
