Executive Safety Course Col Bob Diduch, National Safety Officer, CAP Maj Chris Hamm, Director of...

Executive Safety Executive Safety CourseCourse

Col Bob Diduch, National Safety Officer, CAPMaj Chris Hamm, Director of Safety, CAP-USAFFrank Jirik, Chief of Safety, CAP NHQ

Hometown Citizens - Homeland Heroes

OverviewOverview ScopeScope Mishap Definition UpdateMishap Definition Update Practical ExercisePractical Exercise Good, Bad, Ugly in Notifications and Good, Bad, Ugly in Notifications and

InvestigationsInvestigations What is a “Safe” CommanderWhat is a “Safe” Commander ConclusionConclusion


ScopeScope


ScopeScope

Introduction: Safely directing complex organizations, Introduction: Safely directing complex organizations, like Civil Air Patrol, requires an understanding of the like Civil Air Patrol, requires an understanding of the program requirements and a safety mindset that is program requirements and a safety mindset that is acquired by prior planning, ORM, and constant acquired by prior planning, ORM, and constant situational awareness. This is a key function of the situational awareness. This is a key function of the corporate official in the wing. Safety requires vigilance corporate official in the wing. Safety requires vigilance to ensure the proper education and prevention to ensure the proper education and prevention oversight reaches all of our members in appropriate oversight reaches all of our members in appropriate and relevant methods. When our organization fails to and relevant methods. When our organization fails to be compliant, the wing commander is a key individual be compliant, the wing commander is a key individual in supporting investigations. A wing commander’s in supporting investigations. A wing commander’s responsibility is to ensure subordinate commanders’ responsibility is to ensure subordinate commanders’ recommendations for remedial training are recommendations for remedial training are accomplished.accomplished.


ScopeScope

Introduction: Safely Introduction: Safely directingdirecting complex organizations, complex organizations, like Civil Air Patrol, like Civil Air Patrol, requiresrequires an an understandingunderstanding of of the the program program requirements requirements andand a safety mindset that is a safety mindset that is acquired by prior planning, ORM, and constant acquired by prior planning, ORM, and constant situational awareness. This situational awareness. This is a key function ofis a key function of the the corporate official in the wing. corporate official in the wing. Safety requires Safety requires vigilance vigilance to ensure the to ensure the proper education and prevention proper education and prevention oversight reaches all of our members in appropriate oversight reaches all of our members in appropriate and relevant methods. When our organization fails to and relevant methods. When our organization fails to be compliant, the wing commander is a key individual be compliant, the wing commander is a key individual in supporting investigations. in supporting investigations. A wing commander’sA wing commander’s responsibilityresponsibility is is to ensure to ensure subordinate commanders’ subordinate commanders’ recommendations for recommendations for remedial training remedial training are are accomplishedaccomplished..


ScopeScope

Introduction: Safely directing complex organizations, Introduction: Safely directing complex organizations, like Civil Air Patrol, requires an understanding of the like Civil Air Patrol, requires an understanding of the program requirements and a safety mindset that is program requirements and a safety mindset that is acquired by prior planning, ORM, and constant acquired by prior planning, ORM, and constant situational awareness. This is a key function of the situational awareness. This is a key function of the corporate official in the wing. Safety requires vigilance corporate official in the wing. Safety requires vigilance

to ensure the proper to ensure the proper educationeducation and prevention and prevention oversight reaches all of our members in appropriate oversight reaches all of our members in appropriate and relevant methods. When our organization fails to and relevant methods. When our organization fails to be compliant, the wing commander is a key individual be compliant, the wing commander is a key individual in supporting investigations. A wing commander’s in supporting investigations. A wing commander’s responsibility is to ensure subordinate commanders’ responsibility is to ensure subordinate commanders’ recommendations for remedial training are recommendations for remedial training are accomplished.accomplished.


Definition UpdateDefinition Update

Mishap (New definition): Mishap (New definition): Any Any unplanned or unsought event, or unplanned or unsought event, or series of events, that result, in or series of events, that result, in or has the potential to cause death, has the potential to cause death, injury, or damage to equipment or injury, or damage to equipment or property. property.

What does this mean to CAP’s What does this mean to CAP’s members and what is not required?members and what is not required?


Civil Air P

atrol

Civil Air P

atrol

Rules!Rules!


Practical ExercisePractical Exercise


The NotificationThe NotificationFile the Mishap Notification – Form 78File the Mishap Notification – Form 78

Account: While flying an approach into XYZ airport Account: While flying an approach into XYZ airport that was VFR day, with winds from the east, CAP that was VFR day, with winds from the east, CAP flight 4173, a C182 retractable gear flown by flight 4173, a C182 retractable gear flown by expert pilot Phillip Flysalot, CAP ID 123456, expert pilot Phillip Flysalot, CAP ID 123456, flying a stabilized approach, with all normal flying a stabilized approach, with all normal engine systems, landed smoothly, but upon engine systems, landed smoothly, but upon stopping realized that the landing gear was not stopping realized that the landing gear was not locked down.locked down.


The NotificationThe Notification

XX


Wing Commanders ROCK!

Wing Commanders ROCK!


The NotificationThe NotificationFile the Mishap Notification – Form 78File the Mishap Notification – Form 78

Account: Gear up landing, A/C N1234CP, a Account: Gear up landing, A/C N1234CP, a C182RG, occurred at XYZ airport. No injuries.C182RG, occurred at XYZ airport. No injuries.


The NotificationThe Notification


Safety Officers are Cutting Safety Officers are Cutting Edge!Edge!


The InvestigationThe Investigation

The Investigator is AppointedThe Investigator is Appointed

Select someone that isn’t:Select someone that isn’t:

UnskilledUnskilled Slow to get stuff doneSlow to get stuff done Biased or history of being opiniated, or dishonestBiased or history of being opiniated, or dishonest Close friends with the member(s) involvedClose friends with the member(s) involved



The Investigator is AppointedThe Investigator is Appointed

Consider selecting:Consider selecting:

Someone from a different wing or regionSomeone from a different wing or region A A trainedtrained investigator investigator Perceived of high character and professionalismPerceived of high character and professionalism Readily availableReadily available


Investigation MistakesInvestigation Mistakes

BUT NOT TOO FASTBUT NOT TOO FAST


Investigation MistakesInvestigation MistakesTOP 10TOP 10

10. Uncooperative People or System10. Uncooperative People or System

9. Conflicting Objectives9. Conflicting Objectives

8. Surface Causes Only8. Surface Causes Only

7. Politics7. Politics

6. Unskilled Investigators6. Unskilled Investigators

5. Interview Biases / Untruthfulness5. Interview Biases / Untruthfulness

4. Untimely Investigation4. Untimely Investigation

3. Investigator Biases3. Investigator Biases

2. 2. Ineffective Corrective ActionIneffective Corrective Action

1. Not Investigating Near Misses1. Not Investigating Near Misses


TeamworkTeamwork


We’ll be back in the air in ‘no We’ll be back in the air in ‘no time!’time!’


The InvestigationThe InvestigationThe Investigation – Form 79The Investigation – Form 79

Factual Narrative: The pilots flying the C182RG Factual Narrative: The pilots flying the C182RG aircraft did have a smooth landing as noted by aircraft did have a smooth landing as noted by the straight marks in the fuselage of the aircraft. the straight marks in the fuselage of the aircraft. No one was injured. The pilot and crew were No one was injured. The pilot and crew were long time CAP veterans and are very skilled. The long time CAP veterans and are very skilled. The gear was not lowered. This was a Form 5 check gear was not lowered. This was a Form 5 check ride. The check ride was not completed.ride. The check ride was not completed.



XXXX



Factual Narrative: The flight crew of this C182RG Factual Narrative: The flight crew of this C182RG aircraft did not utilize the proper checklist or aircraft did not utilize the proper checklist or execute the before landing checks required. execute the before landing checks required. Sterile cockpit procedures were not observed. Sterile cockpit procedures were not observed. The gear up audible was checked and The gear up audible was checked and functioning. Checklists in the aircraft were functioning. Checklists in the aircraft were available. available.

What would you expect to see?What would you expect to see?


CAP is th

e ONLY

way

to F

ly

CAP is th

e ONLY

way

to F

ly!!



Recommended Corrective Action: Assess the Pilot Recommended Corrective Action: Assess the Pilot the $500 deductible. Caution the crew on the $500 deductible. Caution the crew on listening for the landing gear audible. Replace listening for the landing gear audible. Replace the checklists with a laminated copy for better the checklists with a laminated copy for better use. use.

Recommend crew be returned to full flight Recommend crew be returned to full flight status.status.



XXXXXX


The Corrective ActionThe Corrective ActionThe Investigation – Form 79The Investigation – Form 79

Recommended Corrective Action: Recommended Corrective Action: Flight crew received remedial ground instruction on checklist use Flight crew received remedial ground instruction on checklist use

and crew communications responsibilities. and crew communications responsibilities. The Pilot, the two CAP Check Pilots, received unique The Pilot, the two CAP Check Pilots, received unique

recertification in their positions of responsibility and recertification in their positions of responsibility and demonstration of crew communication be required. demonstration of crew communication be required.

The aircraft be checked by maintenance to ensure required The aircraft be checked by maintenance to ensure required warning notifications are operational.warning notifications are operational.

The unit maintenance officer ensure the proper checklists are The unit maintenance officer ensure the proper checklists are available within the aircraft.available within the aircraft.

What would you expect to see? What would you expect to see?


If you can’t think, someone If you can’t think, someone already HAS!already HAS!

A quick fix to a CAP Van?



No frost issues here



Where is the nosewheel?



Hey cadet, pass me your flashlight.



Don’t scratch my door when you get in.



Cadets always have chips!


The Corrective ActionThe Corrective ActionThe Investigation – Form 79The Investigation – Form 79Wings Corrective Action:Wings Corrective Action:

THESE PILOTS WILL NOT ACT AS PIC OF CAP AIRCRAFT OR AS MEMBERS OF CAP AIR CREW THESE PILOTS WILL NOT ACT AS PIC OF CAP AIRCRAFT OR AS MEMBERS OF CAP AIR CREW EXCEPT TO COMPLETE THEEXCEPT TO COMPLETE THE

FOLLOWING REMEDIAL TRAINING, GIVEN BY A XXWG OR XXR CHECK PILOT EXAMINER: FOLLOWING REMEDIAL TRAINING, GIVEN BY A XXWG OR XXR CHECK PILOT EXAMINER:

A MINIMUM OF 1 HOUR OF INSTRUCTION IN EACH OF THE FOLLOWING AREAS:A MINIMUM OF 1 HOUR OF INSTRUCTION IN EACH OF THE FOLLOWING AREAS:

1. STABILIZED APPROACHES1. STABILIZED APPROACHES

2. NIGHT LANDINGS2. NIGHT LANDINGS

3. EMERGENCY PROCEDURES.3. EMERGENCY PROCEDURES. CHECK PILOT INVOLVED IN THIS MISHAP MUST SUCCESSFULLY ACCOMPLISH ALL CHECK PILOT INVOLVED IN THIS MISHAP MUST SUCCESSFULLY ACCOMPLISH ALL

MANEUVERS FROM FRONT RIGHT SEAT.MANEUVERS FROM FRONT RIGHT SEAT. PILOTS MUST SUCCESSFULLY COMPLETE AN ADM COURSE THAT MEETS FAA WINGS PILOTS MUST SUCCESSFULLY COMPLETE AN ADM COURSE THAT MEETS FAA WINGS

STANDARDS IN ORDER TO RETURN TO FLYING STATUS.STANDARDS IN ORDER TO RETURN TO FLYING STATUS. UPON COMPLETION OF REMEDIAL TRAINING AS ENDORSED BY THE CHECK PILOT UPON COMPLETION OF REMEDIAL TRAINING AS ENDORSED BY THE CHECK PILOT

EXAMINER, PILOTS MUST PASS A SPECIAL FLIGHT CHECK GIVEN BY A CHECK PILOT EXAMINER, PILOTS MUST PASS A SPECIAL FLIGHT CHECK GIVEN BY A CHECK PILOT DESIGNATED BY XXR/CC.DESIGNATED BY XXR/CC.

AFTER SUCCESSFUL SPECIAL FLIGHT CHECK, RECOMMEND RETURN TO CAP FLYING AFTER SUCCESSFUL SPECIAL FLIGHT CHECK, RECOMMEND RETURN TO CAP FLYING STATUS.STATUS.

ALL XXWG CHECK PILOTS WILL RECEIVE GUIDANCE FROM XXWG/CC TO CONFINE ALL XXWG CHECK PILOTS WILL RECEIVE GUIDANCE FROM XXWG/CC TO CONFINE MANEUVERS DURING CHECK RIDES TO PUBLISHED CAP FORM 5.MANEUVERS DURING CHECK RIDES TO PUBLISHED CAP FORM 5.


What is a Commander?What is a Commander?A Commander IS:A Commander IS:

He/She is THE Safety OfficerHe/She is THE Safety Officer Not just the authority, but the person that is responsible for everyone’s safetyNot just the authority, but the person that is responsible for everyone’s safety

He/She is THE Safety Program ManagerHe/She is THE Safety Program Manager A strong program is led.A strong program is led.

He/She is THE Risk ManagerHe/She is THE Risk Manager They do not walk by risk without correcting it. Not saying anything really says, I They do not walk by risk without correcting it. Not saying anything really says, I

condone this.condone this.


BarriersBarriers

Bodily InjuryBodily Injury

Vehicular

Aircraft

Nat'l Total 19 10 3 29 36 51 12 87 231 308 39 539

Nat'l Total 0 1 0 1 21 21 9 42 38 51 8 89

Nat'l Total 3 4 1 7 84 92 20 176 32 60 6 92

Accidents

Incidents

Mishaps

1

20-50

600

Data FY08 - present

Accidents Incidents Mishaps

*Data Current as of 2/10/2010


Closing CommentsClosing Comments

Safety should be:Safety should be:

A positive environment without any obstacles for disclosure and discussionA positive environment without any obstacles for disclosure and discussion Foster a willingness to share and learnFoster a willingness to share and learn Safety should be proactive not reactiveSafety should be proactive not reactive Should be supported at all levels of leadership and integrated in all CAP programsShould be supported at all levels of leadership and integrated in all CAP programs Safety should be easy to navigateSafety should be easy to navigate

If you think it, it can be done.If you think it, it can be done.


RememberRemember

The Leader You See In The Mirror Each Morning. The Leader You See In The Mirror Each Morning.

The answer is before you.The answer is before you.

Who can change the Safety Culture of CAP?


SummarySummary ScopeScope Practical ExercisePractical Exercise Good, Bad, Ugly in Notifications and Good, Bad, Ugly in Notifications and

InvestigationsInvestigations What is a “Safe” CommanderWhat is a “Safe” Commander BarriersBarriers


Where is the next mishap, incident, accident going to Where is the next mishap, incident, accident going to occur?occur?

Please feel free to send your questions and comments Please feel free to send your questions and comments directly to directly to

the National Safety Team and NHQ Safety @the National Safety Team and NHQ Safety @

[email protected]@capnhq.gov

QUESTIONS?QUESTIONS?


Contact InformationContact Information

Col Bob DiduchCol Bob Diduch Frank JirikFrank Jirik

National Safety OfficerNational Safety Officer Safety, CAP NHQSafety, CAP NHQ

P.O. Box 3036P.O. Box 3036 105 S. Hansell St.105 S. Hansell St.

Trenton, NJ 08619Trenton, NJ 08619 Maxwell AFB, AL 36112Maxwell AFB, AL 36112

609-731-5600 cell 609-731-5600 cell 800-227-9142 ext. 232800-227-9142 ext. 232

907-350-7559 cell907-350-7559 cell

[email protected]@capnhq.gov

Executive Safety Course Col Bob Diduch, National Safety Officer, CAP Maj Chris Hamm, Director of...

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