SMS Pro Aviation Safety Software Blog 4 Airlines & Airports

Why Transparency Promotes Safety Culture in Aviation SMS Programs

Posted by Tyler Britton on Nov 4, 2015 10:00:00 AM

Transparency, a Hot Topic:

Transparency in aviation safety for promoting safety culture

It's no secret that in recent years issues surrounding transparency have become extremely important at all levels of industry and government. So important in fact, that some of our most sensational news stories in recent years - namely Edward Snowden, Wikileaks, the Sony Hack, Bradley Manning - are issues of transparency.

For individuals who defend transparency, we even have a name that has acquired the show-stopping power of words like "terrorist" and "hero": whistleblower.

While many may agree that industries like business, government, and military would garner more support if they chose more transparent practices, it is a particularly sensitive subject in the aviation industry for several reasons:

Transparency Debate in Aviation Safety Cultures

  • Greater transparency about safety issues would seem to create
    • more focus on safety
    • greater awareness of safety issues
    • more proactivity, i.e. a healthier safety culture
  • But there is a strong argument that aviation safety transparency could expose exploitable safety "holes"
  • For workers in the industry, reporting a safety hazard could very well mean "blowing the whistle" on your co-workers, immediate supervisor, and friends

Basically, this is one of those subjects wherein there are are no easy answers, and when there are answers, they are not necessarily what one wants to hear.

But before we look specifically at transparency, let's refresh ourselves on the fundamental model underlying aviation safety management.

The Reason Model: The Swiss Cheese Defense

As many of you are probably already well aware, in 1990 professor James T. Reason published Human Error, which analyzed primary factors in workplace accidents, and provided a framework for understanding how those accidents occurred. Another way of understanding this model is as the relationship between hazards and accidents.

This framework is now widely regarded as the "Swiss Cheese Model." This model is the foundation of understanding the defense layers of aviation safety, among other industries such as cybersecurity.

Swiss cheese model of accident causation commented

The model basically works like this:

  1. Top level decision makers create certain safety policies
  2. Each of those policies has certain procedures
  3. These practices are implemented in the workplace and are supervised
  4. All workplaces have hazardous preconditions, such as environment or psychological factors
  5. There will always be unsafe acts in the workplace
  6. If all 5 of the previous steps line up in the right way, accidents, i.e. losses, will occur

An important part of this model is that it is a top-down model. When applying this model to the work environment, it allows safety managers to focus on several things:

  • It stresses that unsafe acts will happen but many more preconditions need to be met for an accident to occur
  • Therefore, we can focus on the accident's preconditions for happening, rather than just the unsafe act
  • Empowers the idea of a system as a means of risk management, hence safety management systems
  • A proactive philosophy: if enough defenses are in place and carried out correctly, accident "X" should not occur

I especially highlight the importance of the last bullet point, as properly administering a safety management system with limited resources is the ultimate goal and challenge of safety managers, and it is vitally linked to the safety transparency in a workplace.

What Safety Transparency Looks Like in the Workplace

What safety transparency boils down to is this: how much access to safety-related information do workers have in a workplace. It's a simple concept:

  • If safety information about incident X, Y, and Z is hidden from the workplace's population, then that is lack of safety transparency
  • If safety information about incident X, Y, and Z is easily available to the workplace's general population, then that is safety transparency

But like most simple concepts, the intricacies of real-world application greatly complicate matters. What about more sensitive safety issues like:

  • Management circumventing policies, practices, etc.
  • Reporting on an individual, when the reporter's identity would be known
  • Audits

Naturally, absolute transparency isn't always practical - especially because sensitive issues can often require investigation. Whether or not to release sensitive issues is as much a philosophical question as it is a practical one.

None-the-less, though we may cringe at making certain hazard reports public, a transparent work environment will support an extremely high level of employee engagement.

But how transparent should a work environment be?

Nearly 100% - everything but information that is essentially impossible to release.

If a reported issue is affecting any person, in principle it should be available to the general workforce because such a level of transparency promotes safety culture.

Let's look at the main reasons why.

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Transparency Promotes a Culture of Safety as a Line of Defense

Two arguments against transparency, namely exposing exploitable safety holes; and public reporting on coworkers/friends, are generally short-term considerations of a policy of transparency.

Aviation Safety Line of Defense

With safety issues that carry a medium to high level of risk, countermeasures are obviously taken immediately to implement the safety program. Transparency only helps in this regard, as by making it public in the workplace, workers can:

  1. Be aware of the safety risk
  2. Help address the safety risk
  3. Proactively avoid accidents related to the risk

If quick action is taken to address the safety risk and the workforce is aware of the issue, then it is actually much less exploitable than if the hazard were kept confidential, namely because no one would be "looking out" for the issue.

On the problem of reporting on friends/coworkers/etc., without fear of retaliation when the information is made public to the workforce and with the chance of giving the reporter a sort of "whistleblower" status, this issue is tougher and can be a tough hurdle to overcome. The fact is that many work environments struggle with this, and suffer from lack of reporting because of it.

What is hard as a safety culture is switching the mindset from "reporting on individuals" to "looking out for the safety of the workplace," which is the same end goal as making a particular issue about a gap in the SMS and not about the individual.

Attaining transparency in aviation SMS programs is a fundamental precept of making an airline or airport a "safe place to work" - of helping keep a workplace proactive rather than the place where one "tattle-tales."

When management demonstrates that rigid transparency is enforced even at upper levels, it promotes in the general working population:

  1. Openness
  2. Honesty
  3. Integrity

"No secrets" is the foundation of trust in any relationship. It creates better lines of communication and removes barriers between management and the general workforce.

To boil it down to a single sentence -

"Transparency at all levels of the workplace promotes a just reporting culture"

A just reporting culture is a healthy safety culture, and is a foremost line of resistance in preventing accidents, or "losses."

Like I said, implementing a rule of transparency is not easy, especially when it comes to embarrassing or sensitive issues - with such issues the instinct is strict confidentiality. But I would like you to look very hard at such issues and decide if confidentiality is absolutely necessary.

In most cases upholding transparency will be healthier for the safety culture of your workplace, and the success of your SMS program. Transparency starts at the top.


Let's take an overview of how transparency, safety culture, and the Swiss Cheese Model work together:

  1. Transparency promotes an enhanced safety culture
  2. Better safety culture focuses on the system of safety and not the individual
  3. The system of safety cultivates proactive awareness and reporting
  4. Proactivity strengthens safety defenses and provides more reliable aviation safety data
  5. Strong defenses mean less "holes in our cheese"
  6. Fewer holes in our cheese make transparency easier to enforce

It's a revolving door. But the main point is that Transparency leads to better relationships and therefore lines of defense. So when new issues arise that have not been implemented into the SMS, or when workers practice unsafe acts, there will be many other people standing between the hazard and the accident.

Furthermore, I think we can all agree that working in an environment where you trust and feel trusted is a pretty good spot to be.

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Topics: Safety Culture

Site content provided by Northwest Data Solutions is meant for informational purposes only. Opinions presented here are not provided by any civil aviation authority or standards body.



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