Presented to: By: Date: Federal Aviation Administration Airworthiness or Operations Positive Safety Culture R1 Introduction to Risk Management Fundamentals

Presented to:

By:

Date:

Federal AviationAdministrationAirworthiness or

OperationsPositive Safety Culture

R1

Introduction to Risk Management

Fundamentals

Federal AviationAdministration

2

•Risk Management

– Used for years

– Used in many industries environments

– Used to anticipate the effects of hazards becoming events.

– Used to approach aviation tasks with increased awareness

– It can be applied to almost all activities, even non-aviation.

Risk Management Fundamentals

AVS Enterprise

$5.00 or $500 hamburger


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• This briefing of hazards and risk will include:

– Is it safe? The need for better risk management

– Definitions, terms, and basic concepts

– Making better decisions

– Applying Risk Management



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• Purpose of this briefing:

– Provide a common foundation of risk management fundamentals

– Suggest how to integrate risk management into your organization



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Briefing Objectives

• After this briefing, you will be able to:

– Recognize the importance of hazards awareness and risk management

– Describe what a hazard is, what Risk Management is, and what the benefits are of using risk management

– Describe the three levels of Risk Management

– Use the risk management process to make informed decisions


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ANY QUESTIONS BEFORE WE BEGIN?



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Question: What is safe?

a) Freedom from harm or risk

b) Trustworthy and reliable

c) Some risk but acceptable

d) In compliance with regulations and requirements


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Question:

Why do smart, well-trained, intelligent people like ourselves, our friends, and our colleagues continue to have maintenance accidents?

What's missing?

What can we do?


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What Are We Missing?

Systematic and standardized way to identify and manage risk.

– Not everyone has learned to actively seek out the hazards that can hurt and to determine what level of risk the hazards realistically represent.

– Need to make better decisions – • easier

• more comprehensive

• more justifiable.


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Definitions & Basic Concepts

• Hazard

• Risk

• Risk Assessment


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Definitions & Basic Concepts

• Risk Control

• Risk Management


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Risk & Risk Assessment

Risk is an expression of possible loss (consequences) in terms of severity and probability (likelihood). To first perceive the hazards in a given situation, ask yourself:

1.What can happen? What if ?2. What are the consequences?3. How likely is it?

All aviation operations involve risk and requires decisions to be based on common sense, best practices, and well managed risk.


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Improbable

Remote

Occasional

Probable

Frequent

NegligibleMarginalCriticalCatastrophicLikelihood

Severity

RISK ASSESSMENT MATRIX

1

2

3

4

5

6 10

7

8

12

11 15

9

13

16

14

18

19

17 20


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Severity Scale Definitions

CatastrophicResults in fatalities and/or loss of the system.

CriticalSevere injury and/or major system damage.

MarginalMinor injury and/or minor system damage.

NegligibleLess than minor injury and/or less than minor system damage.


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Likelihood Scale Definitions

Frequent

Likely to occur often.

Probable

Will occur several times.

Occasional

Likely to occur sometime.

Remote

Unlikely to occur; but possible.

Improbable

So unlikely, it is presumed that it will never occur.


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QUESTIONQUESTION

• Based on this Risk Matrix, what would be Based on this Risk Matrix, what would be the level of risk if the likelihood was the level of risk if the likelihood was probable and the severity was marginal?probable and the severity was marginal?

Risk level 6.Risk level 6.

Improbable

Remote

Occasional

Probable

Frequent


SeverityRISK ASSESSMENT MATRIX

1

23

45

6 10

7812

11 15

913

16

1418

1917 20


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AnswerAnswer

• Assessment Results = 9Assessment Results = 9

Risk level 6.Risk level 6.

Improbable

Remote

Occasional

Probable

Frequent



1

23

45

6 10

7812

11 15

913

16

1418

1917 20


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USING THE RISK MATRIX

• Provides a relationship of probability and severity

• Risk levels are determined so that educated decision can be made about acceptability of the hazard/risk

• Level of risk determines who in the organization should make the “accept” decision


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Rule #1

When selecting the severity level, you must always consider the worst that can happen … regardless of the likelihood.


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If the risk level is determined to be high, who should make the acceptability decision?

A. The person currently manning the front line manager position.

B. Top level management.

C. You can make the decision as long as it doesn’t interrupt any traffic.

RESPONSE ITEMRESPONSE ITEM


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QUESTIONQUESTION

• When choosing a severity category, what When choosing a severity category, what must you consider?must you consider?

ANSWERANSWER• You must always consider the ______ that

can happen if the hazard becomes an occurrence


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Manage the Risk

You've assessed the risk! Congratulations!! Now what?

There are only four things you CAN do with risk: Transfer Eliminate Accept Mitigate


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Risk Principles

Risk management has five governing principles.

1. Accept risk only when benefits outweigh the cost

2. Accept no unnecessary risk

3. Anticipate and manage risk by planning

4. Make risk decisions at the right level

5. Document all risk decisions


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Making the ‘accept’ decision

Accepting risk may not be a simple matter and can be a difficult concept.

Several points to keep in mind:

(1)Risk is a fundamental reality

(2) Risk management is a process

(3) Quantifying risk doesn't guarantee safety

(4) Risk is a matter of perspective


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Making Better Risk Decisions

• Risk management is an aid to making better decisions and to plan better.

• The three levels of risk management decisions:

1. Time-Critical

2. Deliberate

3. In-Depth


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Three Levels of Decisions

• Time Critical—An “on-the-run” mental or oral review; e.g., – What can cause me to fail the mission (hazard)?– What can I do about it (control measure)? – How am I going to make the control measure work

(implementation and supervision)?

• Deliberate—Application of the complete five-step process primarily using past experience and brainstorming. Documentation is paramount.

• In Depth—A thorough approach to an event involving research of available data, formal testing, or long-term tracking of information.


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Residual Risk

Residual risk is risk that we accept.

– It is the risk remaining after we do risk management

– It consists of the acceptable risk and the unidentified risk

Unidentified


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Factors For Safety

• Develop personal and/or organizational minimums for common tasks and operations

• Minimums are by definition "minimums"

• Plan for what is safe, not for the minimums


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Factors For Safety

• Be prepared to: – stop – reevaluate – reprioritize

• Always have a back up plan or a way out.

• Understand the "why" of a rule, regulation, or policy, not just what it is.


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Putting It All Together

Risk management is a five-step process


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Step 1: Identify The Hazards

• Identifying hazards is the most important part of our risk management process

• Possible ways to help you identify hazards:

1. Task Analysis

2. "What if?" Tool

3. Change Analysis


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Step 2: Assess The Risk

• For each hazard identified in Step 1, assess the risk

• Risk accounts for the likelihood of an event occurring and the severity of the outcome

• Use a risk assessment matrix to determine the level of risk


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Step 3: Make Risk Decisions

• Risk controls are meant to change risk by lowering the likelihood of occurrence and/or decreasing the severity of a risk.

• Control Options fall into three categories:1. Engineering2. Administrative3. Personal Protective Equipment


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Step 3: Make Risk Decisions

• Use common sense when determining appropriate control measure

• It's usually preferred to engineer out a hazard than to add a new procedure

• Start with the most serious risk first

• Reduce the risk to a minimum consistent with the benefits


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Step 4. Implement Controls

• Act to control the risk

• May involve several factors, depending on the situation. – Assets may have to be acquired or made available.– Documentation is always required. – People may have to be notified and responsibilities assigned.– Communication throughout the organization is a must.

• Be realistic in the selection and implementation of controls.

• To be fully effective, the controls must be documented, sustained and periodically reevaluated.


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Step 5: Monitor

• Well developed metrics might reveal additional hazards that will require additional controls.

• Three things to look for:– Are the risk controls effective? – Is there a need for further assessment? – What additional information can be learned?

• Last step of the risk management process– this is a cyclic process – Review old hazards, risks, and controls regularly


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Risk Management Process Review

Five-step process– Each step as a building block for the next step. – A cycle that is continuously seeking new hazards.

Step 1: Identify HazardsStep 2: Assess Risk Step 3: Make Risk DecisionsStep 4: Implement Controls Step 5: Monitor


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What are the two elements of a “risk”

A. The pilot and the mechanic

B. The hazard frequency and severity

C. Good and Bad

RESPONSE ITEMRESPONSE ITEM


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QUESTIONQUESTION

• What are the five steps for Risk Management?What are the five steps for Risk Management?

ANSWERANSWER


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BRIEFING SUMMARY

• After identifying a hazard, the next step is to analyze it for risk level

• Risk level has two components– Likelihood– Severity

• You must always consider the worst severity

• If the residual risk is high, the accept decision must be made by top management


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QUESTIONQUESTION• You have found an electric cord that crosses the You have found an electric cord that crosses the

pilot lounge. There is nothing to keep someone pilot lounge. There is nothing to keep someone from tripping on it. Based on this risk matrix, what from tripping on it. Based on this risk matrix, what risk level would you assign this hazard ? Why.risk level would you assign this hazard ? Why.

Improbable

Remote

Occasional

Probable

Frequent



1

23

45

6 10

7812

11 15

913

16

1418

1917 20


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ANY QUESTIONS BEFORE WE END?


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Did we meet the Objectives ?

• You should now be able to:

– Recognize the importance of hazards awareness and risk management

– Describe what a hazard is, what Risk Management is, and what the benefits are of using risk management.

– Describe the three levels of Risk Management

– Use the risk management process to make informed decisions.


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Conclusion

• Comments or Questions?• FAA Safety Team• www.faasafety.gov• AMT Awards Program• GA Award Program• WINGS • Feedback Wanted: • http://www.faa.gov/about/office_org/

headquarters_offices/avs/stakeholder_feedback/afs/field/sf_faasteam/

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Presented to: By: Date: Federal Aviation Administration Airworthiness or Operations Positive Safety Culture R1 Introduction to Risk Management Fundamentals