37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 259581 |
Time | |
Date | 199312 |
Day | Fri |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : mry |
State Reference | CA |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Flight Phase | climbout : takeoff ground : preflight ground other : taxi |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | other pilot : cfi pilot : flight engineer pilot : atp |
Experience | flight time last 90 days : 100 flight time total : 11000 flight time type : 2000 |
ASRS Report | 259581 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | non adherence : far non adherence : published procedure |
Independent Detector | other flight crewa |
Resolutory Action | none taken : anomaly accepted |
Consequence | Other |
Supplementary | |
Primary Problem | Aircraft |
Air Traffic Incident | Pilot Deviation |
Situations | |
Publication | Unspecified |
Narrative:
On 12/xx/93, our airlines instituted new checklists for all aircraft which consist of widebody transport's large transport's, and medium large transport's. The old '3- holer' large transport will be at a later date.) the reasons for this drastic re-writing of the checklists are: (1) to expedite taxi from the gate area by eliminating after start checklist (which is accomplished while stopped) and placing those items on a before takeoff checklist (which is accomplished while moving). (2) to 'standardize' all fleets in order to justify future training program reductions. The result has been a disruption of proven flow patterns and elimination of critical checklist items. After starting engines at mry, this crew elected to do all items on the before takeoff checklist prior to taxi, to prevent distrs while moving. Because we received our final weights, trim setting and passenger count before starting, we were able to accomplish all items, down to the final items, while parked. As a result, we were able to devote our full attention to taxiing the airplane. I am seeing more and more 'doctored' checklists where crews have added 'APU' and 'landing lights' and 'seat belt sign', etc. Also, arrows have been drawn to indicate where these crews think an item should be. I have also heard that some crews are still using the old checklist! When there is a wide-spread non-acceptance and non-adherence to a new procedure, then that procedure is flawed and potentially unsafe. This new checklist was developed without pilot input.
Original NASA ASRS Text
Title: PUB DEFICIENCY RPTED BY ACR FO IN CHKLIST DESIGN AND SUBSEQUENT CHKLIST USE.
Narrative: ON 12/XX/93, OUR AIRLINES INSTITUTED NEW CHKLISTS FOR ALL ACFT WHICH CONSIST OF WDB'S LGT'S, AND MLG'S. THE OLD '3- HOLER' LGT WILL BE AT A LATER DATE.) THE REASONS FOR THIS DRASTIC RE-WRITING OF THE CHKLISTS ARE: (1) TO EXPEDITE TAXI FROM THE GATE AREA BY ELIMINATING AFTER START CHKLIST (WHICH IS ACCOMPLISHED WHILE STOPPED) AND PLACING THOSE ITEMS ON A BEFORE TKOF CHKLIST (WHICH IS ACCOMPLISHED WHILE MOVING). (2) TO 'STANDARDIZE' ALL FLEETS IN ORDER TO JUSTIFY FUTURE TRAINING PROGRAM REDUCTIONS. THE RESULT HAS BEEN A DISRUPTION OF PROVEN FLOW PATTERNS AND ELIMINATION OF CRITICAL CHKLIST ITEMS. AFTER STARTING ENGS AT MRY, THIS CREW ELECTED TO DO ALL ITEMS ON THE BEFORE TKOF CHKLIST PRIOR TO TAXI, TO PREVENT DISTRS WHILE MOVING. BECAUSE WE RECEIVED OUR FINAL WTS, TRIM SETTING AND PAX COUNT BEFORE STARTING, WE WERE ABLE TO ACCOMPLISH ALL ITEMS, DOWN TO THE FINAL ITEMS, WHILE PARKED. AS A RESULT, WE WERE ABLE TO DEVOTE OUR FULL ATTN TO TAXIING THE AIRPLANE. I AM SEEING MORE AND MORE 'DOCTORED' CHKLISTS WHERE CREWS HAVE ADDED 'APU' AND 'LNDG LIGHTS' AND 'SEAT BELT SIGN', ETC. ALSO, ARROWS HAVE BEEN DRAWN TO INDICATE WHERE THESE CREWS THINK AN ITEM SHOULD BE. I HAVE ALSO HEARD THAT SOME CREWS ARE STILL USING THE OLD CHKLIST! WHEN THERE IS A WIDE-SPREAD NON-ACCEPTANCE AND NON-ADHERENCE TO A NEW PROC, THEN THAT PROC IS FLAWED AND POTENTIALLY UNSAFE. THIS NEW CHKLIST WAS DEVELOPED WITHOUT PLT INPUT.
Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.