During the last 20 years the Aviation Maintenance Industry has seen major developments in the understanding of the organization role as a precursor to incidents and accidents. As well as considerations regarding the role of the organization to accept responsibility to develop appropriate mitigation’s to deal with the challenges faced in dealing with Maintenance Errors.
The introduction of Mandatory Initial and Recurrent Human Factors training has also focused attention on factors which contribute to Maintenance Error.
During the early1990’s Boeing developed a tool “Maintenance Error Decision Aid (MEDA) for investigations the causes of errors made by maintenance technicians and inspectors. It is an organization’s means to learn from its mistakes. Errors are a result of contributing factors in the workplace, most of which are under management control. Therefore, improvements can be made to the workplace to eliminate or minimize these factors so they do not lead to future events.
In 1995, Boeing decided to offer MEDA to all of its airline customers as part of its continued commitment to safety. Since that time, the MEDA process has become a worldwide standard for maintenance error investigation.
In January 2003, JAR 145 amendment 5 (subsequently incorporated into EASA Part-145) introduced paragraph 145.A.60 – Occurrence Reporting, to require organisations to “establish an internal occurrence reporting system…to enable the collection and evaluation of such reports, which have resulted, or may result, in an unsafe condition. This procedure shall identify adverse trends, corrective actions taken or to be taken by the organisation to address deficiencies and include evaluation of all known relevant information relating to such occurrences and a method to circulate the information as necessary.” This development saw the introduction of the Maintenance Error Management System (MEMS) and the initial developments of a Reactive Safety Management Process.
ICAO Doc 9859 was first issued in 2006 to support the implementation of an Industry wide Safety Management System (which was mandated to be introduced from Jan 2009). This document heralded a significant change in that the development of the Safety Management System moving to a Reactive plus Proactive phase, means rather than waiting for an event to take place which would then be investigated, the organization would actively seek risk & exposure and develop appropriate mitigation’s to address the perceived issues.
NOTICE OF PROPOSED AMENDMENT (NPA) 2013-01 provides for an alignment of the SMS provisions mandated for Part OPS to be implemented within the Part 145 environment. This includes the need for both an external and internal reporting system. To be fully compliant the internal system is required to identify potential hazards as well as addressing any workplace issues and exposures.
As we consider Developments in Maintenance Error Management Systems (MEMS) and the implementation within our organization, to also ensure that our system is able to embrace fully the risk exposures within the organization as well as any reactive events which must be analysed.
Sofema Aviation Services provides MEDA training as well as training for the implementation of SMS and MEMS.
Please see www.sassofia.com or email office@sassofia.com
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Aviation Maintenance Industry, Maintenance Error Decision Aid (MEDA), Maintenance Errors, MEMS, Reactive Safety Management Process, Safety Management System, Sofema Aviation Services
