Managing human factors at Qantas:Investing in a new approach for the

""

future

B,\'Captain Jan L/lcas and Dr Graham Edkins

Following on from Captain Andrew Poulsen's article

reflecting on past and present human factors challenges

faced by Qantas, this article will outline a blueprint for

meeting these challenges. Specifically, the implementation

of a new corporate behaviour based training and

assessment program; and the need to better integrate

human factors principles into existing business and safety

systems.

According to the International CivilAviation Organisation (ICAO). themanagement of human error within theaviation industry is one of thegreatest challenges facing airlinemanagers in the new millennium(ICAO. 1993). Human error representsa real threat to airline safety andefficiency and in building a motivatedworkforce that understand the

challenges of today's and tomorrow'sbusiness environment.

The need to change

Australian aviation. Qantas included.remains the safest operatingenvironment on the world stage.While these safety achievements are

something to be proud of, there isfurther room for improvement. A lackof serious safety incidents has thepotential to reinforce a culture thatQantas is immune to airline accidents.lt is difficult to introduce continuous

improvement strategies wheneverything appears to be working.Human factors represents oneimportant area where further safetygains can be achieved.

Recent international developments inEurope and the United States on CRMskill assessment has led Qantas toreconsider its approach to humanfactors training. As a result of thework conducted by the Joint Aviation

Authority (JAA) on NOTECHS (Non­technical skill evaluation in JAR-FCL)(van Avermaete, 1998) and research byBob Helmreich (Helmreich. 2000) onthe Line Orientated Safety Audit(LOSA); individual and attitude basedtraining and evaluation has beenreplaced by team orientatedbehavioural assessment. This has

been the motivation behind a QantasFlight Training development programcalled Advanced Proficiency Training(APT) which was initiated in early]999.

There is now a general acceptancethat expert performance of tasksinvolves both technical and non-

_ Corporate structure for human factors development---CD~ ••••~ ••

A Blueprint for Change

The question facing many airlinemanagers is not if but rather how tointegrate human factors principleswith current resource managementprograms. This section details howQantas proposes to achieve the abovementioned goals.

A Corporate Approach to HumanFactors

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J

BUSINESSMANAGER

In recognition of the potential impactof human factors on Qantas businessobjectives, a Human Factors SteeringCommittee was formed in April 1998 toguide the extension of a newgeneration corporate human factorsprogram well beyond the cockpit toinclude error management acrossvarious operational divisions. Thestructure of this group is outlinedbelow.

identified can be used as learningtools by various operational areas.

Goal 4. Enhance operational andbusiness outcomes through humanfactors initiatives.

While financial imperatives should notbe the sole reason for embarking onhuman factors initiatives, we need to

get smarter at identifying what hasbeen the return on investment.

PROJECTPAlRONGeorge Bsey

GGMHR

HFS'IEERING GROUP

Senior Manage rs fmm:Flight 011" (Chair)

Cabin Senices

Engineering & lYbintOpemtions Resources

AirportsCa teringFreigh t

LFAD PROJECTMANAG ERDrGmham EdkinsMSE& HF

The focus of most airlines has been tocollect and trend data on human

performance problems from reactive,event based information, such as

reported safety incidents andaccidents. Given the unique humancapability to detect and recover fromerror, there is a lot of information that

we are not collecting because anincident may never have occurred.

Goal 3. Integrate hlllnanfactors

principles into existing business andsafety systems.

Human factors must not be isolated

from core business and safetyobjectives. There is a need toestablish a more systematic method ofensuring that the operational risks

the company is headed in regard tohuman factors.

Goal I. Identify the key competenciesof operational experts.

We need to identify and clearly definewhat behavioural competencies arerepresentative of safe and efficientperformance within stafffrom keyoperational areas of the company.

Goal 2. Develop a betterunderstanding of human performanceissues.

technical skills. Technical skills are

typically the procedural and factualknowledge required to complete atask, such as the highly practicedmanipulation skills of flight crew. Incontrast, non-technical skills mayinvolve reasoning, judgement andcommunication skills. While Qantashas been good at defining and trainingoperational staff in technical skills, itis the non-technical or behavioural

skills which need to be more clearlyspeci fied.

Apart from internationaldevelopments, there have also beensome local regulatory changes, whichare indicative of the increasingimportance of human factors forpassenger carrying operators. Forexample, the Australian Civil AviationSafety Authority (CAS A) has releaseda discussion paper, Civil AviationSafety Regulation (CASR) Part l21A,which proposes mandating CrewResource Management (CRM)/HumanFactors training for flight crew basedon nine modules. These nine modules

specify the basic training curriculumrequired during initial, recurrent,command and aircraft type conversionstages and follow that recommendedby the JAA.

CASR Part 121A also proposes thatflight crew should be regularlyassessed on their CRM competenciesduring line flying, consistent with thatrecommended by the European Unioncountries. This means that the formalevaluation of CRM behaviour will

become the norm for flight crew.However, it is the intention of Qantasto go much further than flight crewand make behavioural assessment a

regular practice for all its operationalstaff.

Organisational Goals Driving Change

The challenge for Qantas is to providehuman factors training that is not onlymeaningful for operational staff but

also useful for improving core safetyand business objectives. The

following goals outline the direction

12 Flight

Overall strategy

The role of the Human Factors

Steering Committee is to:

The project will identify and define the

non-technical or expected behaviours

required for safe performance within

senior operational staff across eachDivision. An assessment system will

then be developed to regularly assess

and reinforce these expected

providing management with a

structured process to assessspecific expected behavioursbased on core safety and businessobjectives.

Expected behaviours are actions thatare required to be demonstrated byoperational staff to achieve a safe andeffective operational outcome.

Behaviour based observation systems

will be tailored to the requirements of

each Division. For example, flight crew

will be assessed on expected

behaviours during route checks and

Line Orientated Flight Training (LOFT)

cyclic sessions using the Flight CrewObservation Record Form (FT 11)

currently under trial. (Shown on page15).

Stage 4. implementation of the

behaviour based observation system.

I Klein. G.A .. Calderll'ood. R. &MacGreg01: D. (/989). Crith'al decision

met/lOd for elicting knowledge. / EEETransactions on Systems. Man and

Cyhernetics, /9: 462-472.

Behaviour based observation systems

wi 11be developed so that managementcan assess that staff are

demonstrating the expected

behaviours trained in Stage 2. Qantas

has for many years assessed many of

its operational staff, such as cabin

crew and airports personnel, oncustomer service skills. Assessment of

behavioural skills underpinning safe

performance is seen as a natural

extension of our existing staff

appraisal systems.

External human factors consultancy

expertise will be sourced to develophuman factors training material based

on the expected behaviours identified

from Stage I. New hire operational

staff will be instructed in the expected

behaviours relating to their

operational area. In addition, current

operational staff wi 1Irecei ve training

and information on the expected

behaviours through new or existing

training courses.

Stage 3. Development and trial of

behaviour based observation system.

Stage 2. Development (~f human

factors training material to support

expected behaviours.

Regional airline staff.

Flight Crew;

Qantas catering personnel; and

Engineering & Maintenance staff;

Airports staff;

Freight staff;

Operations resources staff;

Cabin Crew;

•

Expected behaviours are developed

through a process called cognitive

task analysis, based on the Critical

Decision Methodl. This processinvolves interviewing a representative

sample (10%) of experienced staff (eg,

Captains, CS Ms, Senior LAMEs etc)

in each operational area to identify the

key behaviours (non-technical skills)that best determine effective and safe

job performance.

This process has already beencompleted within Flight Operations as

a result of the Advanced Proficiency

Training (APT) project. Approximatelysix categories of expected behaviours

have been developed for Flight Crew

relating to CRM/Human Factors

issues. The expected behaviours for

flight crew are shown on page 14.

behaviours, while providing trendinformation on those behaviours

posing a high potential risk to safety

and behaviours that represent highly

effective performance.

Staff affected by this program include:

The successful development and

implementation of this project will

involve five stages.

Stage i. Development of non­

technical expected behaviours

Other operational divisions

progressively over the next two years

will adopt the same process todevelop their own expectedbehaviours.

providing staff with enhanced

skills to avoid, trap and mitigatehuman error; and

•

•

Development and assessment of

expected behaviours

To provide the foundation forcorporate human factors excellence, abehavioural training and assessmentproject across various operationaldivisions is proposed. This projectwill be managed by Or Graham Edkins,Manager Safety Education and HumanFactors and include Regional Airline,Union and CAS A involvement to helpensure commitment to this program.

This new approach to human factorshas the dual objectives of:

approve and direct fiscal resources

at specific human factorsprograms; and

maintain a corporate level focal

point to ensure human factorsprogram consistency, whileidentifying and reducing costlyduplication of effort.

The committee is comprised of seniormanagement from various operationaldivisions to ensure company widecommitment at a high level.

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EXPECTED BEHAVIOURS1.Knowledae Information and Strateqies 4.Proaress MonitorinCl

1.1 Demonstration of Knowledge Demonstrates required

4.1 Attending to Tasksdepth of know1edge from company and regulator

•Avoids allowing distractions to impact on operation;

publications.

•Checks creN and operational factors before creating duty

roster.1.2 Gathering of Information Gathers information from all available resources and operational areas.4.2 Analysis of Flight Progress

•Checks and recognises discrepancies between desired

1.3 Assessment of Information Recognises informationand actual flight status;

relevant and useful to the operation.•Systematically checks immediate and overall operational

objectives are being achieved;1.4 Structuring of Information Organises information in a•Ambiguities resolved without delay;

useful and consistent format relevant to the operation.•Errors shall be acknowledged, communicated and

resolved.1.5 Assessment/Selection of Strategies Assesses current plan and alternative plans. Decides on a timely and4.3 Response to New Informationappropriate course of action. Rehearses and reviews•Systematically gains additional information as required;

intended actions when situation requires.•Ascertains effect of information on operation;

•Reacts with appropriate actions to ensure neN

2.Crew Coordination

information does not have an adverse impact on2.1 Input of CreN Members

operation;

•Considers impact of changes on operation and reviews• Invites input from all creN;

strategies accordingly.• Assesses value of all input given;•

Actively participates in discussions on decisions;4.4 Controlling of Outcomes•

Communicates concern assertively when required; •Acts in accordance with designated crew role;• Provides effective support to pilot flying. •Demonstrates positive control of all aspects of

2.2 Sharing of Information/Plans/Strategies

operational responsibility in their area of responsibility.

•

States intended course of action dearly;4.5 Management of Errors•

Ensures other crew members understand communicated •Recognises and communicates observed error;information and proposed course of action;

•Assesses relevance and significance of error;•Briefs and shares all relevant information. •Utilises all relevant crew to minimise or negate impact of

error on the effective outcome of the operation;2.3 Consideration of Crew Needs •Recovers with a minimum loss of performance egotimely•

Considers own fitness and that of other creN membersresponse not concerned with irrelevant details.relevant to the operation; •

Considers experience and recency of creN in terms of4.6 Use and Monitoring of Automationtask assignment;•Demonstrates knO'Wledge of standard operational

•Recognises and resolves conflict;

procedures with respect to autoflight modes and• Uses diplom acy and tact in support of crew and their selection;welfare.•Utilises suitable autoflight modes relevant to situation

2.4 Distribution of Workload

and phase of flight;

•Confirms selected autoflight modes were achieving

•Delegates to avoid self or creN overload;

required and/or desired flight path.• Recognises required time to safely accomplish tasks;,~> •

Maintains awareness of effect of external pressures on5.Self Assessmentoperation; •

Anticipates and prepares for foreseeable operational 5.1 Acknowledgment of Performancerequirements.

•Discusses where improvements could be made in

personal and/or crew performance;3.ATC and NaviClation •Realistically assesses performance.

3.1 Optimise & Implement

5.2 Seeking of Feedback•Understands ATC instructions and questions those not •Recognises difference between own performance and

understood; required standard;• Cross checks instructions with planned or desired course•Actively seeks feedback;of action;

•Undertakes and maintains a programme to monitor and•

Follows accepted dearance except in emergencyimprove both self and crew performance.situations; •

Attempts to improve operational effectiveness throughvariations to clearances;•

Takes into account terrain, weather. and traffic when

requesting and accepting dearances;•Maintains awareness of other traffic in operational

vicinity."

• ~ ~OANTAS Flight TrainingDraft

Flight Crew Observation Record FT/11 •

Crew Resource Management

Customer Service

• FT11 (Jan 2001) Version 1.00

Comments

Integration of human factors training with safety

van Amermaete, J.A.G. (1998).NOTECHS: Non-technical skill

evaluation in JAR-FCL. National

Aerospace Laboratory NLR.

Captain Ian Lucas is the Group

General Manager Flight Operations

and Chief Pilot and currently operateson the B767. He has held various

training and managerial positions

within Qantas including Manager Line

Training, Manager Training 8767,

General Manager B744 Operations and

General Manager B737 Operations.

Or Graham Edkins is a qualified

accident investigator and holds

Masters and PhD degrees in

organisational psychology. He

currently manages the strategic

development of human factors

training, research and development

across the Qantas Group.

Helmreich, B. (2000). Culture and error:

The bridge from research to safety.

Paper presented at the IATA/lCAO

Flight Safety and Human Factors

Regional Seminar, Rio de Janeiro, 16-18

August.

ICAO (1993). Human factors digest

No. 10: Human Factors, Management

and organisation. International Civil

Aviation Organisation: Montreal,Canada.

The main objective of this article hasbeen to demonstrate that we take

human factors seriously at Qantas. In

most respects, human factors is thelast frontier in the battle to work safer

and smarter. This recognition at the

highest corporate level guaranteesthat human factors will become an

integrated way of life at Qantas.

References

•( EVENT BASED ,INFORMATION

Conclusion

Stage 5. Longiwdinal evaluation ofthe program

Any change program of this magnitude

needs to be measured against expected

improvements in operating safety and

efficiency. This is where academic

expertise has much to offer. To this

end we will commence in May this year

a joint Qantas/University of Newcastle

PhD scholarship to determine the

impact of the corporate program on

individual and organisational safety

and business objectives. To date the

aviation industry has yet to develop a

valid evaluation methodology for

assessing the effectiveness of human

factors training.

A strategy for the implementation of a

company wide human factors program

has been outlined. This program is

expected to take three years but the

payoff will be a more strategic method

of identifying major human risk factors

that may threaten core business

objectives.

The maturity of our aircrew body in

relation to human factors principles

means that gains in this area will

continue to be small but significant. It

is other operational areas within

Qantas, with less refined human

factors development, that hold the

greatest promise.

•...- ..

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Observation is made with respectto crew/team behaviour not

individual behaviour.

Information on the observation

form will be de-identified.

Information recorded on the form

will be used to continuously

improve training needs across

each operational area rather than

identify training deficiencieswithin each individual.

Staff are assessed ONLY on those

expected behaviours that areobserved ie; if it is not observed itis not assessed.

(OPERATIONAL BASED'INFORMATION

•

•

•

Observation of expected behaviours

wi 11be conducted according to the

following core principles:

•

The expected behaviours will

essentially form a framework to

analyse performance at the individual,

divisional and organisational level,

which can then be compared to

behavioral data reported via safety

incidents and accidents, and through

scheduled audits. The integration of

these two historically isolated areas

of trend information will provide

Qantas with an enhanced ability to

identify the major human factors risks

to safety and efficiency across its

various operational areas. The

organisation of this system is

presented below.

I~IROUTE CHECK

CYCLIC TRAINING

16 Flight