5 NOSS Success FactorsNOSS success is dependent upon methodology and executionFormal CheckRegulatorNobodyAngelPerformanceNOSS ObserverNaturalPerformance- Controller Trust +-+NOSS value-+Low controller trust = Low quality data because there will be no differentiation between NOSS and proficiency checks
6 NOSS: Gaining Controller Trust Over-the-shoulder observations during normal shiftsJoint management / association sponsorshipVoluntary ParticipationTrusted and trained observersAnonymous, confidential, and non-punitive data collectionTrusted and secure data collection siteSystematic data collection instrumentData verification processData-derived targets for safety enhancementFeedback results to controllers
7 NOSS Operating Characteristics Over-the-shoulder observations during normal shiftsNo observations of controllers who are undergoing trainingNo observations while checks are being conductedJoint management / association sponsorshipLetter signed by management & association representatives sent to all controllersVoluntary controller participationControllers have a right to decline a NOSS observationDenial rates in NOSS trials were low – 1 per 50 observations
8 NOSS Operating Characteristics Trusted and trained observersTrust and CredibilitySelection process – management / association approval of candidatesMost observers should be line controllers – but diversity of interested parties is good.TrainingClassroom training, test observations, recalibration sessionCurriculumTEM principles and exercisesNOSS observation protocolsNarrative guidelines
9 NOSS Operating Characteristics Anonymous, confidential, and non-punitive data collectionNo names, employee numbers, dates, experience, or other identifying informationData used for safety purposes only – no punitive actionsObservers identity is known only by the third party facilitatorTrusted and secure data collection siteThird party or controller association gatekeeperControllers and observers must be comfortable with the data collection siteSystematic data collection instrumentNo judgments – observers record data based on TEM events
10 NOSS Operating Characteristics Data verification processTEM data checked to ensure coding accuracy and consistency with SOPData analysis does not begin until verification has been completedData-derived targets for safety enhancementServe as benchmarks for safety changeInitial NOSS, safety change process, follow-up NOSSFeedback results to controllersResults summarized for controllersInformation on how organization intends to respond to the data
11 NOSS DefinedThe 10 characteristics that differentiate NOSS (LOSA) from other methodologies have been endorsed byICAOIATAIFATCA (6)IFALPAUS ALPAUTNOSS must have all ten characteristics
12 Methodological Considerations At which level were the NOSS trial observations focused?GroupsIndividual ControllersPositionsInterviewsThreats, errors, and undesired states must be observable
23 NOSS Report and Raw Data Most frequent and mismanaged threatsMost frequent and mismanaged errorsStrengths and weaknesses of Threat and Error CountermeasuresFacility to facility or sector to sector differencesComparison to similar airspace of other air traffic service providersNOSS ReportNOSS Raw DataText from all narrativesListing and coding of every threat, error, and undesired state observed
25 Raw Data: Narratives - Handovers NOSS Observation #17 Handover/Takeover #1 Time Stamp 14: XYZ Radar Sector Positions Staffed: Radar Controller Position Relieved: Radar ControllerThe oncoming controller was at the start of their shift, when they arrived they walked straight up to the console and started a conversation with the XYZ Controller about non operational matters, this distracted the controller whilst aircraft were calling resulting in a number of missed calls from aircraft being made to the XYZ Controller. The briefing commenced with the oncoming controller not reading any of the requisite briefing material. The controller giving the HO/TO did it from memory, the checklist provided was not referred to and not all the pertinent information was covered. The controller giving the HO/TO did not mention the RWY configuration in XXX or the fact that they were on ILS approaches. At the end of the HO/TO, the relieving controller plugged in and did not voice log on.
26 NOSS Raw Data - Narratives ABC47 crossed into the XYZ sector but did not contact the controller. At time 19:42, BB TMA called the XYZ sector controller requesting a non-standard level of FL350 for a flight, which was approved and properly noted. During this conversation, ABC47 called but was not heard due to the ongoing conversation with BB TMA. At this point the A/C was already 40 nm into the sector (this was a very late call). A minute later, ABC47 called again and this time the controller heard the call. At this point it was discovered that ABC47 was east of track by 3nm without prior authorization leading to a potential conflict with EDF54 who was in the vicinity climbing to FL160. ABC47 given a right turn to manage the situation and both A/C were given traffic information. Additionally, CVR310 was descending through the level of ABC47 while it was not on the appropriate frequency (inside the XYZ sector).
27 Raw Data: ThreatsNOSS Observation #: 27 Threat # 3 XYZ Radar Sector Time Stamp: 17:42Threat DescriptionAAA4103,04,4003, and BBB405 were operating in the XYZ airspace at the same time with similar callsigns.Threat Management DescriptionThe XYZ controller made a general broadcast to the aircraft advising of the potential for confusion and was particularly careful to ensure the correct read-back and callsign with instructions. All calls where made to the appropriate a/c and the correct a/c responded to the calls each time.Threat Type AirborneThreat Code Similar Call SignsThreat Outcome: Inconsequential
28 NOSS Summary Primary features Purely diagnostic – no solutions – “operations health check”Captures system safety and controller performance issues prior to the occurrence of incidentsIdentifies system safety and controller performance strengths and weaknesses in normal operations using observationsAnalysisAggregated TEM data provides a safety snapshot of operations on a typical dayOrganizational changeMeasure the effectiveness safety solutions with a follow-up NOSS
29 NOSS – Future UT Activities NOSS & LOSA: What can each add to the other?NAV CANADA radar trialAirservices Australia tower trialMulti-stage reliability studies in conjunction with the FAA & NOSS trial partnersEuropean trials?