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programme, and LOSA), creating a credible integrated context for all information. This function can
reduce duplication of follow-up investigations.
• Replay operative and administrator. This person is responsible for the day-to-day running of the
system, producing reports and analysis. Methodical, with some knowledge of the general operating
environment, this person keeps the programme moving.
16.3.52 All FDA team members require appropriate training or experience for their respective area of
data analysis. Each team member must be allocated a realistic amount of time to regularly spend on FDA
tasks. With insufficient human resources, the entire programme will underperform or even fail.
Off-the-shelf FDA packages
16.3.53 The QARs available on most large, modern aircraft can be analysed on a suitably configured
replay and analysis system. Even though the operators themselves can configure the various event
equations and exceedence levels, suppliers of ground replay software offer both starter packs and advanced
FDA programmes for a variety of different aircraft types. It is not normally cost-effective for new operators to
configure FDA systems themselves, although most suppliers will review the relevance and levels of event
triggers with each new operator.
16.3.54 Some aircraft manufacturers actively support FDA programmes for their aircraft. They provide
airlines with packages including tools and software, handbooks to support their FDA methods and
procedures, and additional assistance for operators implementing their programme. (They see the sharing of
data and information provided by the airline as a means for improving their aircraft, SOPs and training.)
16.3.55 Most system vendors provide one year of maintenance and support in the original package
but charge an annual fee thereafter. In addition, other cost factors to be considered by prospective
purchasers include:
a) installation costs;
b) training costs;
c) software upgrade costs (often included in the maintenance contracts); and
d) other software licence fees that may be necessary.
16.3.56 FDA programmes are often viewed as one of the most expensive safety systems in terms of
the initial outlay, software agreements and personnel requirements. In reality, they have the potential to save
the company considerable money by reducing the risk of a major accident, improving operating standards,
identifying external factors affecting the operation and improving engineering monitoring programmes.
Chapter 16. Aircraft Operations 16-15
16.4 LINE OPERATIONS SAFETY AUDIT (LOSA) PROGRAMME
Introduction
16.4.1 As has been discussed earlier, the negative consequences of human behaviour can be
proactively managed. Hazards can be identified, analysed and validated based on data collected through
the monitoring of day-to-day operations. Line Operations Safety Audits (LOSA) are one method for
monitoring normal flight operations for safety purposes. LOSA programmes then provide another proactive
safety management tool.
16.4.2 Similar to FDA programmes, LOSA facilitates hazard identification through the analysis of
actual in-flight performances. Whereas FDA provides accurate data on exceedences from expected aircraft
performance, LOSA provides information on joint system and human performance. It facilitates
understanding the context for the performance that may have precipitated the exceedence.
16.4.3 LOSA is a tool for the understanding of human errors in flight operations. It is used to identify
the threats to aviation safety that lead to human errors, to minimize the risks that such threats may generate
and to implement measures to manage these errors within the operational context. LOSA enables operators
to assess their resistance to operational risks and errors by front-line personnel. Using a data-driven
approach, they can prioritize these risks and identify actions to reduce the risk of accidents.
16.4.4 By observing normal day-to-day flight operations, data about flight crew performance and
situational factors are collected. Thus, LOSA facilitates understanding both successful performance and
failures. Hazards deriving from operational errors can be identified and effective countermeasures
developed.
16.4.5 LOSA uses experienced and specially trained observers to collect data about flight crew
performance and situational factors on “normal” flights. During audited flights, observers record error-inducing
circumstances and the crew’s responses to them. The audits are conducted under strict non-punitive
conditions, without fear of disciplinary action for detected errors. Flight crews are not required to justify their
actions.
16.4.6 Data from LOSA also provide a picture of system operations that can guide strategies in regard
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Safety Management Manual (SMM) 安全管理手册(116)