CULTURE VS. EMPLOYEE DECISION-MAKING A
s part of this discussion, it’s important to look at how we use judgement. The reality is that pilots and mechanics have differing
levels of judgement. Our personalities and attitudes toward risk, combined with pressures from others, may cause us as pilots or mechanics to make decisions that would be considered imprudent by others [Source: Stanley Trollip, Ph.D. & Richard Jensen Ph.D., 1991]. How many times have we read a post-accident report and boasted we would never do that or wondered what the participants were thinking? In the U.S. Joint Helicopter Safety Analysis Team’s 2011 Compendium Report, their baseline analysis of 523 U.S. registered helicopter accidents in 2000, 2001, and 2006 identified several standard problem statements (SPS) that were associated with the accidents’ causes. The findings for the three years of combined data, reflects that the vast majority of accidents (84 percent) had an SPS of “Pilot Judgment and Actions” with “Safety Management” second at 43 percent. In their report, the team stated: “The conclusions of this report indicate
there was a greater need for aeronautical decision-making (ADM) training and use of risk analysis tools by pilots.”
Pilot or maintenance judgement is truly a process or series of steps that we must use to help make a decision. In their two- part judgment model, Trollip and Jensen relate the ability to having good judgment with headwork (intellectual activities – rational process) and attitude (motivation – less rational). Each are equally important with performance, but we see that attitude tends to be more easily affected through outside sources. Attitudes towards risk taking by pilots or mechanics are typically the result of personal background, training, and experience. They can evolve over time and can be easily influenced to become either positive (more cautious) or negative (more vulnerable). Some examples of negative influences referenced by Trollip and Jensen are “non-safety factors such as job demands, convenience, monetary gain, self-esteem, and commitment.”
When an organization’s culture has a profound influence over an employee, you
can see how easily a decision could be biased and pilot or mechanic perspectives skewed. As you might imagine, these hazardous attitudes can have a major impact on decision outcomes and require significant self-control to avoid these pressures. If we allow ourselves and others to cultivate this irrational conduct—and for it to become accepted through repetition— it might develop into an organization’s standard accepted behavior and have a lasting harmful effect. This type of effect is known as “normalization of deviance” and often results in what Sidney Dekker refers to as drift into failure, defined as “a slow, incremental decline into bad judgment by organizations that take past results as a guarantee for continued success.” To guard against these drift-inducing impulses, theorists of high-reliability organizations suggest we stay curious, open-minded, complexly sensitized, inviting of doubt, and ambivalent toward the past [Weick, 1993]. Always being mindful of what could be done better and resisting the temptation to give into outside influences will ultimately result in using better judgement while helping to prevent quality and safety deficiencies.
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May/June 2016
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