Ctrl, Alt, Delete – Part II: Is it safe to be human?

Author: Scott Macpherson

To reboot to a fresh starting point in safety management, we should probably admit a few things up front:

• First: Safety is not our first priority. Operating aircraft is. Doing so safely is our mode of operations, but if it were truly our first priority, we would put the airplane on a pedestal after draining it of all fluids, electrical power, and pressure.
• Second: With very few exceptions, everyone wants to operate safely; no sane person goes flying or maintains an airplane thinking, “Today, I’m going to cause an accident.”
• Third: Humans make mistakes, and punishing a mistake is itself an even greater mistake.

In short, Safety Management Systems are pointless unless you have a culture of grace.

A few years ago, I helped develop a toolkit that was intended to help business aviation operators assess their culture. This was around the time the industry at large was waking up to the importance of group culture as an enabler or disabler of safety management. Since then, many more articles and books by PhDs in Safety Culture have been written about the topic. The overwhelming message is that if we accept human error as inevitable and learn by encouraging reporting, then we become safer. If we punish errors (we are not talking about malicious or grossly negligent behaviour here), then we decrease safety. In a word, we need the grace to improve safety.

If people know that it is simple and effective (meaning that something is improved after reporting) to report their mistakes, they will participate in the SMS. If they are not punished—or if they are even rewarded—for reporting their errors, then research shows that they will continue to report them and help the overall operation improve. Who wouldn’t want that? Yet, there are many operations where punishment is meted out in several forms to those who make mistakes, even if they report freely. If training or ‘debriefing’ has negative implications in an operation, then being subjected to such punishment without due consideration of all other potential contributing factors to an incident is certainly going to have a suppressing effect on the reporting of mistakes or hazardous circumstances.

So, if we extend grace to each other, recognizing that everyone makes mistakes in the performance of our duties maintaining, flying, and supporting business aircraft, then we improve safety (and quality) performance. It will also be nicer to work together to ensure safety. And who wouldn’t want that, too?

In the next installments of this “safety reboot” series, we will look at simplicity, reduced administration resulting from properly scaled, effective SMS implementation, and how to measure results.

View Part I here.

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Scott Macpherson is the President and Founder of TrainingPort.net and Vice-Chairman of the International Business Aviation Council (IBAC) Governing Board. He is currently Captain on a Falcon 900LX.