Read More: Safety Needs a Safety Culture
August 14, 2020

SMS works when people are empowered to act on safety.

I once asked one of our veteran aviation investigators what the toughest part of his job was. His response: seeing in accident investigations the same safety deficiencies over and over again that, for some reason, haven’t been addressed.

I can relate. In an effort to prevent crashes and injuries and save lives, the US National Transportation Safety Board (NTSB) has repeatedly urged operators across all modes of transportation to develop and implement a safety management system (SMS) and called on federal regulators to mandate SMS in operations. A key component of the most basic SMS is fostering a positive safety culture. Without a healthy safety culture, there’s no way an operator can actively manage and improve safety consistent with an SMS.

This past May, the NTSB held a public meeting to consider the tragic Jan. 29, 2019, Zaleski, Ohio, crash of a helicopter air ambulance operated by Survival Flight that killed three heroes: the pilot and two medical personnel. Our investigation revealed numerous safety deficiencies at Survival Flight—including their failure to perform comprehensive preflight risk assessments, which would have identified prior flight refusals or required obtaining forecasts of en route weather information. In fact, one pilot said he expected the accident pilot to complete the so-called preflight risk assessments after the flight.

Other deficiencies we identified at Survival Flight included noncompliance with regulations and procedures, pressure from management to complete flights in poor weather, and a safety culture described to investigators as so “damaging” and “toxic” that employees were afraid to report unsafe conditions. In fact, current and former employees reported negative consequences for speaking up, verbal abuse from management when flights were declined, and a complete lack of concern by management to learn about, much less address, pervasive safety problems.

I don’t think this is the norm; I think most commercial helicopter operators, including helicopter air ambulance operations, are safe. However, what the NTSB has learned about both the Zaleski accident and another accident, in New York, give me a great deal of pause.

In December 2019, we held a public meeting on the Mar. 11, 2018, crash of a doors-off flight in New York’s East River that tragically killed five passengers. The crash was preventable; in fact, aspects of it were predicted by Liberty pilots, who repeatedly raised safety concerns that were disregarded by the NYONair CEO and management. Pilots raised concerns about the difficulties passengers would have in accessing the carabiners on their harness/tether systems in an emergency and the inadequacy of the passengers’ cutting tools to quickly sever their tethers. Some pilots were also aware of the potential for entangling the harness/tether system with the helicopter’s floor-mounted controls and the possibility that the emergency flotation system would only partially inflate. All of these issues played a part in this crash and the loss of life. 

Had these safety issues been addressed by management, tour operations could have continued with safer equipment and procedures, likely preventing the crash or loss of life. That’s why the NTSB continually focuses on safety culture as part of a comprehensive SMS program. In a healthy safety culture, employees aren’t just casually encouraged to “be safe”; they’re empowered to report unsafe conditions without fear of reprisal. Their concerns are taken seriously by management, thoroughly evaluated (and then constantly reevaluated), and resolved before an accident chain has the chance to form. In our Zaleski report, the NTSB reiterated our recommendation to the FAA that all Part 135 operators implement an SMS program. But don’t wait for federal action: operators should implement this recommendation now to save lives. 

Read More: License to Learn
June 05, 2020

Where will pilots get the education they need to fly safely?

As an 18-year-old planning for my future in 1968, I was asked, “When you go to Vietnam, do you want to walk to the war or do you want to fly there?” I chose the latter, and in that moment my life changed. After I learned to march in basic training, I joined my class in flight school.

The first month of flight school was called preflight. As the name implies, we spent the entire time in the classroom learning the fundamentals of aerodynamics, helicopters, airspace, maneuvers, emergency procedures, and safety. Eight hours a day, five days a week for a month adds up to 160 hours of classroom training before we made it to our first day on the flight line.

For the next eight months, we spent half of each working day on the flight line and the other half in the classroom. The flight line was the fun part, but the classroom education continued to round out our knowledge of flight procedures and decision-making skills (as well as combat maneuvers). Four hours a day, five days a week for eight months adds up to around 640 hours of additional education before we were called pilots. 

To be fair, I’ll deduct the 320 hours I estimate were dedicated to tactics and say that my army flight training required me to take 320 hours of follow-on classroom instruction, in addition to my 160 hours of ground school. Now, let’s compare my 480 hours of pilot education with the typical classroom education of a commercial pilot today: 150 hours of ground school.

And yet we wonder, why are we crashing helicopters?

Look, I’m not saying that everything was great back then. The aircraft were less capable and engine failures more common. Our industry lacked a strong safety culture, and we had the accident rate to prove it. While my flight school buddies and I did study hard, we were motivated by more than the usual competition among pilots: the next stop for washouts was the infantry.

But there’s no getting around the data. In a recent list of causal factors for helicopter accidents prepared by the US Helicopter Safety Team, 41% of fatal accidents happened because the pilot lost control of the aircraft. The causal factors identified include bad performance management, exceeding the operating limits of the aircraft, improperly responding to an onboard emergency, and improperly performing ground duties such as performance calculations, fuel calculations, flight risk assessment tools, and preflighting of the aircraft.

Aviation is a demanding profession. As pilot in command, you have to be able to assess dynamic situations, remember your aerodynamic theory, apply aeronautical decision-making, translate it into actionable inputs, and employ your senses and motor skills to “listen” to what your aircraft is telling you. And when you get it wrong, one mistake can effectively cancel out thousands of hours of accident- and incident-free flight.

A pilot’s only protection is to treat every day, every flight, as another chance to improve. The opportunities to do just that by pursuing continuing education are endless, many of them free or low cost. And we know it works: pilots who consistently seek out continuing education have safety records that are better by a factor of 10 than pilots who don’t. 

The FAA already mandates 40 hours of continuing education annually for Part 135 pilots; Part 91 pilots need to pass the oral portion of their biennial flight review. Professional pilots see these requirements for what they are—the minimum amount of continuing education—and seek instead to become lifelong learners. Professional pilots actively seek to sharpen their skills and master their craft so they can stay out of the accident database.

So what kind of pilot are you?

Read More: Designing Urban VTOL Safety
January 16, 2020

Volume of flights demands new safety standards.

Today, the intersection of autonomy and electric propulsion has created the potential for a new class of short-range urban mobility solutions to move people in our increasingly congested city centers. We should view the challenge of creating a future with thousands of city-center VTOL (vertical takeoff and landing) rooftop operations with the appropriate mix of excitement and reverence.

Some industry forecasts predict global VTOL activity to reach 150 million flight hours per year. While significant technology and infrastructure obstacles remain, we can address them. But to achieve the vision of cityscapes humming with VTOL aircraft, the emerging electric VTOL, or eVTOL, community must take on the responsibility for safety that comes with this mission.

We should start to address aviation’s future by looking at its history. Helicopter operations in the center of New York City in the 1970s ended in part because the safety level at the time didn’t support the usage rate: while aircraft safety was adequate for a small number of operations, it was inadequate to support the demands of a busier system.

The FAA faced a similar challenge in the past few decades as the number of global airline operations climbed tenfold. The airlines’ safety level had to mature concurrently with their operation in order to stay ahead of the demand curve. The ability of the regulatory community and aviation industry to safely support this expansion in airline operations was impressive; now, the urban mobility community must be prepared to do the same.

To glimpse the magnitude of this undertaking, consider current helicopter safety standards. Sikorsky’s S-92 helicopter, for example, received the 2002 Collier Trophy from the US National Aeronautic Association for its spectrum of safety features. In the 15 years since its introduction, the S-92 has earned an impressive fatal-accident rate of nearly one per million flight hours. This is made possible by the helicopter’s certification to the toughest regulatory standards.

A few examples underscore the rigor required to prepare for high-tempo commercial aviation operations. Flaw-tolerant design requires dynamic components to be purposely compromised prior to fatigue testing to ensure safe continued operation. High-intensity radiated fields (HIRF) testing requires aircraft to be intentionally exposed to significant electromagnetic radiation to ensure system integrity. The list goes on.

Yet, if the S-92 were to be deployed in a fully mature urban eVTOL market that demanded 150 million flight hours of operation per year, its outstanding safety rate could result in approximately 150 fatal accidents per year. A fatal accident nearly every other day is clearly unacceptable!

Perhaps we could assume that, in a mature eVTOL market, people would accept one fatal accident a year. But this frequency would require an approximate target accident rate of one per 100 million flight hours—100 times better than that of the current state-of-the-art S-92.

A 100-fold improvement in safety will be possible if the eVTOL community embraces the most exacting design, manufacturing, testing, and regulatory standards. Additionally, the community must successfully deploy electric propulsion and autonomy to drive out the leading causes of today’s helicopter accidents, such as controlled flight into terrain.

The concept of pushing for lower standards to ease introduction is risky. An early provider who lowers the safety bar will damage and maybe end the market for us all. Enterprises without the appetite to achieve the required level of safety should consider other ventures.

We have an exceptional opportunity to serve the public with new eVTOL technology. Let’s assume the responsibility that comes with that challenge.

Read More: Let’s Be Honest About Safety
November 14, 2018

Helicopters are wonderful. They can rise vertically, transition forward and back, move left and right, and rotate around the vertical axis without changing their location. What enormous flexibility! This fabulous capability makes helicopters powerful tools for doing so many things.

This great agility, along with helicopters’ ability to operate away from airports and their cleared paths for approach and departure, comes with very apparent risks. That’s why discussions about safety are particularly important to the helicopter community. Sadly, much of this discussion hasn’t been as helpful or insightful as it could be—and in some cases, it can actually be counterproductive.

Much of the unhelpful talk has come from well-intentioned folks with lots of responsibility on the subject. After a very public accident, people like the secretary of transportation or the FAA administrator will often reassure the public with soothing comments like “Safety is our No. 1 priority” or “There can be no compromise with safety.”

The assertions are meant to be comforting, and they are. They assure the public of the firm resolve by people in power to do better. The problem is they aren’t—and can’t be—true. You can’t start an engine without compromising safety. If safety were our No. 1 priority, we’d never move an aircraft. It would always be safer to stay put.

Clearly, flying is, in itself, proof that moving the aircraft ranks ahead of safety. The problem is that these little intellectual dishonesties tend to end thoughtful discussion on the subject.

A while back, an FAA administrator declared that there can only be one level of safety. It is a comforting thought that, no matter what aircraft you fly in, you are equally safe. But once again, it can’t be true. A multi-engine helicopter with ultrareliable turbine engines will always be more dependable and capable, or “safer,” than a single-engine piston training helicopter.

When noted Australian thought leader and avid helicopter pilot Dick Smith (with two around-the-world helicopter flights under his belt) was chairman of the Australian Civil Aviation Safety Authority, he steered people away from disingenuous talk about safety. He shocked them instead by calling for “affordable safety.”

Smith’s point was that when safety becomes too expensive, there can be a net reduction in safety. When excessively expensive safety measures are mandated, say for transportation to offshore oil rigs, the cost of flying goes up. This could drive people to take the less expensive and less safe marine option instead, resulting in a net increase in risk to passengers.

Moreover, safety advice can even generate resistance. It can be preachy, with an off-putting air of smugness and superiority. When commenting on an accident, people commonly suggest that the pilot did not exercise proper judgment or sound aeronautical decision-making. This comes across as vague, demeaning criticism that contributes little positive guidance.

So what is the alternative?

We need to change our safety vocabulary. In nearly every case, it is more insightful and helpful to talk about how we can best manage the risks of helicopter aviation.

The concept of risk management suggests a proactive habit of identifying hazards, assessing their severity and likelihood, and mitigating those that pose real dangers. For helicopters in particular, it is time to adopt clear, straightforward, and honest discussion about managing risks.

A wonderful example is provided by HAI President and CEO Matt Zuccaro. His simple, clear recommendation for lowering the risk of a flight in deteriorating conditions? “Land the damn helicopter!”