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Safety Management
Systems
A safety management system is a businesslike
approach to safety. It is a systematic, explicit and
comprehensive process for managing safety
risks. As with all management systems, a safety
management system provides for goal setting,
planning, and measuring performance. A safety
management system is woven into the fabric of
an organisation. It becomes part of the culture,
the way people do their jobs.
Transport Canada TP 13739 E (04/2001)
Targets of Management
Systems
The target for a finance system is control of money
(financial risks to the business) and improving
financial results.
The target of Quality Assurance is the control of
process to achieve predictable and desirable results
that meet with the customers and companys
requirements.
The target of a Safety Management System is the
control of operational risks and to provide an
improving safety record.
All of these systems are primarily the business of
Top Management and it essential that they lead, are
committed and involved.
CAAS Aviation Safety Forum 2007
Priorities
What top management considers
important will get done
People see what is really important
by what they see their bosses DO,
not from what they hear them say
Customers are increasingly buying
on safety as well as price
Company Board
Management & Direction
Finance Plan
Sets Policy
QA/Safety Plan
Budget
Budget
Accountabilities
Levels of Authority
Accountabilities
Line Management
Authorities
Procedures
Procedures
Allocates Resources
Accountants
Audit
Findings
Balance
Sheets
Profit/Loss
CAAS Aviation Safety Forum 2007
Compliance Monitoring
Management of Both
Major Loss Generators
Makes Business Sense
Finance Case
Business Case
or Safety Case
Audits
QA/Safety
Committee
Audit
Findings
Measure
Performance
Profit/Loss
Risks
Risks are what organisations and individuals
take
Risks come in many different sorts
Running Risks
Safety is often seen as taking risks (decision
making), but outcomes are the result of running
risks (action)
The Organisational Accident Model distinguishes
two parts
Running Risks - Individuals at the time
Taking Risks - Organisations in advance
Bow--tie Concept
Bow
Events and
Circumstances
BARRIERS
H
A
Z
A
R
D
C
O
N
S
E
Q
U
E
N
C
E
S
Evaluating risks
You need to decide what level of risk is
acceptable
A Risk Assessment Matrix helps define the
limits of tolerability and acceptance
These limits have to be set by top
management
Top management also has primary
responsibility for ensuring that the
necessary controls are resourced
Neither of these responsibilities can be
delegated lower down in the organisation
CAAS Aviation Safety Forum 2007
Never
heard of in
industry
Incident
heard of in
industry
Incident
heard of in
company
People
A ssets
Env iron
ment
No injury
No effects
Low
Risk
Low
Risk
Slight
injury
Minor
injury
Major
injury
Single
fatality
Multiple
fatality
No
damage
Slight
damage
Minor
damage
Local
damage
Major
damage
Extensive
damage
Slight
effect
Minor
effect
Localised
effect
Major
effect
Massive
effect
Low
Risk
Rating
2
3
4
5
Low
Risk
Incident
happens
several
times per
year in
company
Low
Risk
Incident
happens
several
times per
year in a
location
Low
Risk
Low
Risk
Low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Med/low
Risk
Medium
Risk
Medium
Risk
Medium
Risk
Medium
Risk
Medium
Risk
Medium
Risk
High
Risk
High
Risk
High
Risk
High
Risk
High
Risk
High
Risk
High
Risk
The Edge
The Edge
Normally Safe
SMS
Inherently
Safe
8%
12%
Normally Safe
The Edge
Safety Culture
CAAS Aviation Safety Forum 2007
15%
Return on
Capital
Invested
8%
Inherently safe
12%
Normally safe
15%+ The Edge
Shareholders want more than 15% return, but are
not prepared to tolerate losses
The Core of a
Safety Management System
Safety management is centered round the management of the
risks and hazards
Plan - what are we going to do?
Do - will we actually do what we planned?
Check - do we check that what we planned and did actually
worked?
Feedback - do we learn from our successes and failures?
The Regulator requires proof that these are
In place - we have a system
In operation - we are using the system on a daily basis
Effective - the system is producing measurable
improvements
Permanent - we would still use the system even if everybody
moved out
CAAS Aviation Safety Forum 2007
CAAS
The senior management of the organisation led
by the Chief Executive Officer is ultimately
responsible for the entire organisationsa attitude
towards safety. Its organisational safety culture
will depend on the senior managements level of
commitment toward safe operations.
The accountable manager, having full authority
over human resources and financial issues, must
ensure that the necessary resources are
allocated to the management of safety.He or she
has direct responsibility for the conduct of the
organisations affairs and final responsibility for
all safety issues.
Singapore CAAS AC 1-3(0)
CAAS Aviation Safety Forum 2007
Progressive implementation
Entire enterprise, however, start with a
manageable task; dont try and implement a
SMS overnight
Its all about culture - Change the way you do
things before you implement the infrastructure:
its all about culture
Development of performance
measurements
Clear and concise standards
Champions in all areas
CAAS Aviation Safety Forum 2007
Safety Culture
A good safety culture is the embodiment of effective
programs, decision making and accountability at all
levels.
When we talk about safety culture, we are talking first
and foremost about how managerial decisions are
made, about the incentives and disincentives within
an organization for promoting safety.
One thing I have often observed is that there is a great
gap between what executives believe to be the
safety culture of an organization and what it actually
is on the ground. Almost every executive believes he
or she is conveying a message that safety is number
one. But it is not always so in reality.
Carolyn W. Merritt - U.S. Chemical Safety and Hazard Investigation Board,
November 2005
CAAS Aviation Safety Forum 2007
Governance
Governance is about how an organisation is run,
rather than the business
The governance is a primary role for top management
Safety responsibilities TC
example
Accountable executive
Safety Review
Board (SRB)
Director of
operations
Director of
maintenance
Other directorates
Safety services
office
Flight
safety officer
Safety Action
Group (s)
(SAG)
Maintenance
safety officer
Ref. ICAO training
Program
Shell EP Safety
performance
LTIF(TRCF (( ((((( ((( ((( (((( FAR ((( 10 ((( (((
16
14
Piper
Alpha
SMS
started
LTIF
TRCF
SMS in place
FAR
best ever
12
10
8
6
4
2
0
87 88 89 90 91 92 93 94 95 96 97 98 99 '00 '01 '02 '03
Conclusion
Safety management systems give you control
over the safety risks of the business
In aviation safety is the core activity
Like financial management top management
needs to control how these risks are
managed
Singapores CAAS requires and supports an
approach that puts top management in
charge of their business
The best organisations have SMS in place
without any requirement from a regulator