National Academies Press: OpenBook

Safety Reporting Systems at Airports (2014)

Chapter: Appendix C - Survey Questionnaire

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Suggested Citation:"Appendix C - Survey Questionnaire ." National Academies of Sciences, Engineering, and Medicine. 2014. Safety Reporting Systems at Airports. Washington, DC: The National Academies Press. doi: 10.17226/22353.
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Suggested Citation:"Appendix C - Survey Questionnaire ." National Academies of Sciences, Engineering, and Medicine. 2014. Safety Reporting Systems at Airports. Washington, DC: The National Academies Press. doi: 10.17226/22353.
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Suggested Citation:"Appendix C - Survey Questionnaire ." National Academies of Sciences, Engineering, and Medicine. 2014. Safety Reporting Systems at Airports. Washington, DC: The National Academies Press. doi: 10.17226/22353.
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Suggested Citation:"Appendix C - Survey Questionnaire ." National Academies of Sciences, Engineering, and Medicine. 2014. Safety Reporting Systems at Airports. Washington, DC: The National Academies Press. doi: 10.17226/22353.
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Suggested Citation:"Appendix C - Survey Questionnaire ." National Academies of Sciences, Engineering, and Medicine. 2014. Safety Reporting Systems at Airports. Washington, DC: The National Academies Press. doi: 10.17226/22353.
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Page 64

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60 The following questionnaire was sent to airport representatives prior to scheduling a telephone inter- view. Five of the thirty-five airports completed the forms prior to the call and two airports did not participate in phone discussion and provided responses by e-mail correspondence. Interview Questionnaire Worksheet Interviewer: Interviewee: Name, Title, Airport or Organization Date and Time: Interview Duration: 1. Systems Definitions: Discuss mandatory reporting of incidents (accidents, fuel spills etc.) and the voluntary or confidential reporting from tenants. This information will used to identify which reports the airport collects and the various systems used to collect the information. Reports may include hazard, incident, strike, inspections, etc.) a) Mandatory System Description: Yes  No  Comments: b) Voluntary/Confidential System Description: Yes  No  Comments: 2. Are you a CFR Part 139 Certificated Airport? Yes  No  Comments: 3. Do you have a formal safety program or Safety Management System (SMS) at your airport? Yes  No  Comments: 4. Data Collection/System Type(s). What types of systems are used to collect data? Select all that apply. Comments: appendix c SURVeY QUeSTiOnnaiRe Paper  Software  Drop Box  Phone Line  Verbal Reports  Email  Meetings  Other  Excel  *see Q #4 below Number of Drop Boxes: Responsible Dept: Responsible Dept: Responsible Dept: Safety Meetings  Describe: Word  Documentation Type (form): Dedicated Line? Yes  No  Documentation Tracking: Documentation Type: Airline Meetings Hardcopy  Types of Locations (airside, landside): 24/7: Yes  No  Biz Hours: Received Through what means? Sent to what Dept (s)? Airport Meetings  Other  Additional notes: Additional Notes: Additional Notes: Additional Notes: Other

61 5. If a software system is used, please describe the type of system; if a hybrid of the systems presented, indicate all and provide comments: System (s) Purchased  Custom Built  Hosted by Vendor  Hosted in House  Web-based Solution  Client/Server Solution  Combined with other SW  When: #1 #2 #3 IT Dept:  Vendor:  Same as SW:  IT Dept:  Internal:  SW: Customized: #1 #2 #3 3rd Party:  Different than SW:  External: System: Combo: URL: Comments: 6. If using a software system, please provide vendor and cost information (if known). Comments: Vendor Name Software Name Initial Costs Ongoing maintenance/ per year Costs Other costs (training, customization, etc.) Comments: 7. Who or what entities submit reports? a) Mandatory and b) Voluntary (Reports = hazard, incident, strike, inspections) Comments: Airport (s)  Police, Fire  Tenants: Airlines, GSPs, etc.  FBO/ Fuelers  FAA  Passengers/ Public  Pilots  Third parties (construction)  Other  Mandatory (a) Voluntary (b) 8. Do all groups submit reports through the same system? Yes  No  Comments: a) Mandatory reports include what groups? b) Voluntary reports include what groups? Comments: 9. Are tenants required to report through any of the following agreements? Lease Agreements  Licenses  Rules and Regulations  Contracts  Muni or City Ordinance  Other  10. When was/were the system(s) initiated (if multiple list all known)? 11. When the voluntary system was rolled out where any promotional campaigns used? Posters  Web Site  Meetings  Briefings  Special Event  Memos  Training  Other  Comments: 12. Approximately how many voluntary reports were submitted per month during the initial rollout? /per month

62 13. Approximately how many voluntary reports are submitted per month a year after rollout? / per month 14. Of the total number of voluntary reports submitted approximately what percentage are ano n- ymous or unidentified? 15. System development strategies; why, when, and what prompted the development or implemen- tation of the voluntary system? 16. What, if any, future strategies are planned? (Integration with other systems, converting paper to software, etc.) 17. Data Collection and Processes. Please describe the processes used to receive, respond, inves- tigate, analyze, assess, trend, and report on safety data collected. Below is an overview of the typical steps, see questions 17a through 17k for specific comments. a. b./c. d. e. f. g. h. i. j./k. Safety Report Received Methods to analyze or collect additional Information Methods of Response to Submitter (if any) Methods to assess Risk Methods to identify mitigation or resolution Methods to trend and track activities Identified Trends Methods to report on activities Frequency and audience of Reports a. How are voluntary safety reports received? Software  Website  Hardcopy  Phone  Email  Meetings/Briefings  Verbal  Other  b. What methods are used to collect additional information from the submitter or through investigations? Email  Phone  Inspection  Assessment or Investigation  Further Analysis  Interview/ Meeting  External Validation (experts hired)  Personal follow up  Other  c. What methods are used to analyze additional information from the submitter or through investigations? Email  Phone  Inspection  Investigation  Further Analysis  Meetings  Other  d. What methods are used to respond to the submitter (if any)? (Indicate whether anonymous or name provided) Web site  Meetings  Phone  Email  Personal follow up/ face to face  Bulletin Board  Other  e. What methods (if any) are used to assess risks? Initial Triage/ Response  Risk Matrix  Risk Guide  Risk Definitions  Formal Safety Risk Assessment (SRA)  Formal Meeting (not SRA)  Individual/Small Team Decision  Other  Only for SRA? Yes  No  f. What methods are used to identify mitigations or resolutions? Initial Triage/ Response  Formal Meeting  Mgmt. Decision (escalation)  Brainstorming  Risk Parameters or Thresholds  Regulatory or Safety Guidance  Individual/Small Team Decision  Other  g. What methods are used to trend and track activities? Software  Web Site  Excel  Manual Review  Meeting  Other 

63 h. Are there any identified trends that have been observed thus far? Fewer Reports  Incomplete Reports  More anonymous Reports  Fewer Accidents and Incidents  Better Quality Reports  More complete Reports  Other  i. What methods are used to present status and statistics of reporting activities? (number of reports received, hazards, mitigations, costs, time to resolution, etc.) Posters  Web Site  Bulletin Boards  Meetings  Training Briefings  Verbal Reports  Email  Other  j. What is the frequency of status and statistics of reporting activities? As they occur or as needed  Daily  Weekly  Monthly  Quarterly  Bi-annually  Annually  Other  k. Status and statistics of reporting activities are presented to what audiences? Staff  Tenants  Management  Community/Public  Regulatory (FAA, NTSB)  Other  18. Please provide a list of Key Data Types collected. Comments: Data Type Collected Yes 1. Part 139 Reports  2. Voluntary Safety Reports  3. Staff Accident or Incident  4. Tenant Accident or Incident  5. Vehicle Accident or Incident  6. Facility Damage  7. Health and Safety/or OSHA Equivalent Report  8. Near Miss, Near Hit  9. Slip, Trip, Fall  10. Medical Run (Ambulance) Dispatch  11. Medical Run (Ambulance) Transport  12. First Responder Dispatch—Police, Fire, EMT, etc.  13. Emergency Operations Center  14. Hazard or Formal Risk Data  19. Staff Responsibilities; provide an overview of the number of staff and responsibilities to support the data collection, analysis, investigation, and reporting functions. 20. Number of Staff full time: 21. Number of Staff collateral duties: 22. What staff or departments are responsible for the following: For example, Operations, Risk, Maintenance, Corporate? a. Data and report collection: b. Report review and analysis: c. Data scrubbing or de-identification: d. Accident incident investigation: e. Hazard assessment: f. Data analysis and trending:

64 23. Data reports development and distribution: 24. Has the data collected thus far been used for Preventive Measures? Yes  No  g. Provide examples of successes from safety data trending an analysis (if any). h. What amount of data (how long of a collection period) was needed to be able to accurately assess trends? 25. Describe general challenges and benefits of the data collection and reporting program. i. Most significant Benefit: j. Most significant Challenge: k. Have any sunshine law/Freedom of Information Act (FOIA) requests for safety related data been received? If so, how were these addressed? l. Have any stakeholders refused to participate in the safety data collection process? Is so, why? What was the airport’s response? m. Does the airport report to other entities for research or other purposes? If so, to whom and for what purpose? 26. Other comments from Interviewee

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TRB’s Airport Cooperative Research Program (ACRP) Synthesis 58: Safety Reporting Systems at Airports describes safety reporting methods and systems for airports certificated under Title 14 Code of Federal Regulations Part 139 by assessing current practices, processes, and systems used to collect and analyze safety data and information.

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