Transcript Performing Missions For America - The Civil Air Patrol is a federally

Civil Air Patrol
Performing Missions For America
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Civil Air Patrol
Performing Missions For America
Safety Down Day
October 2010
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Thank you for your
participation!
ORM
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In flying, I have learned that carelessness and
overconfidence are usually far more dangerous
than deliberately accepted risks.— Wilbur
Wright in a letter to his father, September 1900
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ORM
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http://flash.aopa.org/asf/flightrisk/learn-about-flight-risk.cfm
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Operational Risk Management
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The 5M Concept
Man, Media, Machine, Management, Mission
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The 5M Concept – Man (1)
I’M SAFE
Illness
Medication
Stress
Alcohol
Fatigue
Emotion
All of the above can degrade performance and
should be considered a risk.
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The 5M Concept – Media (2)
Media is the environment in which anyone is conducting an activity.
Snow Storm
Runway
Dust Storm
Mountain Areas
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The 5M Concept – Machine (3)
This is an example of the proper user
interface with a computer. It minimizes the
effects of muscle fatigue, carpel tunnel,
and straining of the eyes, among other
things. You can use ORM each day at a
computer to prevent such injuries.
When dealing with a machine, knowing its
maintenance history (logbook, check
recent issues), performance (max weight),
parts, upkeep, repair, et cetera is all
important. The preflight inspection is
therefore significant in order to check and
review the design, maintenance, logistics,
and tech data of the particular aircraft you
are about to takeoff in.
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The 5M Concept –
Management (4)
Management is always YOU!
After all the regs, policies, analyses,
and gathered opinions, YOU are the
one who makes the final decision if
the activity you are about to partake
in is risky.
Does the benefit(s) outweigh the
risk(s)?
YOU have the final say: Go/No-Go
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The 5M Concept – Mission (5)
Traffic Reports
EPA Watches
Counter Drug Ops
Search and Rescues
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Operational Risk Management
Now that we’ve reviewed what contributes to ORM,
where does the Civil Air Patrol stand with ORM and how
do we conduct an actual ORM assessment for a
situation?
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CAP ORM Vision
“Create a Civil Air Patrol in
which all personnel
manage risk such that all
operations are successfully
completed at the least
possible cost.”
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CAP ORM Mission
“Enhance mission
effectiveness at all levels
while minimizing risk.”
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ORM Principles
Accept no unnecessary risks.
Make risk decisions at the appropriate
level.
Accept risks when benefits outweigh
costs.
Integrate ORM into doctrine and planning
at all levels.
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Accept no unnecessary risk
What are the three main reasons that
“unnecessary risks” are sometimes taken?
How can the taking of unnecessary risks
be minimized?
Corollary is “Accept Necessary Risk”.
Flying is tough, it's even tougher if you do
something stupid. Don't do nuthin dumb!
~ Ralph Royce (US WWII Army Air Forces
General)
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Three reasons for taking
unnecessary risks
#1 - Not aware of the risk.
#2 - An incorrect assessment of cost
versus benefit.
#3 - Interpreting “bold risk taking” to
mean gambling.
Don’t be a show-off. Never be too proud
to turn back.. There are old pilots and
bold pilots, but no old, bold pilots. E. Hamilton Lee
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Procedures for minimizing the
taking of unnecessary risk
 Improve hazard detection procedures and
awareness of risks.
 Improve risk decision making skills at all levels
of the organization.
 Train personnel at all levels regarding the risk
management “credo” not “Mission
accomplishment at any cost”, but “Mission
accomplishment at the least cost.”
There is no reason to fly through a
thunderstorm in peacetime.
~ Sign over squadron ops desk at DavisMonthan AFB, AZ, 1970.
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The ORM 6 - Step Process
6. Supervise
and Review
5. Risk Control
Implementation
4. Make
Control
Decisions
1. Identify
the Hazards
2. Assess
the Risks
3. Analyze
Risk Control
Measures
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Operational Risk Assessment
ORM Simplest Example
1. Identify the Hazards: Limited visibility due to the fog and a
hill. You are unfamiliar with this road and have no idea what is
on the other side.
2. Assess the Risks: Due to the fog and hill obstructing your
vision you will have difficulty seeing traffic or obstructions on the
road.
3. Analyze Risk Control Measures: You have no control over
the weather but you can control your speed.
4. Make Control Decisions: Slow down. This is the only option
available to you.
5. Implement Risk Controls: Slow down to a safe speed.
6. Supervise and Review: Assess whether or not your new
speed is slow enough for the conditions and adjust as needed.
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HAZARD
RISK
HAZARD VERSUS RISK
A description of a condition that
can impair mission accomplishment.
No indication of its mission
significance.
A hazard for which we have
estimated the severity,
probability, and scope
with which it can impact
our mission.
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SEVERITY
What impact on mission?
What impact on people?
What impact on things (material,
facilities, environment)?
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SEVERITY CATEGORIES
•CATASTROPHIC - Complete mission failure, death, or loss of system
•CRITICAL - Major mission degradation, severe injury, occupational illness, or
major system damage
•MODERATE - Minor mission degradation, injury, minor occupational illness,
or minor system damage
•NEGLIGIBLE - Less than minor mission degradation, injury, occupational
illness or minor system damage
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PROBABILITY
Use the cumulative probability of all
causation factors.
Express in descriptive or quantitative
terms.
Use experience data when possible.
Acknowledge uncertainty.
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•
•
•
•
•
PROBABILITY CATEGORIES
Frequent
Likely
Occasional
Seldom
Unlikely
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The Risk Assessment Index
Probability
Frequent
A
S
E
V
E
R
I
T
Y
Catastrophic
I
Critical
II
Moderate
III
Negligible
Likely
B
Occasional
C
Seldom
D
Unlikely
E
Extremely
High
High
Medium
Low
IV
Risk Levels
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Risk Assessment (detailed)
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Operational Risk Management
Conclusion
Realize the rock is there, Analyze if the rock will cause
harm, Mitigate the harm.
Don’t get caught under a boulder! But a pebble won’t hurt.
(if not dropped from a large distance, that is…)
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Some Delaware Wing Mishap
Reports
 Weather damage to aircraft:
snow and ice caused aircraft tail
to hit ground.
Mitigation: Sand bag on nose
during icing and heavy snow
conditions
 Fire during engine start:
minimal damage due to situational
awareness and quick action of
crew
Mitigation: sustain the least
damage by being aware and
anticipating what to do in the event
of a fire
 Cadet Laceration: due to fall over pipe
sticking out of the ground
Mitigation: stay on lighted path; require a
flashlight in night conditions while off a
path; be sure grounds are safe
 Cadet Sprained Ankle: due to fall in
hole in ground
Mitigation: Walk around inspection of
grounds before activity
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How can the following be
mitigated?
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How can the following be
mitigated?
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How can the following be
mitigated?
Performing Missions For America
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How can the following be
mitigated?
Performing Missions For America
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How can the following be
mitigated?
Performing Missions For America
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How can the following be
mitigated?
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How can the following be
mitigated?
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How can the following be
mitigated?
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Additional Information
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AOPA Aviation Security:
http://www.aopa.org/whatsnew/la-security.html
Additional information available at the ORM University through the
Civil Air Patrol Website: http://creports.capnhq.gov/ormu/
Canadian Safety Management System (SMS) Transport Canada
website
GAIN products (including risk assessment, airline flight ops, etc.) and
proceedings available – www.gainweb.org
– report on Safety Management Systems on the cd and website
Aviation Conference Education (ACE) – courses
http://www.skygod.com/quotes/piloting.html
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Additional Information (con’t)
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FAA – introductory System Safety Course (OKC; 3-day course)
http://rgl.faa.gov/regulatory_and_guidance_library/rgadvisorycircular.
nsf/0/6485143d5ec81aae8625719b0055c9e5/$FILE/AC%2012092.pdf
FAA Office of System Safety (www.faa.gov) - advice on system
safety issues
System Safety Handbook – FAA
http://www.faa.gov/library/manuals/aviation/risk_management/ss_ha
ndbook/
Appendix to FAA order 8040.4 for FAA contact points for specific
areas of expertise
SAE – www.sae.org
– ARP4761 – guidance for airlines and other organizations
– courses/conferences
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Thank you for your attention and as always,
Be Safe!
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