Maintenance Error Management System

[rest have risen above me]

Looking at the conversation reference AT at Brize and ETOPS etc..
Human factors and MEMS is the latest management buzz word/ tool that is being touted to save the world around the frozen North. Apparently it's the bee knees in civvystrasse. From all you rats that deserted the sinking ship to sell your souls to the dastardly filthy rich civvy firms PDT_Xtremez_15: )... Is it?

 

[MrMasher]

It's in action here. Wouldn't fancy being the mems coordinator. Inundated springs to mind.

 

[theladf]

Mems is widely publicised where I work but not often used. Reasons being lack of confidence in confidentiality, suspicions of some on the shop floor towards management. A perception from some that it just causes more work, by identifying a problem you may have to put some effort in to resolving it. It also has the potential to turn into a p!ssing match as recently happened here when a MEMS raised was taken to heart by someone who assumed it was a personal slight and then initiated a MEMS war!!!!!

 

[Rigga]

I'm trying to get it off the ground where I now work - and I've run it several other locations - it does work and is directed at the workplace unlike QA reports which are mainly directed at correcting procedures.

It relies on the workers reporting problems from the shop floor, and a decent response within a short time. It also requires a 'JUST' culture where culpability, not blame, is paramount.

For those that lack confidence in confidentiality - take the plunge and try it. You should be able to post your report to MEMS anonymously if you dont want to put your name to it.

The MEMS coordinator has been trained not to let any personal info out of his system - and ONLY he should see who the reporter is. HE needs your name so that he can find out any extra details from you and feedback any findings directly to you - and for no other reason.

A hint to its easier implementation: Replace one or two other reporting systems with MEMS - dont just ADD it to the Notice board with all the other things!

 

[I Look Like Kevin Costner]

Looking at the conversation reference AT at Brize and ETOPS etc..
Human factors and MEMS is the latest management buzz word/ tool that is being touted to save the world around the frozen North. Apparently it's the bee knees in civvystrasse. From all you rats that deserted the sinking ship to sell your souls to the dastardly filthy rich civvy firms PDT_Xtremez_15: )... Is it?

Human Factors and Maintenance Error Management Systems are very much a cornerstone of civil aviation thinking from EASA through the national regulatory authorities and down into commerical companies. In companies operating to PART M regulations, especially PART 145 approved organisations, Human Factors training, including MEMS are mandatory for permies and they will not employ Connies that do not have vaild human factors certificates. The CAA issue several publications on Human Factors in Aviation Maintenance, the main one being CAP715, and in regards to training (for 145 organisations, but used by BAe as well) being CAP 716.

If you read CAP 715, it becomes apparent why human factors is taken so seriously by the CAA. Those with decent memories will also remember the classic military human factors incident involving the loss of a pilot and his Hawk aircraft at Valley in 1996. This and other incidents with RAF aircraft is the reason why senior RAF management across the Air Force view the introduction of formal MEMS systems over things such as the Murphy reports of old...

The one thing that Officers must understand is that effective MEMS to operate within an organisation that a blame culture is completely detrimental to a sucessful system. The links are there for people to see what HF is all about.. Remind you of something that happened on your shift recently??:raf:

Damm Rigga, You got the "Just" Culture in first!! My first interview with a civvy firm included a question by the hangar manager, on what happened in the RAF if somebody made a maintenance error!!

 

[Realist78]

Mems is widely publicised where I work but not often used. Reasons being lack of confidence in confidentiality, suspicions of some on the shop floor towards management. A perception from some that it just causes more work, by identifying a problem you may have to put some effort in to resolving it. It also has the potential to turn into a p!ssing match as recently happened here when a MEMS raised was taken to heart by someone who assumed it was a personal slight and then initiated a MEMS war!!!!![/QUOTE]

That's what happened when QA first hit the streets, remember the NCR farce? It's taken years for folks to realise that the QA system is a useful tool if adopted correctly.

 

[shettie]

I might be wrong - but is this not just a "Murphy" report with a jazzy new acronym/name?

 

[Realist78]

I might be wrong - but is this not just a "Murphy" report with a jazzy new acronym/name?

It might appear that way but a more thorough investigation is carried out and it is far more higher profile. Uber management have realised that you can't just say 'human error' and close the file.

 

[I Look Like Kevin Costner]

I might be wrong - but is this not just a "Murphy" report with a jazzy new acronym/name?

No it is not.. For 145 organisations, the company MEMS system includes the CAA Mandatory Occurance Reporting System. If a maintenance error occures due to a badly writtern AMM proceedure, etc the engineer that puts in the orignial report will pass it throught the companies QA department. If the QA guys feel that the incident merits passing up to the CAA, then the engineers report will be passed to the CAA for investigation and subsquent action. It must be remembered that an aircraft type in civvy street has a large number of operators. While the RAF is one operator, it has different station opperating fleets in slighty different manners (I know Lossie do different things iin regards to Marham and Coningsby in regards to general Tonka F700 entries etc.) A corhesive MEMS allows an IPT to ensure that effective prevention measures are introduced to try and ensure a mistake / laspe does not occur again..

 

[shettie]

Ah! Gotcha - it all becomes clear - is this a result of the "deskilling" of the 1st line guys (if thats the case these days?)

 

[rest have risen above me]

What I found strange was in this Just culture that there was the mention of punishment which is a move backwards (good or bad remains to be seen) as punishment may mean slightly (massively) different things from civvy street.
We've been through years of "Own up.. It'll be fine culture" and now we're moving toward "there's a consequence for you actions" system.

 

[Rigga]

Over that past ten (no!) eleven years, I have investigated many technical misdemeanors (and many using using MEMS and MEDA) and in one particular case (a 2lb Rivetting Block left in a wing) the company declined to renew a Contractors Contract - this was a serious case of negligence (through complacency) and this £80Kpa licenced engineer was no longer required.

In another case, a pair of pliers found jammed against a Turbine engine casing, a letter of formal warning was placed in the "Culprits" File for 6 months and removed after that time. No other record was made. I used "Culprit" as he was culpable, in the case, of not adequately checking his tools.

Punishment must fit the error, but it must be "Just" and not too punitive (or no-one would work for us!)

However, deliberate acts would be likely to be dealt with more punitively, possibly including dismissal or legal action.

A deliberate act of non-conformance - but with good reasons for the actions taken - may also be dismissed as a process or HF issue causing the error to be made.

In the words of Legal Beagles - the intent of the deliberate act must be proven to show malice.

Errors would be investigated and in some cases fault MAY be found but any punishment would fit the findings of the investigation - Errors would be recognised as simply that - an error!

Read "Just Culture" by Sidney Dekker - a good book (if you can stay awake!)


Just to retitterate -

QA, MEMS, MEDA, HF - and all that other 'civvy' stuff - is there to PROTECT the engineers NOT to Hang 'em High!

It is there to make you more aware of what you do, and why. Not to fill someones books with claptrap-jingo-business speak Ticked-Boxes.
'Civvies' actually do aviation quite well (!) and, because it hits them in the pocket, they make it WORK and get profit from it.


I need a very large Red one now!


Added Bit:

Of course, to help not getting into an 'issue' in the first place - Do the paperwork right (first time) and make sure you've recorded part numbers and lifing details correctly (First Time!)

 

[wgaf]

I might be wrong - but is this not just a "Murphy" report with a jazzy new acronym/name?

Not quite but not far off.
Being a Human factors facilitator and having read up on MEMs and other human factors reporting systems it is MY belief that it is just a b@stardisation of several systems combined.
Please don't expect anything other than the usual civvy companies 'providing' the RAF with contracts, costing god alone knows how much, then in a few years time changing the titles and reselling the same systems in a new box.
A lot of the problems occur because the RAF cannot and will not invest the money to operate these systems correctly. A perfect civilian system cannot be operated in the heat and pressure of Afghanistan or many of the other operations we conduct worldwide. Many more problems are induced by civilians and ex RAF types thinking they must change the way we operate. Whilst I am not against change I firmly believe it must be for the good of the service and the way we operate. Not for the benefit of a few civvy companies with ex air staff on their boards.
Many ex service personnel working for these companies worked in the RAF of yesteryear and have no experience of live ops and all that it entails. In fact we now have many SACs who will have done more live ops and lived a damn site more 'exciting' (used for want of a better word) life in a single year than many ex commisioned/sncos could possibly have imagined in their entire careers.
Safely ensconced within their safe civilian domains they pontificate from on high, presuming to tell us how best we should run our aircraft with little or no idea of the conditions we operate under.
I care not one jot for their 'rules' or 'systems' and if they honestly think that the people who actually count, i.e. those on the shop floor, will pay credence to them then they are sadly deluded and have given themsleves over to the corporate culture that our modern society seems obsessed by. They have forgotten that the most important rule we think of in the forces is to look after our own. We are not, at grass roots level, a corporate society.
These systems are not put into place for the benefit of the man/woman on the shop floor. They are merely there to cover the backs and consciences of the people who are supposed to be there to protect us if the sh1t hits the fan.
I have to stand before people of all ranks, week after week, trying to sell this and each time it demeans me a little bit more. I just wish I had the balls to stand there and say what a load of hypocritical toss it really is! In fact fukk it I will. If any of you would care to be in the audience I would welcome you with open arms and an open mind!

 

[rest have risen above me]

Was that JD or Gordon's Wgaf? lol

I agree with the principle of this system, but as you say it is a tool to protect the higher echelons, they are supplying this system instead of addressing the fact that we are under resourced at the moment. In fact I suspect that there may be a few more changes to come once Mr Haddon Cave reports his findings.

 

[wgaf]

Was that JD or Gordon's Wgaf? lol

I agree with the principle of this system, but as you say it is a tool to protect the higher echelons, they are supplying this system instead of addressing the fact that we are under resourced at the moment. In fact I suspect that there may be a few more changes to come once Mr Haddon Cave reports his findings.

Neither to be honest. I was having one of my rare sober, reflective moments. Doesn't happen very oten so enjoy it when it does!
I just get fukkin sick of the hypocritical meanderings of ex RAF people who try to sell us all on the "No it's not the same as last the last package". Knowing full well that it is the same system that they ignored when they were in. Smacks to me of selling themselves to the highest bidder and leaving their morals behind!
This wheel has been reinvented so many times it ridiculous. The stupid thing is, it will continue to be reinvented everytime some ex air rank sitting on the board of a company listens to people who have never served and have no idea of what the problems involved in engineering in the RAF are.

 

[duffman]

Good post wgaf, there are so many HF sheets/briefs/processes, that people now just switch off. HF briefing just turn into yawnfests, people just aren't interested. It's coming in at my unit and so far all people see is filling in more paperwork in to confirm that you've done the paperwork. Plus a redesign of the issue/QA/lean paperwork that you could flag problems up on. Regardless of the name of the system, if problems aren't followed up properly and solved it undermines the system. Too many problem come back with half hearted answers, such as 'better co-ordination of manpower needed' read as undermanded. Or issues that take months to come back with an answer. Too many mixed messages that it should be done right to the book first time, then in the same brief/messege remember we in the military and we need to get things done and a/c airborne. Bringing in mems or any system isn't the answer. We need to decide how we want to operate in a clear message our a/c then bring in a system which best meets that, not the other way around.

 

[wgaf]

Good post wgaf, there are so many HF sheets/briefs/processes, that people now just switch off. HF briefing just turn into yawnfests, people just aren't interested. It's coming in at my unit and so far all people see is filling in more paperwork in to confirm that you've done the paperwork. Plus a redesign of the issue/QA/lean paperwork that you could flag problems up on. Regardless of the name of the system, if problems aren't followed up properly and solved it undermines the system. Too many problem come back with half hearted answers, such as 'better co-ordination of manpower needed' read as undermanded. Or issues that take months to come back with an answer. Too many mixed messages that it should be done right to the book first time, then in the same brief/messege remember we in the military and we need to get things done and a/c airborne. Bringing in mems or any system isn't the answer. We need to decide how we want to operate in a clear message our a/c then bring in a system which best meets that, not the other way around.

Spot on. We need a system DESIGNED to run military aircraft. Not pander to some half baked fukkwit ex air officer and his civvy chums giving us a b@stardisation of a civvy system that only works in certain scenarios!

 

[I Look Like Kevin Costner]

Spot on. We need a system DESIGNED to run military aircraft. Not pander to some half baked fukkwit ex air officer and his civvy chums giving us a b@stardisation of a civvy system that only works in certain scenarios!

HF training for Civvy 145 organisation is an initial course, followed by a refresher of a couple of hours every 2 years. MEMS in the civvy world is used to allow a scenario to be told to other people in that company and tothe rest of the world. Its allows others to remain educated to the distractions and effects that can cause accidents/incidents to happen to all aircraft.. It is inmaterial wherever it is civil or miltary because the operating pressures can be very similar as Dirty Harry would propably be happy to testify (justifiably as he has seen both sides of the stick). When was the last real fcuk up that was made at Lyneham reported to the rest of the RAF in a format that was open to all? Did you ever hear about the Jaguar airtest that had a kick in the tail? Possibly not, because it was kept in house and not reported in a way that would have been mandatory to CAA regs..

This is an interesting thread on Air Mech at the mo about a companies response to a couple of incidents Linky .. Human Factors involved?? TOO bloody right it is..

 

[185]

dos this system work? dos it improve aircraft safety,do engineers feel able to report on this system without comeback. dos it slow down engineering turn round(ie getting the aircraft back into the air) dos it work in a military environment,or is it best in a civvy environment.or is it just a paper work exercise to keep someone in a job.

 

[Weebl]

dos this system work? dos it improve aircraft safety,do engineers feel able to report on this system without comeback. dos it slow down engineering turn round(ie getting the aircraft back into the air) dos it work in a military environment,or is it best in a civvy environment.or is it just a paper work exercise to keep someone in a job.

Like all these things the RAF bring in, it could work if it was correctly implemented, sufficiently resourced and actually believed in from the ground floor up.

In reality it is another ass covering exercise by those who live in ivory towers who put half a system in place, and swan off happy in the knowledge that the people who have to work it will find enough wiggle room to still get aircraft airborne.

RAF Engineers these days do report stuff and feel comfortable about the comeback. The last of the 'Blame Culture' went away about 7-10 years ago in my experience (apart from a few old dinosaur holdouts who nobody listens to anyway) This system has not changed that, they were happy before.