cx losa © cathay pacific airways 2005 cathay pacific losa training for safety aiming for excellence...
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CX LOSA CX LOSA © Cathay Pacific Airways 2005
Cathay Pacific Cathay Pacific LOSALOSA
Training for SafetyAiming for Excellence
2001 & 20052001 & 2005
LOSA 2005.LOSA 2005.22CX LOSA CX LOSA © Cathay Pacific Airways 2005
Cathay Pacific AirwaysCathay Pacific Airways
2006 is our 602006 is our 60thth Birthday! Birthday!
from 2 DC3s to a fleet of 95 wide-bodiesfrom 2 DC3s to a fleet of 95 wide-bodies
> 80 pax Aircraft (A340, A330, B777, B747)> 80 pax Aircraft (A340, A330, B777, B747)
14 all-cargo B747 aircraft14 all-cargo B747 aircraft
~ 2000 pilots
~ 16000 total staff
LOSA 2005.LOSA 2005.33CX LOSA CX LOSA © Cathay Pacific Airways 2005
Cathay’s homeCathay’s home Chep Lap Kok, Hong KongChep Lap Kok, Hong Kong
50 Destinations worldwide50 Destinations worldwide
CX aircraft daily in: CX aircraft daily in:
NYC or JNBNYC or JNB
LHR or SYDLHR or SYD
NRT or FRANRT or FRA
DEL or DPSDEL or DPS
CX is truly international…
LOSA 2005.LOSA 2005.44CX LOSA CX LOSA © Cathay Pacific Airways 2005
"Without data you're just another person with an opinion"
"Without data you're just another person with an opinion"
We've got data…We've got data…lots of it!lots of it!
LOSA 2005.LOSA 2005.55CX LOSA CX LOSA © Cathay Pacific Airways 2005
Data Sources…
FOQA/QAR FOQA/QAR – a mature program capturing 90% of flightsa mature program capturing 90% of flights
(part of our change management system)(part of our change management system)
FOQA/QAR FOQA/QAR – a mature program capturing 90% of flightsa mature program capturing 90% of flights
(part of our change management system)(part of our change management system)
Reporting Culture – Air Safety Reports
– Confidential ReportsConfidential Reports
– Training & Check ReportsTraining & Check Reports(8 per pilot per year ~16,000 reports)(8 per pilot per year ~16,000 reports)
Reporting Culture – Air Safety Reports
– Confidential ReportsConfidential Reports
– Training & Check ReportsTraining & Check Reports(8 per pilot per year ~16,000 reports)(8 per pilot per year ~16,000 reports)
LOSA 2005.LOSA 2005.66CX LOSA CX LOSA © Cathay Pacific Airways 2005
How do we make sense of all the data? How do we make sense of all the data?
Is it valid?
Is it relevant?
Does it reveal trends? (or conceal them!)
How can we make the data smarter?
1. In Cathay Pacific, LOSA pointed us to where
we should focus our efforts.
LOSA 2005.LOSA 2005.77CX LOSA CX LOSA © Cathay Pacific Airways 2005
LOSA: - is not Reactive (to an incident / accident)
LOSA: - LOSA: - is not Guessworkis not Guesswork (he who shouts the loudest will be heard)(he who shouts the loudest will be heard)
LOSA: - LOSA: - isis “a day in the life of CPA”“a day in the life of CPA”
LOSA 2005.LOSA 2005.88CX LOSA CX LOSA © Cathay Pacific Airways 2005
Aircraft typeAircraft type Observations Observations
A330/340 A330/340 83 / 117 83 / 117
B777B777 51 / 46 51 / 46
B747-200FB747-200F 0 / 44 0 / 44
B747- 400 (incl. Freighters) B747- 400 (incl. Freighters) 26 (0) / 6726 (0) / 67
Total:Total: 160 / 274 160 / 274
LOSA Flights 2001 / 2005
LOSA 2005.LOSA 2005.99CX LOSA CX LOSA © Cathay Pacific Airways 2005
LOSA 2001 was used to validate and verify data LOSA 2001 was used to validate and verify data from other sources. from other sources.
LOSA 2001, together with the other data, has LOSA 2001, together with the other data, has driven some changes in Cathay Pacific:driven some changes in Cathay Pacific:
– New stabilised approach criteria.New stabilised approach criteria.
– New SOP for Flap and Gear selection.New SOP for Flap and Gear selection.
– New take-off and approach briefings. New take-off and approach briefings.
– New standardised approach and landing callouts.New standardised approach and landing callouts.
LOSA 2005.LOSA 2005.1010CX LOSA CX LOSA © Cathay Pacific Airways 2005
Biggest single shift in Cathay as a result of LOSA 2001
Threat & Error Management programThreat & Error Management program
– Every pilot has completed a TEM course
– Built modules to emphasise TEM into annual recurrent training
– Named "threats" in all departure & arrival briefings
– Got Check & Training pilot buy-in
LOSA 2005.LOSA 2005.1111CX LOSA CX LOSA © Cathay Pacific Airways 2005
We Knew Changes Had Occurred In Our Airline.
2. LOSA helped us to understand these changes.
2. LOSA helped us to understand these changes.
Obvious– Analogue to glass– 3-man to 2-man cockpits– Demographics - multi-cultural crew
Subtle– Experience levels dropping (Hours ≠ Experience)
– Automation complacency (Magenta / green line pilots)
– High threat environment (Weather, ADDs, ATC, etc)
LOSA 2005.LOSA 2005.1212CX LOSA CX LOSA © Cathay Pacific Airways 2005
3. LOSA is underpinned by TEM Principles.
3. LOSA is underpinned by TEM Principles.
Monitor / x-check has become a common phrase among Cathay pilots(LOSA had told us that we were average at monitoring!)
We encourage a culture of “healthy skepticism” on our flightdecks
Error Management can actually be commended (Criticism and blame are not the only responses!)
Threat anticipation is a key ingredient of our briefings
LOSA 2005.LOSA 2005.1313CX LOSA CX LOSA © Cathay Pacific Airways 2005
Moving On…Moving On…In Cathay we took the positives from LOSAIn Cathay we took the positives from LOSAIn Cathay we took the positives from LOSAIn Cathay we took the positives from LOSA
• What have we been doing right?What have we been doing right?
• What are our strengths?What are our strengths?(don’t lose these)
• What are our weaker areas?What are our weaker areas?(let’s focus our attention here)
CX LOSA CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.LOSA 2005.1414
Captain’sLeadership
SOP BriefingsAutomation Management
Where Do We Start?
Everybody likes to hear what we are doing well(Captain’s leadership, Communication environment)
But the safety culture (water level) can only reach the height of the weakest performance mark (lowest stave).
LOSA can point to which stave needs fixing first.
LOSA 2005.LOSA 2005.1515CX LOSA CX LOSA © Cathay Pacific Airways 2005
SUMMARY
• LOSA is underpinned by TEM
• LOSA helped us to understand the changes in our airline
• LOSA pointed us to where we should focus our efforts
LOSA 2005.LOSA 2005.1616CX LOSA CX LOSA © Cathay Pacific Airways 2005
Managing the future…Managing the future…
LOSA is a Safety Management Tool that gives us a health-LOSA is a Safety Management Tool that gives us a health-check of our safety culture. It gives valuable data, enabling check of our safety culture. It gives valuable data, enabling
us to introduce changes to our safety lifestyle. us to introduce changes to our safety lifestyle.
““Life is lived forward but understood backward.”Life is lived forward but understood backward.” Kierkegaard
We all want to be able to see into the future!We all want to be able to see into the future!
LOSA is helping to
“ensure safety comes first”in Cathay Pacific