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A Glimpse at Archie: The LOSA Archive

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1 A Glimpse at Archie: The LOSA Archive
Ashleigh Merritt, Ph.D. The University of Texas Human Factors Research Project (UT) First ICAO Global Symposium on TEM & NOSS in ATC 9-10 November, 2005, Luxembourg

2 What is Archie? “Archie” is the LOSA Archive
A database of de-identified airline data which is maintained and updated by UT Airlines that do a LOSA with The LOSA Collaborative contribute their data to Archie for research purposes Archie provides the airline perspective

3 How old is Archie? Five LOSAs in five years to develop the methodology
Data in the Archive starts in 2000 Had to wait for Archie to grow before doing any benchmarking or industry-wide analyses. If we think of Archie as a dog, he would be a young bloodhound

4 How big is Archie? As of September 2005, Archie has data from
23 airline LOSAs 4800 flights 4800 flight narratives written by trained observers 4800 ratings of TEM countermeasure performance 17,500+ threats 12,500+ errors 2,400+ undesired aircraft states

5 Why is Archie here? To show what is possible when you build an archive of observational data based on TEM To show what is possible when two TEM archives talk to each other

6 Archie’s Attributes Archie is loyal and faithful
Archie is a persistent and diverse tracker Archie plays well with others

7 After five years, Archie remains loyal to its aviation master
The Archive is housed at UT All data are de-identified as to airline and individual No airline has been publicly identified No individual pilots can be or ever have been identified from the Archive

8 Archie is a good tracker
ATC threats Intentional Noncompliance Outstanding performance

9 Tracking ATC threat chains
Data are based on 10 LOSAs – 2426 Flights – 9450 threats 2350 ATC threats = ¼ of all threats = about 1 per flight 236 mismanaged ATC threats = 30% of all mismanaged threats 10% of all ATC threats were mismanaged

10 Mismanaged ATC threats
2426 Flights – 9450 threats Challenging clearances (53%) 236 mismanaged ATC threats Runway Changes (14%) Language difficulty (8%) Similar call signs (5%) ATC error (7%)

11 ATC threats -> Crew Errors
Communication errors (27%) - misinterpret ATC instructions 2426 Flights – 9450 threats 280 errors 236 mismanaged ATC threats Aircraft handling (24%) – unintentional speed, lateral, vertical deviations Ground navigation errors (6%) Cross-verification errors (7%) Automation errors (20%) – wrong MCP/FCU altitude setting dialed

12 ATC threats -> Crew Errors -> UAS
76 Communication errors 2426 Flights – 9450 threats 2 UAS 280 errors 236 mismanaged ATC threats 67 Aircraft handling errors 58 UAS 16 Ground navigation errors 19 Cross-verification errors 56 Automation errors 9 UAS 21 UAS 5 UAS

13 236 mismanaged ATC threats ¾ occurred during descent/approach/land
ATC threats -> UAS 2426 Flights – 9450 threats Lateral deviation % Speed too high % Vertical deviation % Unstable Approach % Continued Landing % Incorrect Automation configuration % Taxiway/runway incursion % Speed too low % Incorrect Aircraft configuration % Other % 280 errors 236 mismanaged ATC threats 106 UAS Bottom line: 4% of flights had a UAS arising from an ATC threat that was mismanaged. ¾ occurred during descent/approach/land

14 Archie & Intentional Noncompliance
Across 22 LOSAs, the average is 40% of flights with one or more noncompliance errors Range: 23% - 90% Most common noncompliance errors: checklist performed from memory / nonstandard checklist use failure to cross-verify MCP/FCU altitude alerter changes PF makes own MCP/FCU changes Seems pretty trivial stuff, eh?

15 Noncompliance correlates with..
Based on 22 LOSAs, airlines with higher rates of intentional noncompliance also have more flights with: Mismanaged threats (r = .7) Mismanaged handling errors (r = .9) Undesired aircraft states (r = .9) Mismanaged UASs (r =.8) Noncompliance – a measure of safety culture? Archie was shocked…

16 Archie is a diverse tracker
The richness and complexity of the data allow literally thousands of paths to be pursued When did it happen, was it Captain or First Officer flying, how was it managed, what else was going on, what happened next, has it happened before, does it happen often, does it happen more on certain aircraft, does it happen at particular airports, etc. etc. etc. Archie can dig and dig…

17 Test Your Understanding
Q. What would you get if you asked Archie to find all the flights that have four or more threats, zero mismanaged threats, zero crew errors, zero UAS, and the observer rated the crew “outstanding” for overall effectiveness? A. Archie would find the flights that had above average operational complexity (4 or more threats), and that the crews managed very, very well. In the current Archive of 4800 flights, there are 102 of these defined flights. We can read the flight narratives to explore best practices… GOOD BOY, ARCHIE!

18 Archie plays well with others
Queries from / data-sharing with: ATC (NOSS group) IATA/ICAO (ITA) Boeing Airlines Incident Reporting systems Transport Safety Boards

19 Archie plays well with others
LOSA/TEM/NOSS data can complement other safety management data Flight Data Recorder is the aircraft perspective Incident reporting is the actor’s perspective LOSA/NOSS is a neutral third party perspective We’ve never really had that before. One Big Advantage: Pilot-ATC see the others’ world!

20 Conclusions You have to be patient while the methodology matures and the Archive grows, but once in place: You can benchmark within and across facilities to determine a facility’s safety strengths and vulnerabilities You can benchmark across the industry to determine systemic strengths, vulnerabilities, and best practices within the industry A TEM-based Archive would allow ATC to “converse” freely with the LOSA Archive on matters of mutual interest to pilots and controllers

21 The University of Texas
Human Factors Research Project


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