Safety Management – Safety Management – A Compromise Between A Compromise Between
Production and ProtectionProduction and Protection
Captain Dan MaurinoCaptain Dan MaurinoFlight Safety and Human Factors – ICAOFlight Safety and Human Factors – ICAO
Worldwide Symposium on Performance of the Air Navigation SystemWorldwide Symposium on Performance of the Air Navigation SystemMontrealMontreal
26 – 30 March 200726 – 30 March 2007
The First Ultra-Safe Industrial SystemThe First Ultra-Safe Industrial System
Ultra-safe system (mid 1990’s onwards)Ultra-safe system (mid 1990’s onwards)Business management approach to Business management approach to
safety (SMS)safety (SMS)Routine collection and analysis of Routine collection and analysis of
operational data operational data
1010-3-3
1010-5-5
1010-7-7
Fragile system (1920’s -1970’s)Fragile system (1920’s -1970’s)Individual risk management & intensive trainingIndividual risk management & intensive trainingAccident investigationAccident investigation
Safe system (1970’s – mid 1990’s)Safe system (1970’s – mid 1990’s)Technology & regulationsTechnology & regulationsIncident investigationIncident investigation
Less than one Less than one catastrophic breakdown catastrophic breakdown per million production cyclesper million production cycles
Truth or Falsehood?
TruthTruth
What is the fundamental purposeWhat is the fundamental purposeof a business organization?of a business organization?
The Business Management PerspectiveThe Business Management Perspective
To achieve specific production goals, service To achieve specific production goals, service providers must manage providers must manage corecore business processesbusiness processes
Managing safety is one such business processManaging safety is one such business processSafety Safety management is a management is a core business functioncore business function just just as financial management, HR management, as financial management, HR management, etcetc..
To achieve specific production goals, service To achieve specific production goals, service providers must manage providers must manage corecore business processesbusiness processes
Managing safety is one such business processManaging safety is one such business processSafety Safety management is a management is a core business functioncore business function just just as financial management, HR management, as financial management, HR management, etcetc..
A Balanced CompromiseA Balanced Compromise
ProductionProductionProtectionProtection
ResourcesResources
The DilemmaThe Dilemma
Production
ProtectionProtection
Bankruptcy
Resources
Resources
The DilemmaThe Dilemma
Production
ProtectionProtection
Resources
Resources
Catastrophe
Building Safety Resilience…Building Safety Resilience…
RiskRisk
HighHigh
LowLow
System outputSystem outputMaximumMaximum MinimumMinimum
SafetySafetySpaceSpace
TrainingTraining
System’s System’s Production Production Objective(s)Objective(s)
RegulationsRegulationsTechnologyTechnology
……Upon Business Management PracticesUpon Business Management Practices
Safety issues are a Safety issues are a byproductbyproduct of activities of activities related to production/services delivery. related to production/services delivery.
Managing safety – An analysis of an Managing safety – An analysis of an organization's resources and goals leading to organization's resources and goals leading to
Balanced and realistic Balanced and realistic allocation of resourcesallocation of resources between protection and production goalsbetween protection and production goals
Support of the Support of the needsneeds of the organization of the organization
Safety issues are a Safety issues are a byproductbyproduct of activities of activities related to production/services delivery. related to production/services delivery.
Managing safety – An analysis of an Managing safety – An analysis of an organization's resources and goals leading to organization's resources and goals leading to
Balanced and realistic Balanced and realistic allocation of resourcesallocation of resources between protection and production goalsbetween protection and production goals
Support of the Support of the needsneeds of the organization of the organization
Production, Protection & ICAO SARPsProduction, Protection & ICAO SARPsStates shall establish a States shall establish a safety programmesafety programme, in , in
order to achieve an order to achieve an acceptable level of safetyacceptable level of safety in: in:The operation of aircraft The operation of aircraft The maintenance of aircraft The maintenance of aircraft The provision of air traffic services The provision of air traffic services Aerodrome operationsAerodrome operations
States shall establish a States shall establish a safety programmesafety programme, in , in order to achieve an order to achieve an acceptable level of safetyacceptable level of safety in: in:The operation of aircraft The operation of aircraft The maintenance of aircraft The maintenance of aircraft The provision of air traffic services The provision of air traffic services Aerodrome operationsAerodrome operations
Production, ProtectionProduction, Protection & ICAO SARPs & ICAO SARPsStates shall require, as part of their safety programme,
that a [service provider] implements a safety management system accepted by the State that, as a minimum: Identifies safety hazards Ensures that remedial action necessary to maintain
an acceptable level of safety is implemented Provides for continuous monitoring and regular
assessment of the safety level achieved Aims to make continuous improvement to the
overall level of safety
States shall require, as part of their safety programme, that a [service provider] implements a safety management system accepted by the State that, as a minimum: Identifies safety hazards Ensures that remedial action necessary to maintain
an acceptable level of safety is implemented Provides for continuous monitoring and regular
assessment of the safety level achieved Aims to make continuous improvement to the
overall level of safety
Enter Acceptable Level of SafetyEnter Acceptable Level of Safety
The acceptable level of safety to be achieved shall be The acceptable level of safety to be achieved shall be established by the State(s) concernedestablished by the State(s) concerned
Minimum safety performance that service providers should achieve while conducting their core business functions
Each agreed acceptable level of safety should be commensurate to
Complexity of individual service provider specific operational contexts
Availability of service provider resources to address safety concerns
The acceptable level of safety to be achieved shall be The acceptable level of safety to be achieved shall be established by the State(s) concernedestablished by the State(s) concerned
Minimum safety performance that service providers should achieve while conducting their core business functions
Each agreed acceptable level of safety should be commensurate to
Complexity of individual service provider specific operational contexts
Availability of service provider resources to address safety concerns
In Search of the Balanced CompromiseIn Search of the Balanced Compromise
Statesafety
programme
Organization’ssafety
management system (SMS)
Organization’sproductionprocesses
Objective:Publicsafety
Objective:Controlsafety risk
AcceptanceOversight
Objective:Achieve commercialgoals andcustomer satisfaction
Safety assurance
Oversight
ProductionProductionProtectionProtection
ResourcesResourcesProtection
ProductionProduction
Denial: ritualistic rejection of Denial: ritualistic rejection of changechange
Repair: cover-up, cosmetic Repair: cover-up, cosmetic adaptation denying progress adaptation denying progress
Reform: engaging the will to Reform: engaging the will to changechange
Safety Management – Excuses and FearSafety Management – Excuses and Fear