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SMS and QMS For Airplane Maintenance

SMS and QMS For Airplane Maintenance. JULY 28, 2010 Gerardo Hueto. Outline. Concept of Safety SMS QMS Integration or Coordination Example. Concept of safety (Doc 9859).

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SMS and QMS For Airplane Maintenance

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  1. SMS and QMS For Airplane Maintenance JULY 28, 2010 Gerardo Hueto

  2. Outline USC Concept of Safety SMS QMS Integration or Coordination Example

  3. Concept of safety (Doc 9859) USC Safety is the state in which the risk of harm to persons or property damage is reduced to, and maintained at or below, an acceptable level through a continuing process of hazard identification and risk management.

  4. Safety Management System Definition A Safety Management System (SMS) is a set of integrated tools, policies, processes, and procedures used by corporate management to fulfill their responsibility to manage the safety risks associated with their organization’s operations as a part of its overall business. USC

  5. ICAO Annex 6 Requirements • “…a safety management system acceptable to the State of the Operator that, as a minimum: • identifies safety hazards; • ensures that remedial action necessary to maintain an acceptable level of safety is implemented; and • provides for continuous monitoring and regular assessment of the safety level achieved.” • “An accepted safety management system shall clearly define lines of safety accountability throughout the operator’s organization, including a direct accountability for safety on the part of senior management.” USC

  6. The components of SMS (ICAO) USC • Safety policy and objectives • Safety risk management • Safety assurance • Safety promotion

  7. What to include in an SMS? • Flight Operations and Maintenance (ICAO) • Other safety activities that could be included in SMS • Personnel safety • Environmental safety • It may also include • Dispatch, In-flight, Ramp, Fueling USC

  8. Maintenance SMS • Acceptable level of Safety? • Hard to define, but can use metrics • Maintenance metric examples • In-flight shut downs • Rejected take-offs (mechanical) • Write-ups after heavy checks • Number of MEL items (or fleet rate) • Flight delays due to maintenance? USC

  9. Maintenance Safety Metrics USC • Should be numerical: • Number of events/calendar time or departures • Should have performance targets: • % reduction of events in a certain period

  10. Hazard identification • ICAO hazard identification is Flight Operations oriented • Does not really focus on Maintenance hazards • But hazards in maintenance can pose risk to safety of flight USC

  11. Maintenance - related accidents • An airplane failure caused by Maintenance may be: Primary Cause of an accident. Contributing Factorto an accident. USC

  12. Example: primary cause Aloha Airlines - 1988 USC

  13. Example: primary cause • Investigation findings: • Hundreds of cracks undetected prior to accident • Contributing factors: • Lack of resources • Fatigue • Lack of training USC

  14. Example: primary cause • Alaska Airlines Flight 261 • January 31, 2000 USC

  15. Alaska Airlines Flight 261 Ascent from Puerto Vallarta Up to 50 pounds Pulling Force Autopilot Disconnect Stabilizer Movement Stops Approximately 30 pounds Pulling Force

  16. Click on CVR Above Maximum Airspeed Stabilizer moves beyond full nose down Extremely Loud Noise First Dive “…kinda stabilized” Cleared to descend to 17,000 feet Slats, Flaps Extended Slats, Flaps Retracted Sound of faint thumps Alaska Airlines Flight 261 Final 12 Minutes

  17. Recovered Jackscrew Assembly • Screw attached to horizontal stabilizer • Separated from acme nut • Nut thread remnants on screw

  18. Summary of Findings • Material and structural conditions did not contribute to the acme nut wear • No grease in working area of the screw • Grease not removed by ocean impact, exposure, or recovery • Jackscrew grease not contaminated • The wear is caused by sliding contact and is consistent with an unlubricated condition • Torque tube fractured by low cycle fatigue

  19. Lubrication:The Procedure • Gain access to the tail • Remove access panels

  20. FAIRING ACCESS PANELS GREASE GUN Lubrication:The Procedure • Apply grease to acme nut fitting with grease gun until grease exits out top of acme nut

  21. Lubrication:The Procedure • Brush application of “light coat of grease” onto jackscrew threads • Operate jackscrew “through full range of travel” BRUSH

  22. Jackscrew Lubrication:Alaska Airlines Interval Extension Alaska Airlines Interval Manufacturer's Recommended Interval

  23. End Play Check:Alaska Airlines Interval Extension Manufacturer's Recommended Interval

  24. Example: primary cause • Loss of pitch control due to the in-flight failure of the horizontal stabilizer trim system jackscrew assembly’s acme nut threads caused by excessive wear due to insufficient lubrication. • Contributing factors • Airline extended lubrication interval and FAA approval of that interval. • Airline extended end-play check interval and FAA’s approval of the interval. • Acme nut zerk fitting was clogged with hardened grease residue. USC

  25. SMS and QMS • Quality is the degree to which a system consistently meets specified requirements, satisfies stated needs, or produces desired outcomes USC

  26. SMS and QMS USC • ICAO • Document 9859, Section 7.6 • SMS focuses on the safety, human and organizational aspects of an organization (i.e. safety satisfaction); while QMS focuses on the products and services of an organization (i.e. customer satisfaction) • ..”ICAO safety management SARPs included in Annexes 1, 6, 8, 11 and 14…are limited to SMS. There are no ICAO requirements…with regard to QMS, with the sole exception of a requirement for approved maintenance organizations (AMO) in Annex 6, Part I, Chapter 8”

  27. SMS and QMS Quality Control Rejection Review Quality Assurance Findings Review Quality Review Process Quality Review Board Reliability Review Board USC

  28. SMS and QMS Acceptable level of Quality? Metrics Nature of rejections/findings Operational Both should be numerical and have performance targets AloQ alignment with AloS? Coordinated Metrics, Risk Matrix Shared Objectives USC

  29. SMS and QMS Options Integrate or Coordinate Pros / Cons In a Large Carrier QMS reviewed by CASS (Continued Analysis and Surveillance System) SMS can be integrated or coordinated with CASS USC

  30. RISK MATRIX PROBABILITY SEVERITY A B C D E I SEVERE CATASTROPHIC SEVERE 2 3 HIGH II CRITICAL 4 MEDIUM LOW III MARGINAL 2 3 4 5 LOW NEGLIGIBLE IV NEGLIGIBLE 3 4 5 5 30

  31. 31 USC

  32. Source Jul 20XX Rolling 20XX Findings / Audits 7 / 5 241 / 96 ASAP 3 11 Self Disclosure 2 4 MSR 1 Risk Level Jul 20XX Rolling 20XX Qty Distribution Risk Average 2 2 X 1.2.3 Maintenance Log / Recording Requirements Low Low 2 1 X 1.2.1 Airworthiness Release or Log Book Entry Medium High 3 3 X 1.2.2 Major Repairs and Alterations Records High Corrective Actions Jul 20XX Rolling 20XX In-Progress 3 Closed 16 417 Example: SMS and QMS Coordination * Rate per 1000 Revenue Departures USC

  33. SMS and QMS: Education and Training Prior to Implementation During Deployment Phase Ongoing after SMS is in Place Dealing with Interfaces Vendors Other Operational Areas Providing Feedback To Individuals To Other Departments USC

  34. SMS and QMS Questions? USC

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