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Evaluating the Safety Culture

What is a safety culture and where can I get one? There were several threads running through the recent CHC Safety & Quality Summit in Vancouver, all related to that question. No surprise there, but it was interesting to see where we are as we enter the second century of powered flight. To an outsider, it would appear we are not too sure of where we are or where we want to be, which leaves us free to follow just about any road that might take us there. To jump to the end of this story, safety and the safety culture are not simply a destination, but rather the journey itself and the travellers we meet along the way.

The first day of the conference was dedicated to keynote plenary sessions covering the business side, and regulatory and academic approaches to safety in aviation. Mark McCominskey, managing director of First Reserve Corporation, CHC’s parent, emphasized safety cannot be mandated from the corporate level, but it can only come from the shop floor. He went on to speak to creating an atmosphere of accountability within an organization, where people wake up in the morning wondering what they can do better that day.

Martin Eley, Transport Canada’s director general of civil aviation, spoke to the conference about the move to a more collaborative and non-judgmental way of assessing safety in the air from the historical punitive methods. The message? Encouraging pilots and operators to be more forthcoming and sharing of their mistakes with the idea that others can learn from these incidents and apply the knowledge. The reaction of pilots seated at my table would seem to indicate this is not yet the case.

U.S. astronaut Gene Cernan, the last man to walk on the moon, stressed there is a huge difference between making a mistake and doing something “absolutely dumb,” saying “it takes a conscious decision to do something stupid.” He then proceeded to tell a story on himself – of flying a Bell 47G into the Indian River near Cape Canaveral while showing off to nearby boaters, a move that left him intact but destroyed the aircraft and nearly washed him out of the Gemini program. He knew what he was doing was the wrong, yet he did it. He survived, although many others have died under similar circumstances. It is interesting to read accounts of the incident from the time and understand how close Cernan was to being terminated from the program. It was only the support of his peers and superiors who rallied to his defence by creating a slew of hypotheses about what might have happened. Today, Cernan candidly states the only contributing factor to the crash was his conscious and deliberate decision to fly that helicopter in a reckless manner.

Cernan survived a second helicopter crash in 2001 while visiting the Czech Republic. He was being flown to visit his grand-father’s birthplace when the Mi-8 experienced a sudden engine failure and plummeted to the ground. The cause of this incident was found to be a red/green indicator light on a fuel transfer gauge that had been installed upside down. From the back seat, Cernan had noticed the light on this helicopter was different from the same model they had flown on the day before. Did the pilots notice this and fly anyway? What about the mechanic who replaced the light in question? Why does someone design a module that can be put in upside down and allowed to continue in use?

Cernan’s experiences underscore the theme of the conference. There are very few true-blue accidents; incidents are totally unforeseen and beyond the scope of human control. While the majority of crashes are still written off to “pilot error,” the pilot is just one cog in a very large machine, the last in a long string of inputs to an equation that may stretch back over several years, and which includes design of the aircraft and its systems, the pilot’s training through levels of certification, corporate culture and government policies, to name but a few. Think of it as musical chairs. When the music stops, who do we see? The poor pilot.

Safety culture is simply attitude – corporate and personal. Are you living the life or just mouthing the words? Why do other people do dumb things, but never us? Cartoonist Walt Kelly said it through his character Pogo: “We have met the enemy and he is us.” Whoever we are, at any level in an organization, from CEO to ramp attendant, it starts with us.

Paul Dixon is a freelance photojournalist living in North Vancouver.