1. CX LOSA © Cathay Pacific Airways 2005 Cathay Pacific LOSA Training for Safety Aiming for Excellence 2001 & 2005

2. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.2 Cathay Pacific Airways Cathay Pacific Airways 2006 is our 60 th Birthday! 2006 is our 60 th Birthday! from 2 DC3s to a fleet of 95 wide-bodies from 2 DC3s to a fleet of 95 wide-bodies > 80 pax Aircraft (A340, A330, B777, B747) 14 all-cargo B747 aircraft 14 all-cargo B747 aircraft ~ 2000 pilots ~ 16000 total staff

3. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.3 Cathays home Chep Lap Kok, Hong Kong 50 Destinations worldwide CX aircraft daily in: NYC or JNB LHR or SYD LHR or SYD NRT or FRA NRT or FRA DEL or DPS DEL or DPS CX is truly international…

4. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.4 "Without data you're just another person with an opinion" We've got data… We've got data… lots of it!

5. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.5 Data Sources… FOQA/QAR FOQA/QAR –a mature program capturing 90% of flights (part of our change management system) FOQA/QAR FOQA/QAR –a mature program capturing 90% of flights (part of our change management system) Reporting Culture –Air Safety Reports –Confidential Reports –Training & Check Reports (8 per pilot per year ~16,000 reports) Reporting Culture –Air Safety Reports –Confidential Reports –Training & Check Reports (8 per pilot per year ~16,000 reports)

6. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.6 How do we make sense of all the data? Is it valid? Is it relevant? Does it reveal trends? (or conceal them!) How can we make the data smarter? 1. In Cathay Pacific, LOSA pointed us to where we should focus our efforts.

7. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.7 LOSA: - is not Reactive (to an incident / accident) LOSA: - is not Guesswork (he who shouts the loudest will be heard) LOSA: - is a day in the life of CPA

8. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.8 Aircraft type Observations Aircraft type Observations A330/340 83 / 117 A330/340 83 / 117 B777 51 / 46 B777 51 / 46 B747-200F 0 / 44 B747-200F 0 / 44 B747- 400 (incl. Freighters) 26 (0) / 67 B747- 400 (incl. Freighters) 26 (0) / 67 Total: 160 / 274 Total: 160 / 274 LOSA Flights 2001 / 2005

9. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.9 LOSA 2001 was used to validate and verify data from other sources. LOSA 2001, together with the other data, has driven some changes in Cathay Pacific: –New stabilised approach criteria. –New SOP for Flap and Gear selection. –New take-off and approach briefings. –New standardised approach and landing callouts.

10. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.10 Biggest single shift in Cathay as a result of LOSA 2001 Threat & Error Management program –Every pilot has completed a TEM course –Built modules to emphasise TEM into annual recurrent training –Named "threats" in all departure & arrival briefings –Got Check & Training pilot buy-in

11. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.11 We Knew Changes Had Occurred In Our Airline. 2. LOSA helped us to understand these changes. –Analogue to glass –3-man to 2-man cockpits –Experience levels dropping (hours: not = experience!) –Demographics - multi-cultural crew Obvious –Analogue to glass –3-man to 2-man cockpits –Demographics - multi-cultural crew Subtle –Experience levels dropping (Hours Experience) –Automation complacency (Magenta / green line pilots) –High threat environment (Weather, ADDs, ATC, etc)

12. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.12 3. LOSA is underpinned by TEM Principles. Monitor / x-check has become a common phrase among Cathay pilots (LOSA had told us that we were average at monitoring!) We encourage a culture of healthy skepticism on our flightdecks Error Management can actually be commended (Criticism and blame are not the only responses!) Threat anticipation is a key ingredient of our briefings

13. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.13 Moving On… In Cathay we took the positives from LOSA What have we been doing right?What have we been doing right? What are our strengths?What are our strengths? (dont lose these) What are our weaker areas?What are our weaker areas? (lets focus our attention here)

14. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.14 Captains Leadership SOP Briefings Automation Management Where Do We Start? Everybody likes to hear what we are doing well (Captains leadership, Communication environment) But the safety culture (water level) can only reach the height of the weakest performance mark (lowest stave). LOSA can point to which stave needs fixing first.

15. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.15 SUMMARY LOSA is underpinned by TEM LOSA helped us to understand the changes in our airline LOSA pointed us to where we should focus our efforts

16. CX LOSA © Cathay Pacific Airways 2005 LOSA 2005.16 Managing the future… LOSA is a Safety Management Tool that gives us a health- check of our safety culture. It gives valuable data, enabling us to introduce changes to our safety lifestyle. Life is lived forward but understood backward.Life is lived forward but understood backward. Kierkegaard We all want to be able to see into the future! LOSA is helping to ensure safety comes first in Cathay Pacific