PPRuNe Forums - View Single Post - Aviation safety jeopardised by judges?
View Single Post
Old 2nd Mar 2009, 15:13
  #36 (permalink)  
lomapaseo
 
Join Date: Mar 2002
Location: Florida
Posts: 4,569
Likes: 0
Received 1 Like on 1 Post
For example, are they encouraged, from the start of the investigation, to consider the organisational influences upon the accident, as well as the local direct-efffect causes?

An example of Organisational factors would be company ethos or commercial cost impacting on crewing levels, rostering policy, lack of fatigue monitoring, poor training system etc. Whereas, the local factors could be crew mishandling, incorrect procedures, lapses, errors, violations etc?
Unlike Pprune, the investigators search for facts at the scene against a specific accident before considering so called organizational factors that might have been.

After having gathered the facts and established the direct causal factors in the chain, then you necessarily move on to developing preventive actions against a future accident. If it can effectively be done by altering organizational factors (as above) then these will be identified.

Remember, the purpose of the investigation is not to establish blame but to prevent future accidents.
lomapaseo is offline