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Threat and Error Management

Threat and Error Management

CHIEF WARRANT OFFICER 3 PATRICK S. COTTER
B Company, 6th Battalion
52nd Aviation Regiment
Fort McCoy, Wisconsin

Threat and error management is an industry term that describes the holistic approach to ensure high-quality flight operations. It is currently used in the commercial aviation industry to catch problematic situations, thereby removing a link in the accident chain. In this case, I am identifying threats as being instances where weather, slippery surfaces, terrain, human factors or other aircraft could cause bent metal or worse. Army aviation currently utilizes ACT-E or aircrew coordination in a similar manner to discuss troublesome situations. However, the main difference between these two systems is the approach or the management model.

I have worked at three commercial air carriers during my tenure as an Army aviator. One of these carriers used an ingrained system of identifying threats prior to even reaching the terminal area or, in our case, the landing zone. Automated, textual weather, notices to airmen and a good dose of common sense have been used to identify situations which could cause problems during the approach to the terminal area.

One case might be the pilot pointing out a temperature/dew point split of 3-5 degrees in a high-humidity environment from the arrival airport. Realizing this may be an issue, the flight could start alternate planning and revise fuel numbers. Another may be the recognition that the airport is near water during bird migration season. Knowing that their approach might be compromised, they alter their pattern to avoid the water and possibly prevent damage to the aircraft. This coordination is completed far in advance of a compromising situation.

Army Regulation 40-8, Factors Affecting Aircrew Efficiency, for short, certainly gives us an outline to prepare for flight. Physiology is of the utmost importance. A single functional crewmember in a cockpit of two is no way to conduct flight operations. If you are able to see past the directives to avoid drugs and nicotine, you enter into a territory where one starts to recognize other issues.

Helicopter or fixed-wing, spending 6-10 hours in a cockpit will make anyone stressed physiologically. I have been with many aviators who did not manage their diet properly or get enough rest the night before. Depriving one’s body of the essential needs will not aid in breaking the error chain. In one case, a very skilled and experienced instructor pilot elected to descend early while hand-flying an instrument approach after eight hours of flight. We corrected this error, but if there were two individuals fatigued in the cockpit, the results may have been much worse.

Showing up to the mission in a fatigued state is unacceptable. This happens all too often in aviation. One of my recent flight manuals stated: “A pilot must show up to work free of stress.” Although we may not be stress-free, we may show up well rested and mentally ready to go the distance. A bright-eyed pilot is the best defense against adverse and sudden changes in the cockpit.

Rest will prepare the body and mind. Along with this comes the mental preparation for flight. Ensure you know what the next few actions will be in the conduct of the flight. Be ready not only for your takeoff and cruise, keeping mind alternate plans of action in case of emergency or other diversion, but also when to descend for approach and hazards you may encounter near your landing area. Be prepared for the event when the PI or PC may deviate from the plan. If a mistake occurs, have the fortitude to promptly correct the situation in a positive manner. After all, that other pilot may save your six at some point. We are brothers and sisters in this line of work. Strengthening teamwork will catch errors, omissions and threats to the safety of flight.

As the day moves along, don’t be afraid to take a mental break to rest. It is important to be rested and ready at the end of your day just as it is in the beginning. Split the flight legs to manage the flying workload in a long day. As the non-flying pilot, you can be aware of your situation while putting yourself in a state of relaxation in the cockpit. This relaxation will help you be more alert and to analyze the issues at the end of the flight just as you did in the beginning. Taking this action in shifts will allow your fellow pilot to do the same for you, thus, strengthening the quality of the operation.

  • 1 August 2015
  • Author: Army Safety
  • Number of views: 10074
  • Comments: 0
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