just culture in aviation
TRANSCRIPT
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A Just Culture
MIKE SHAMA
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AIM
To introduce the concept of what a Just Safety Culture is in aviation, with application to all staff at Starlite Aviation
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CONTENTS
• What is Just Culture• Evolution of Safety Thinking• Benefits of a Just Culture• Defining the borders of Bad Behaviour• Four Types of Unsafe Behaviour• Determining The Culpability Of Unsafe Acts• So where do you fit in at Starlite Aviation?
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What is Just Culture
• An atmosphere of trust in which people are encouraged (even rewarded) for providing essential safety-related information, but in which they are also clear about where the line must be drawn between acceptable and unacceptable behaviour.
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Evolution of Safety Thinking
Technical Factors
Human Factors
Org Factors
1950s 1970s 1990s
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Benefits of a Just Culture
• Increased Reporting• A lack of reported events is not indicative of a safe operation, and
likewise, an increase in reported events is not indicative of a decrease in safety. Event reporting illuminates potential safety concerns, and any increase in such reporting should be seen as a healthy safety indicator.
• Trust Building• Most violations are caused by a desire to please rather than willfulness.
This observation emphasizes the inherent nature of the majority of safety violations: (i) that they are indeed inadvertent and (ii) that they are intended to further the organization’s operational objectives.
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Benefits of a Just Culture
• More Effective Safety and Operational Management • Will enhance the organization’s effectiveness by defining job
performance expectations, establishing clear guidelines for the consequences of deviance from procedures, and promoting the continuous review of policies and procedures.
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Defining the borders of Bad Behaviour
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• Human Error• Inadvertent error
• Negligent Conduct• Intentional , increases risk
• Reckless Conduct (gross negligence)• Conscious disregard of substantial and unjustifiable risk
• Violations• Knew the result and went ahead anyway
Four Types of Unsafe behaviours
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A Decision Tree For Determining The Culpability Of Unsafe Acts
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Sidney Dekker on Just Culture
• Human Factors and System Safety, Leading Opinion from Professor Sidney Dekker. Explains Just Culture; why you need it, what it is, and how you get it.
• https://www.youtube.com/watch?v=t81sDiYjKUk
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So where do you fit in at Starlite Aviation?
• Importance of safety consciousness in all job roles• Proactive approach to reporting
hazards/occurrences/incidents• Sense of responsibility: an engineer can spot
something that saves a pilot’s life, a pilot can spot something in maintenance that could save an engineer’s life
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SUMMARY
• Increased reporting improves safety for all, builds trust between individuals and with Starlite (in both directions), and makes us as an organisation more effective and more efficient.
• Awareness of your behaviour and the potential for errors.• Just Culture is not a “no blame” culture. The individual and
the organisation are responsible for their actions and policies.• If you are ever unsure, or think something could be unsafe,
DO NOT BE QUIET. ASK.
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QUESTIONS
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A Just Culture
MIKE SHAMA