Wednesday, June 26, 2013

STANDARD OPERATING PROCEDURES AND SAFE OPERATIONS

Introduction      What are Standard Operating Procedures (SOPs)? A letter by the US Federal Aviation Administration (FAA) aptly answered this question where in it was stated that, “SOPs are written, tested procedures that are applied uniformly and consistently within an organization and involve all aspects of flight, both normal and non-normal”. It further stated that “SOPs are widely recognized as a basic element of safe aviation operations”. Safety is one of the pre-requisites for mission accomplishment in aviation, and thus the importance of SOPs can never be under estimated.

Design of SOPs

The aircraft manufacturer provides the initial SOPs for the aircraft based on lessons learned from previous operating experience; analyses performed during design; experience gained during development and certification flight testing; and also experience from the route-proving program. These manufacturer-provided SOPs are adopted without change by an aviation organisation, or these are used as the basis for the development of customized SOPs that promote standardisation across the different aircraft fleets in service at the organisation. Company SOPs so developed reflect the organisation’s operating and training philosophies. Thus, SOPs represent the collective wisdom of the aviation community on how operations could be conducted safely.

To ensure safety, training and operations need to be consistent, implying that training and operations should both be conducted as per the SOPs. This can only happen if everyone in the organisation is convinced of the need to follow SOPs. Bringing about this awareness places a great responsibility on the flying supervisory staff.  Instructors and check airman of the operator are required to ensure that crews are made aware of the reasons for SOPs; are trained as per the SOPs, and are also required to enforce the same during routine line operations.

SOPs published by the operator normally include expected procedures that would be utilised during the flight profiles that are used by the operator, including pre & post flight procedures. SOPs lay down the most effective and efficient procedure to execute any task safely. New procedures need to be added to the SOPs, and redundant ones modified/ deleted based on requirements, and also based on experiences gained by the aviation community. To undertake this task, review of SOPs should be an ongoing task, ideally accomplished with suitable feedback from the end user, the flight crew.

All of this is done with an aim of ensuring safe aviation operations. It is now abundantly clear that safety is not dependant only on the training of the crew, but also on good crew coordination as well as optimum crew performance (or good CRM). This can best be ensured if the crew has a shared mental model of each task that is being undertaken. SOPs provide that vital link that can effectively ensure this shared mental model between crew members, with the least communications, because when every crew member is following SOPs, he/ she is aware of what needs to be done; when it needs to be done; and by whom.

To ensure that every crew member follows the SOPs, these procedures should be clear, comprehensive, and readily available to the flight crew members. In addition the crew members should be aware and convinced of the need to follow the SOPs. All this sounds logical but a study of aircraft incidents and accidents indicates that some of these have been caused due to the crew not following the SOPs.

Operational and Human Factors Involved in Deviations from SOPs

To ensure effective compliance with SOPs, it is important to understand why pilots intentionally or inadvertently deviate from the SOPs. In most cases of deviation from SOPs, the procedure that was followed in place of the published procedure seemed appropriate to the crew, for the prevailing situation, considering the information available in the cockpit at the time. However, it was later found that it was either inappropriate, or at best suboptimal. Experts cite the following factors and conditions as making it more likely that a deviation from SOPs will occur. Awareness of these factors can influence adherence to SOPs and may also be useful in developing corresponding prevention strategies.

  • ·         Corporate culture (e.g., the absence of company management’s clear commitment to SOPs and standardization; double standard practices)
  • ·         Ineffective or unclear company policies (e.g., regarding schedules, costs, go around, diversion, crew duty time, etc.)
  • ·         Inadequate awareness/ knowledge of, or failure to understand the procedure, or action (e.g., quality of wording or phrasing; procedure or action being perceived as inappropriate)
  • ·         Insufficient emphasis on strict adherence to SOPs during routine training and checks.
  • ·         Insufficient vigilance (e.g., due to fatigue)
  • ·       Distractions (e.g., due to cockpit activity)
  • ·         Interruptions (e.g., due to ATC communication)
  • ·         Task saturation resulting in fixation/ degraded multi-tasking ability or task overload leading to reduced attention.
  • ·         Incorrect management of priorities (e.g., lack of or incorrect decision-making model for time-critical situations)
  • ·         Incorrect CRM techniques, especially the absence of cross-checking, crew coordination or effective backup
  • ·         Personal desires or constraints (e.g., personal schedule, press-on-itis)
  • ·         Complacency or Over confidence


An Effective SOP

An effective SOP would need the active collaboration of all stake holders, at the formulation as well as the implementation stages. The following factors should thus be considered for creating effective SOPs: -

  •  All crew members should be aware of the reasons for the procedure, and should also be convinced of the need to follow the same. It is a known fact that when flight crew members are so convinced, then they are more likely to follow the procedure, and also offer valuable feedback to improve upon an existing procedure, or  introduce a new relevant procedure.
  •   All crew members should hold the belief that the procedure is appropriate to the stated flight situation, and would cover all the likely eventualities. This should be reinforced during effective training sessions conducted by the operator’s flight instructors/ check pilots.
  •  The procedure should clearly lay down what needs to be done, by whom (PF/ PM), and when it is to be done. Each crew’s responsibilities would thus be clearly delineated.
  •  The senior supervisors should set an example through word, and more importantly through their deeds that SOPs are to be followed. Any shortcomings/ misgivings about the procedure that are pointed out by the line crew should be discussed and remedial action initiated, if considered appropriate; otherwise the crew member should be provided feedback of the reason why the suggestion is not considered worthy of implementation.

 It has been seen that many a times SOPs are not consistently implemented, in that double standards are practiced by the crew and these are also condoned by the instructors/ check pilots/ managers. Flight crews follow the SOPs during training and check rides, but do it their own way during routine line operations. When this kind of a situation exists, it is an indication that the SOP is either not practical or effective for some reason. The reason for the deviation should thus be investigated and remedial action initiated.

Summary


Safety in aviation continues to depend on good crew performance. Good crew performance, in turn, is founded on standard operating procedures that are clear, comprehensive, and readily available to the flight crew. Development of SOPs is most effective when done by collaboration, using the best resources available including the end-users themselves, the flight crew. Once developed, effective SOPs should be consistently enforced during training as well as during line operations and ineffective SOPs should be continually reviewed and renewed. Double standards should not be permitted.