GAP ANALYSIS .1 INTRODUCTION TO SAFETY

7-6 Safety Management Manual SMM 7.4.5 A description of this system in term of its components and their interactions, utilizing the SHEL model discussed in Chapter 2, could be as follows. The function of the socio-technical system is package delivery. It interfaces with other systems: a topographical system, a weather system, a wildlife system. There is a social component: people. There are human performance considerations which are fundamental for system operation: how will people perform when interacting with the lions, with the mountains and with the weather? There are hardware components in the system: the road across the mountains, the warning signs. There are also software components: documentation, procedures and training to guide people in the operation of and interaction with the system how to deal with the lions, how to negotiate the curves in the road, how to protect against the weather while at the same time ensuring service delivery packages must be delivered intact to the other side of the mountain. 7.4.6 In formal or technical terms, a system description in aviation should include the following: a system interactions with other systems in the air transportation system; b system functions; c required human performance considerations for system operation; d hardware components of the system; e software components of the system, including related procedures that define guidance for the operation and use of the system; f the operational environment; and g contracted and purchased products and services. 7.4.7 Appendix 1 to this chapter provides guidance on system description. 7.5 GAP ANALYSIS 7.5.1 The first step in identifying sources of safety vulnerability, specified as hazards in the interfaces between people and other components of the system, is the system description. Once the system is described in term of components and interactions, the second step is to address these safety vulnerabilities, specified as hazards in the interfaces between people and other components of the system, through an analysis of the resources already present in the system. The analysis has two objectives. The first objective is to identify eventual mismatches in the interfaces between the different components identified through the system description. These mismatches are the safety vulnerabilities. The second objective is to identify whatever additional resources might be considered necessary to smooth rough interfaces, to assist people involved in the delivery of services in safely and efficiently discharging their tasks. This analysis is known as gap analysis. 7.5.2 From the perspective of an SMS, a gap analysis is basically an analysis of the safety arrangements already existing within the organization as compared to those necessary for the SMS to function. The gap analysis is important because the basic organizational structures necessary to start developing an SMS may already exist in the organization: it will seldom be necessary to build an SMS from scratch because most organizations will have various activities related to an SMS in place and functioning. The development of an SMS should take advantage of and build upon existing organizational structures. 7.5.3 Returning to Figure 7-2, and keeping in mind that the service provided by the system is the delivery, by people, of small packages to the other side of the mountains, a simple gap analysis is exemplified. The guiding question for the analysis should be: are the operational personnel in this case, the caveman who are actually going to deliver Chapter 7. Introduction to Safety Management Systems SMS 7-7 the service properly equipped with the necessary resources to do so? The reply to this question must address both safety i.e. are personnel properly equipped to deliver the service safely? and efficiency i.e. are personnel properly equipped to deliver the service efficiently?. 7.5.4 The SHEL model, discussed in Chapter 2, is a useful tool to reply to the question and guide the gap analysis see Figure 7-3. The caveman is the Liveware L. The road, the STOP sign, the speed sign and the tunnel near the top of the mountain pass are the Hardware H. The trees, the lions, the mountains and the clouds are the Environment E. Although not visible, the training the caveman has received and the procedures and instructions the caveman must follow to deliver the service are the Software S. As shown in Figure 7-3, the gap analysis would produce the following results when compared to Figure 7-2: a The caveman must travel though the mountains, on a circuitous and probably uneven road, but he is barefooted. He might therefore hurt his feet and experience a fall safety andor make progress at a slow pace and therefore delay the delivery of packages efficiency. The gap analysis suggests that providing footgear would then be important to address a mismatch in the interface between the caveman L and the road H. b The clouds in the pass at the top of the mountains may generate rain and thunderstorms. Providing headgear would then protect the caveman and address a mismatch in the interface between the caveman L and the clouds E. Figure 7-3. Gap analysis 15 15 S H L L E S S H H L L L L E E 7-8 Safety Management Manual SMM c The lions are a clear hazard to the caveman and to the delivery of the service. The STOP sign is a resource that already exists in the system, intended to alert the caveman about the hazard i.e. entering a particularly dangerous zone. Nevertheless, a self-defence tool would be an appropriate additional resource. Providing a spear for the caveman would therefore address a mismatch between the caveman L and the lions E. d In addition to the STOP sign, yellow “hold” lines painted on the road just before entering the particularly dangerous zone would increase awareness and direct the attention of the caveman towards the lions, thus supplementing the spear as an additional resource to address the mismatch between the caveman L and the lions E. e The caveman has no equipment to carry the small packages so that his hands are free to handle the spear as well as to maintain better balance and stability while travelling on the rough and uneven mountain road. A backpack to carry the packages would be an additional resource to address a mismatch in the interface between the caveman L and the lions E and the caveman L and the road H. f There is a speed sign that indirectly alerts travellers at the beginning of the winding road. The speed sign does not convey an unequivocal message about the upcoming road conditions. A dedicated and obvious alerting sign would be an additional resource to address a mismatch in the interface between the caveman L and the road E. g There is no warning that the pass at the top of the mountain is through a tunnel. An alerting sign would be an additional resource to address a mismatch in the interface between the caveman L and the road E. 7.5.5 A gap analysis thus reveals the resources, structures and safety arrangements existing in the system to address safety vulnerabilities, specified in terms of hazards, that arise as a consequence of the interaction of people and other components of the operational context. It also reveals additional resources, structures and safety arrangements that would be necessary to mitigate safety vulnerabilities and increase operational resilience to the hazards. 7.5.6 Once the gap analysis is complete and fully documented, the resources, structures and arrangements that have been identified as missing or deficient will form, together with those already existing, the basis of the SMS implementation plan. Organizations may format their SMS implementation plan to suit their individual needs; however, a spreadsheet format, Gantt chart or MS Project type layout is recommended for ease of viewing and tracking. Each item will be assessed to determine how the organization will create or modify policies, objectives, procedures or processes to incorporate the required SMS components and elements. Appendix 2 to this chapter provides an example of a gap analysis for service providers with suggested questions to assist an organization in finding out what is missing once they have described their own system in the organization. 7.6 SMS AND QMS 7.6.1