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Fatigue Risk Management Systems Regional Meeting
GOL FRMS Implementation
May 27 ‐May 28, 2015Lima, Peru
Summary
• “a step back”– Numbers & Demand– What were we doing?
• Current Status– Back to the Basics– Lessons Learned
• Survey• Next Steps
– Electronic Flight Bag TOD Survey– AQD Mobile Fatigue Report Form
“a step back”
Numbers & Demand
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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dez
Fatigue Analysis 2014
Total: 1.576 ASR
70%
3%
13%
14%
Fatigue Analysis Result 2014
Objective Fatigue
Subjective Fatigue
Nothing Identified
Not Analyzed
Numbers & Demand
Total: 1.576 ASR
What were we doing?
• Safety reporting culture;• FRMS Implementation;• Policy and Documentation;• Classroom and E‐learning.
What were we doing?Safety Reporting Culture
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OthersFRMS
PHASE II:Implement Reactive
PHASE III:Implement Proactive and Predictive FRMS
PHASE IV:Implement FRMS Safety
Assurance Process
PHASE I: Planning
DEVELOP and IMPLEMENT FRMS DOCUMENTATION Chapter Three
DEVELOP and IMPLEMENT FRMS COMMUNICATIONS Chapter Six
DEVELOP and DELIVER FRMS TRAINING Chapter Six
TIMELINE
• Gap Analysis• Policy and Documentation
• CHAPTER THREE
• Identification of fatigue Hazards
• Risk Assessment• Risk Mitigation strategies
• CHAPTER FOUR
• Identification of fatigue Hazards
• Risk Assessment• Risk Mitigation strategies
• CHAPTER FOUR
• Monitoring of FRMS performance
• Managing Organizational & Operational changes
• Continuous improvement
• CHAPTER FIVE
What were we doing?FRMS Implementation
PHASE II:Implement Reactive
PHASE III:Implement Proactive and Predictive FRMS
PHASE IV:Implement FRMS Safety
Assurance Process
PHASE I: Planning
DEVELOP and IMPLEMENT FRMS DOCUMENTATION Chapter Three
DEVELOP and IMPLEMENT FRMS COMMUNICATIONS Chapter Six
DEVELOP and DELIVER FRMS TRAINING Chapter Six
• Gap Analysis• Policy and Documentation
• CHAPTER THREE
• Identification of fatigue Hazards
• Risk Assessment• Risk Mitigation strategies
• CHAPTER FOUR
• Identification of fatigue Hazards
• Risk Assessment• Risk Mitigation strategies
• CHAPTER FOUR
•Monitoring of FRMS performance
• Managing Organizational & Operational changes
• Continuous improvement
• CHAPTER FIVE
What were we doing?TIMELINE
FRMS Implementation
What were we doing?Policy and Documentation
• Identifies FRMS elements• Identifies FRMS operations• Reflects Shared Responsibility• States Safety objectives• Declares management commitment
• Identifies lines of accountability
Policy
• Policy and objectives• Processes and procedures• Accountabilities, responsibilities and authorities
• Mechanism for involvement of all stakeholders
• FRMS training records• Planned and actual times worked• Outputs
Documentation
What were we doing?Classroom and e‐Learning
• Subject dealt in class to all crewmembers andcrew planners.
• Use our existing training structure:
CRM – Corporate Research
Management
TEM – Threath and Error
Management
Periodical Training e‐Learning
What were we doing?Classroom and e‐Learning
Current Status
Back to the Basic
• FRMS & SMS;– DOC 9966– FRMS Implementation Guide
• Fatigue Safety Action Group (FSAG);• Bio‐mathematical Models.
Back to the Basic
• FRMS & SMS;– DOC 9966– FRMS Implementation Guide
FRMS & SMS
Back to the BasicFRMS & SMS
SMS Framework
1. Safety policy and objectives2. Safety risk management3. Safety assurance4. Safety promotion
FRMS
1. Safety policy and objectives2. FRM processes3. FRMS safety assurance processes4. FRMS promotion processes
Back to the BasicFSAG
• Lack of FSAG on 2014;• Re‐started with the new year;• All envolved areas invited:
– Safety Management;– Schedule Management;– Flight Operations;– Flight Standarts;– Medical Department.
Back to the Basic
• Review the use of the Fatigue Avoidance Scheduling Tool (FAST);
• Request feedback from changes proposed;• Identify which situations are not covered.
Bio‐mathematical Models
Lessons Learned
• As Low as Reasonable Possible (ALARP);• Bio‐mathematical Models are not the FRMS;• Develop Safety Performance Indicators (SPIs);• Data collection is necessary.
Lessons Learned
• How much is it costing?• Don’t forget the M in FRMS;• Make things more personal.
ALARP
Lessons Learned
• Look to all the roster;– Search for improvement possibilities.
• There will be critical operations;• It’s not a GO/No GO tool;• It’s not a shadow over the common sense.
Bio‐mathematical Models are not the FRMS
Lessons LearnedBio‐mathematical Models are not the FRMS
Lessons Learned
• Look to all the roster;• We need to find our threshold;• Total hours below the threshold;• Pairing/Roster Comparisons ;
Develop SPIs
Lessons Learned
• Review our database;• Too much useless info;• Too much unused info;• Too much missed info;
• Expand our coverage area;• Maintain the current reactive process;• Field survey.
Data collection is necessary.
Survey
Survey
• Methodology Test;• Demografic Data;
– Morningness‐eveningness questionnaire– Epworth sleepiness scale
• Subjective Fatigue Forms;– Samn‐Perelli– Sleep LOG
• Objective Analysis;– FAST & CFAS Comparison
Survey
Next Steps
Electronic Flight Bag TOD Survey
• Available in all flights;• Pairing evaluation;• Quick‐Response;
– Pairing– Crew‐members
• Development in Company.
AQD Mobile Fatigue Report Form
• Works in any smartphone/tablet;• Off‐line (transfers info when conected);• Get the information where it happens;• Assure the quality of gathered data.
