Where Birds Don't Fly

Safety has been involved in aviation since the first flight in 1903 and since then safety result randomly, but without directions, were able to improve. Airlines did what they could to improve safety but were unsuccessful in total elimination of accidents. Over time, as aircraft became larger and more of them at the airports, airside accidents became systemic errors. When operators become overly focused on safety, but they do not know what to do with it, then safety has become its worst enemy. No one wants to expose themselves to danger, but the real hazard when overestimating risks is overcontrolling processes to remain safe.  Overcontrolling safety is a common reaction to opinion-based root cause analyses. When a root cause is based on preliminary assumptions, there is a strong temptation to overcontrol safety to ensure, in their own mind, that everything possible was done for immediate safety improvements. After a severe aircraft occurrence everyone wants answers, but impatience...

Secrets of the SMS are not all positive secrets but are also pitfalls to watch for and secretly hidden in processes. On the surface a safety management system (SMS) in aviation is a perfect system to avoid or eliminate accidents. When SMS in aviation was first sold to the aviation industry, it was sold as a tool, if an operator followed the rules, to reduce number of accidents. The sales philosophy was that if an operator didn’t have any major accidents, they would for sure have one in the future if they did not implement the safety management system. Their sales pitch intentions were honorable, and the regulator firmly believed what they sold to operators. Virtual and fictional accident cost scenarios were developed to prove how beneficial an SMS system would be in the future. The predication was that the cost of implementing and maintaining a safety management system would become less significant and well worth the investment when contrasted with the cost of doing nothing. Every oper...

The law of unintended consequences is when a planned strategy fails. Sometimes an unintended consequence is winning the jackpot and mostly celebrated as flukes, but when a tragedy strikes, it is bad luck or murphy’s law.  The Safety Management System (SMS) regulations requires that there is a process in place for ensuring that personnel are trained and competent to perform their duties, that there are training requirements for the person managing the safety management system and for personnel assigned duties under the safety management system, and a method to determine the adequacy of training required. These training requirements are required for all personnel, including the Accountable Executive (AE).  Conventional wisdom is that the only two requirements, roles, responsibilities, or duties for the AE is to support the SMS with human and financial resources. An SMS is ineffective and without an excuse if an AE remains untrained to comprehend their responsibility for ope...