Threat and Error Management in Aviiation
- 2. In 1994, the University of Texas Human Research Project and Delta Airline developed the Line Operations Safety Audit (LOSA) program. With time, the LOSA program evolved into what is now known as Threat and Error Management (TEM). The TEM framework is an applied concept which emerged from the observations and surveys of actual flight operations. It considers the various issues that a flight crew may encounter as a result of internal and external factors.
- 3. This model explores the contributing factors of the threat to aviation safety and, in turn, allows for the unearthing of ways to mitigate them and maintain proper safety margins. Now recognized and adopted across continents, the TEM framework aims to educate flight personnel on managing threats and errors before they degenerate into serious incidents or accidents. It is important to note that TEM is also applicable to maintenance operations, cabin crew, and air traffic control. Three components make up the Threat and Error Management framework: threats, errors, and undesired aircraft state. Each element requires proper definition as threats and errors have subjective meanings when defined generally.
- 4. Threats are negative occurrences that are primarily out of the control of the pilot or the flight crew. Nonetheless, the flight crew must still manage these expected or unexpected adverse events to preserve the ideal safety margin. Threats may be internal or external. Internal threats are fatigue, personal issues, low experience level, boredom, and health-related problems. From the examples given, it is easy to deduce that internal threats are individual-related. They are the different factors that could hamper the effectiveness of any member of the flight crew. Ideally, individual flight personnel is expected to address them before a scheduled flight.
- 5. In contrast, external threats are broader and contextual. They could be pilot-related in adverse weather conditions and obstacles or cabin crew-related in the case of fire and disruptive passengers. External threats could also relate to air traffic control and maintenance-related issues. Although errors are widely known to be unintentional, they are said to be within the control of the flight crew. Erring is a normal phenomenon with humans. That may not justify it, but it should be expected in a dynamic and highly technical work environment like the aviation sector. Errors are actions and inactions of flight personnel that result in the digression from operational standards, expectations, and the reduction of the safety margin.
- 6. One classification of errors splits it into four categories: Slip, lapses, mistakes, and violations. Slips are entirely unintentional as one mistakenly does something different from what was initially intended. In the case of lapses, they could be in the form of memory failures or momentary inattention. Mistakes refer to instances of poor judgment, doing something one intends to do, which turns out to be inappropriate for the situation at hand. Mistakes could be due to inexperience or limited knowledge.
- 7. However, when flight personnel deliberately deviates from the set rules and instructions or procedures provided, it is a violation. Examples of errors include; aircraft mishandling, scheduling errors, incorrect calculations, and speed deviations. Undesired aircraft state is the last stage when all efforts to mitigate the adverse effects of threats and errors prove futile, or the threats and errors go undetected or misdiagnosed. At this point, the resolution of the undesired aircraft state may either result in recovery or an accident.