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Assessing risk from a stakeholder perspective

Planetary exploration missions are subject to a vast array of interpretations of 'success' based on the concerns of multiple stakeholder groups. While project risk management generally focuses on issues of cost/schedule constraints or reliability issues, a broader interpretation of 'risk' as it applies to stakeholders such as sponsors (e.g., NASA), the public at large, the scientific community, the home organization, and the project team itself can provide important insights into the full spectrum of risk that needs to be managed. This paper presents a stakeholder view of risk which is divided into failure, not-a-failure, success, and stunning-success zones. Using the Mars Pathfinder mission as an example, an alternative interpretation of the risks to that mission is presented from the view of key stakeholders. The implications of the stakeholder perspective to project risk management are addressed.

risk management success/failure graph↗

Covariance Manipulation for Conjunction Assessment

The manipulation of space object covariances to try to provide additional or improved information to conjunction risk assessment is not an uncommon practice. Types of manipulation include fabricating a covariance when it is missing or unreliable to force the probability of collision (Pc) to a maximum value ('PcMax'), scaling a covariance to try to improve its realism or see the effect of covariance volatility on the calculated Pc, and constructing the equivalent of an epoch covariance at a convenient future point in the event ('covariance forecasting'). In bringing these methods to bear for Conjunction Assessment (CA) operations, however, some do not remain fully consistent with best practices for conducting risk management, some seem to be of relatively low utility, and some require additional information before they can contribute fully to risk analysis. This study describes some basic principles of modern risk management (following the Kaplan construct) and then examines the PcMax and covariance forecasting paradigms for alignment with these principles; it then further examines the expected utility of these methods in the modern CA framework. Both paradigms are found to be not without utility, but only in situations that are somewhat carefully circumscribed.

Conjunction↗

Development of Risk Assessment Matrix for NASA Engineering and Safety Center

This paper describes a study, which had as its principal goal the development of a sufficiently detailed 5 x 5 Risk Matrix Scorecard. The purpose of this scorecard is to outline the criteria by which technical issues can be qualitatively and initially prioritized. The tool using this score card has been proposed to be one of the information resources the NASA Engineering and Safety Center (NESC) takes into consideration when making decisions with respect to incoming information on safety concerns across the entire NASA agency. The contents of this paper discuss in detail each element of the risk matrix scorecard, definitions for those elements and the rationale behind the development of those definitions. This scorecard development was performed in parallel with the tailoring of the existing Futron Corporation Integrated Risk Management Application (IRMA) software tool. IRMA was tailored to fit NESC needs for evaluating incoming safety concerns and was renamed NESC Assessment Risk Management Application (NAFMA) which is still in developmental phase.

Malone, Roy W., Jr.↗

Implementing an Objectives-Driven, Risk-Informed, and Case-Assured Approach to Safety and Mission Success at NASA

NASA is developing a “Standard for Assurance of Space Flight Safety and Mission Success” that implements an objectives-driven, risk-informed, and case-assured approach to safety and mission success (S&MS) for NASA space flight programs and projects. The standard aligns with the philosophy of risk leadership that has recently been established in NASA policy to assure acceptable levels of flight crew safety and mission success risk. It is consistent with existing NASA risk management requirements and is compatible with NASA program management and systems engineering requirements. The methodology described in the standard is presented in terms of an S&MS assurance framework that is designed to allow substantial flexibility in the specific means by which programs and projects achieve acceptable mission S&MS risk. Such flexibility is necessary to accommodate the increasingly broad range of acquisition strategies employed by NASA, including commercial transportation services, as well as to accommodate the increasingly rapid evolution of space flight-related technologies and practices. A key feature of the S&MS assurance framework is the specification of S&MS success criteria for each life-cycle review (LCR). The S&MS assurance case is structured around these criteria, the satisfaction of which indicates that the program/project is adhering to the S&MS risk posture. This enables the evolving S&MS assurance case to be used as a fundamental program/project submittal at each LCR, where its inherent structure of argument, supported by evidence, directly supports the evaluation of the program/project with respect to the S&MS success criteria, and by extension, the S&MS risk posture. As such, the S&MS assurance case is integral to program/project systems engineering, risk management, and S&MS oversight activities, and provides the principal basis for S&MS risk acceptance by the Decision Authority throughout the program/project life cycle.

Risk Posture↗

Another Approach to Enhance Airline Safety: Using Management Safety Tools

The ultimate goal of conducting an accident investigation is to prevent similar accidents from happening again and to make operations safer system-wide. Based on the findings extracted from the investigation, the "lesson learned" becomes a genuine part of the safety database making risk management available to safety analysts. The airline industry is no exception. In the US, the FAA has advocated the usage of the System Safety concept in enhancing safety since 2000. Yet, in today s usage of System Safety, the airline industry mainly focuses on risk management, which is a reactive process of the System Safety discipline. In order to extend the merit of System Safety and to prevent accidents beforehand, a specific System Safety tool needs to be applied; so a model of hazard prediction can be formed. To do so, the authors initiated this study by reviewing 189 final accident reports from the National Transportation Safety Board (NTSB) covering FAR Part 121 scheduled operations. The discovered accident causes (direct hazards) were categorized into 10 groups Flight Operations, Ground Crew, Turbulence, Maintenance, Foreign Object Damage (FOD), Flight Attendant, Air Traffic Control, Manufacturer, Passenger, and Federal Aviation Administration. These direct hazards were associated with 36 root factors prepared for an error-elimination model using Fault Tree Analysis (FTA), a leading tool for System Safety experts. An FTA block-diagram model was created, followed by a probability simulation of accidents. Five case studies and reports were provided in order to fully demonstrate the usefulness of System Safety tools in promoting airline safety.

Lu, Chien-tsug↗

Space Life Sciences at NASA: Spaceflight Health Policy and Standards

In January 2005, the President proposed a new initiative, the Vision for Space Exploration. To accomplish the goals within the vision for space exploration, physicians and researchers at Johnson Space Center are establishing spaceflight health standards. These standards include fitness for duty criteria (FFD), permissible exposure limits (PELs), and permissible outcome limits (POLs). POLs delineate an acceptable maximum decrement or change in a physiological or behavioral parameter, as the result of exposure to the space environment. For example cardiovascular fitness for duty standards might be a measurable clinical parameter minimum that allows successful performance of all required duties. An example of a permissible exposure limit for radiation might be the quantifiable limit of exposure over a given length of time (e.g. life time radiation exposure). An example of a permissible outcome limit might be the length of microgravity exposure that would minimize bone loss. The purpose of spaceflight health standards is to promote operational and vehicle design requirements, aid in medical decision making during space missions, and guide the development of countermeasures. Standards will be based on scientific and clinical evidence including research findings, lessons learned from previous space missions, studies conducted in space analog environments, current standards of medical practices, risk management data, and expert recommendations. To focus the research community on the needs for exploration missions, NASA has developed the Bioastronautics Roadmap. The Bioastronautics Roadmap, NASA's approach to identification of risks to human space flight, revised baseline was released in February 2005. This document was reviewed by the Institute of Medicine in November 2004 and the final report was received in October 2005. The roadmap defines the most important research and operational needs that will be used to set policy, standards (define acceptable risk), and implement an overall Risk Management and Analysis process. Currently NASA is drafting spaceflight health standards for neurosensory alterations, space radiation exposure, behavioral health, muscle atrophy, cardiovascular fitness, immunological compromise, bone demineralization, and nutrition.

Davis, Jeffrey R.↗

Risk as a Resource: A New Paradigm

In the new NASA, risk management must be developed as a skill to a far greater degree than has existed in the past. Past approaches have produced great successes but at great cost and lengthy schedules. In the future, risk and its component contributors must be re-evaluated. There are three contexts of risk that will be addressed in this paper: risk as a resource, which expands and shifts traditional risk considerations; marginal cost of risk, which addresses the cumulative and time related effects of risk reduction; and an alternative definition or new meaning of success and how it relates to work.

risk management risk success mission risk↗

Commercial Orbital Transportation Services (COTS) Program Lessons Learned

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the COTS Program. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

COTS↗

Qualification Strategies of Field Programmable Gate Arrays (FPGAs) for Space Application

This viewgraph document reviews the issue of using Field Programmable Gate Arrays (FPGAs) in Space Application, and the some of the strategies for qualifying the FPGA. Qualification and risk management of such complex systems requires new approaches. The paper presents a matrix approach to qualification has been presented that: - Complements historical specifications - Highlights the importance of device physics as a cornerstone to qualification. - Provides levels of risk management that expressly document trade offs. - Stresses the role of the FPGA vendor as team member in the development of modern spacecraft.

Mil Standard 883↗

Ares Knowledge Capture: Summary and Key Themes Presentation

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the MSFC Chief Engineers Office. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Ares Knowledge↗

Systems Engineering Lessons Learned from Solar Array Structures and Mechanisms Deployment

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the Engineering Directorate at LaRC. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

Solar Array Structures↗

Software reliability through fault-avoidance and fault-tolerance

Strategies and tools for the testing, risk assessment and risk control of dependable software-based systems were developed. Part of this project consists of studies to enable the transfer of technology to industry, for example the risk management techniques for safety-concious systems. Theoretical investigations of Boolean and Relational Operator (BRO) testing strategy were conducted for condition-based testing. The Basic Graph Generation and Analysis tool (BGG) was extended to fully incorporate several variants of the BRO metric. Single- and multi-phase risk, coverage and time-based models are being developed to provide additional theoretical and empirical basis for estimation of the reliability and availability of large, highly dependable software. A model for software process and risk management was developed. The use of cause-effect graphing for software specification and validation was investigated. Lastly, advanced software fault-tolerance models were studied to provide alternatives and improvements in situations where simple software fault-tolerance strategies break down.

Vouk, Mladen A.↗

Aerospace Safety Advisory Panel

This report covers the activities of the Aerospace Safety Advisory Panel (ASAP) for calendar year 1998-a year of sharp contrasts and significant successes at NASA. The year opened with the announcement of large workforce cutbacks. The slip in the schedule for launching the International Space Station (ISS) created a five-month hiatus in Space Shuttle launches. This slack period ended with the successful and highly publicized launch of the STS-95 mission. As the year closed, ISS assembly began with the successful orbiting and joining of the Functional Cargo Block (FGB), Zarya, from Russia and the Unity Node from the United States. Throughout the year, the Panel maintained its scrutiny of NASA's safety processes. Of particular interest were the potential effects on safety of workforce reductions and the continued transition of functions to the Space Flight Operations Contractor. Attention was also given to the risk management plans of the Aero-Space Technology programs, including the X-33, X-34, and X-38. Overall, the Panel concluded that safety is well served for the present. The picture is not as clear for the future. Cutbacks have limited the depth of talent available. In many cases, technical specialties are 'one deep.' The extended hiring freeze has resulted in an older workforce that will inevitably suffer significant departures from retirements in the near future. The resulting 'brain drain' could represent a future safety risk unless appropriate succession planning is started expeditiously. This and other topics are covered in the section addressing workforce. The major NASA programs are also limited in their ability to plan property for the future. This is of particular concern for the Space Shuttle and ISS because these programs are scheduled to operate well into the next century. In the case of the Space Shuttle, beneficial and mandatory safety and operational upgrades are being delayed because of a lack of sufficient present funding. Likewise, the ISS has little flexibility to begin long lead-time items for upgrades or contingency planning. For example, the section on computer hardware and software contains specific findings related to required longer range safety-related actions. NASA can be proud of its accomplishments this past year, but must remain ever vigilant, particularly as ISS assembly begins to accelerate. The Panel will continue to focus on both the short- and long-term aspects of risk management and safety planning. This task continues to be made manageable and productive by the excellent cooperation the Panel receives from both NASA and its contractors. Particular emphasis will continue to be directed to longer term workforce and program planning issues as well as the immediate risks associated with ISS assembly and the initial flights of the X-33 and X-34. Section 2 of this report presents specific findings and recommendations generated by ASAP activities during 1998. Section 3 contains more detailed information in support of these findings and recommendations. Appendix A is a current roster of Panel members, consultants, and staff. Appendix B contains NASA's response to the findings and recommendations from the 1997 ASAP Annual Report. Appendix C details the fact-finding activities of the Panel in 1998. During the year, Mr. Richard D. Blomberg was elected chair of the Panel and Vice Admiral (VADM) Robert F Dunn was elected deputy chair. VADM Bernard M. Kauderer moved from consultant to member. Mr. Charles J. Donlan retired from the Panel after many years of meritorious service. Ms. Shirley C. McCarty and Mr. Robert L. ('Hoot') Gibson joined the Panel as consultants.

Source record↗

Environmental Justice Needs Assessment for Disasters: Assessing the Landscape and Capacity of Organizations & Communities Working Towards Environmental Justice with Potential to Use NASA Earth Observations to Support Equitable Disaster Management and Risk Reduction

Natural disasters pose an increasing risk to communities worldwide. Marginalized populations, in particular, experience compounding vulnerabilities that contribute to unequal burdens of natural hazards as a result of systemic inequality stemming from historical disenfranchisement, disinvestment, and discriminatory policies such as racial redlining. This project connected with community organizations working at the intersection of environmental justice (EJ) and natural disaster management throughout the United States, to assess how NASA DEVELOP can leverage geospatial science to advance EJ efforts. Our team conducted a landscape analysis, which included a literature review, annotated bibliography, and identification of organizations working in EJ and disasters. We engaged EJ organizations in discussions to understand their current resources, challenges, and geospatial needs to inform how DEVELOP and NASA Applied Sciences can support their EJ and disaster work. Findings were compiled in a synthesis report and visualized in an ArcGIS StoryMap to showcase the work of EJ organizations, provide geospatial resources for them to explore, and provide examples of how remote sensing can be utilized in EJ and disasters work. The knowledge gained and end products created support the integration of EJ in future DEVELOP projects, and the expanded use of Earth observations by communities in support of a more just tomorrow.

Julianne Liu↗

NASA safety program activities in support of the Space Exploration Initiatives Nuclear Propulsion program

The activities of the joint NASA/DOE/DOD Nuclear Propulsion Program Technical Panels have been used as the basis for the current development of safety policies and requirements for the Space Exploration Initiatives (SEI) Nuclear Propulsion Technology development program. The Safety Division of the NASA Office of Safety and Mission Quality has initiated efforts to develop policies for the safe use of nuclear propulsion in space through involvement in the joint agency Nuclear Safety Policy Working Group (NSPWG), encouraged expansion of the initial policy development into proposed programmatic requirements, and suggested further expansion into the overall risk assessment and risk management process for the NASA Exploration Program. Similar efforts are underway within the Department of Energy to ensure the safe development and testing of nuclear propulsion systems on Earth. This paper describes the NASA safety policy related to requirements for the design of systems that may operate where Earth re-entry is a possibility. The expected plan of action is to support and oversee activities related to the technology development of nuclear propulsion in space, and support the overall safety and risk management program being developed for the NASA Exploration Program.

Sawyer, J. C., Jr.↗

Human Factors Throughout the Life Cycle: Lessons Learned from the Shuttle Program

With the ending of the Space Shuttle Program, it is critical that we not forget the Human Factors lessons we have learned over the years. At every phase of the life cycle, from manufacturing, processing and integrating vehicle and payload, to launch, flight operations, mission control and landing, hundreds of teams have worked together to achieve mission success in one of the most complex, high-risk socio-technical enterprises ever designed. Just as there was great diversity in the types of operations performed at every stage, there was a myriad of human factors that could further complicate these human systems. A single mishap or close call could point to issues at the individual level (perceptual or workload limitations, training, fatigue, human error susceptibilities), the task level (design of tools, procedures and aspects of the workplace), as well as the organizational level (appropriate resources, safety policies, information access and communication channels). While we have often had to learn through human mistakes and technological failures, we have also begun to understand how to design human systems in which individuals can excel, where tasks and procedures are not only safe but efficient, and how organizations can foster a proactive approach to managing risk and supporting human enterprises. Panelists will talk about their experiences as they relate human factors to a particular phase of the shuttle life cycle. They will conclude with a framework for tying together human factors lessons-learned into system-level risk management strategies.

human factors↗

The Future of Safety Management

As the pace of aviation evolution accelerates, our approach to safety and risk management needs to evolve to cover expanded current day operations as well as participants not traditionally included in the airspace. To assure safety of an increasingly complex aviation system it is essential to leverage new processes and techniques that can more quickly identify and respond to emerging risks. The concept of an In-Time Aviation Safety Management System (IASMS) presents an advanced SMS framework designed to enable integrated safety management and assurance. To assure safety of future aviation operations and technologies, advanced SMS concepts must be designed such that they can evolve to keep pace as aviation continues to change and as new safety and risk management tools and techniques emerge.

safety↗

Engineering and Safety Partnership Enhances Safety of the Space Shuttle Program (SSP)

Project Management must use the risk assessment documents (RADs) as tools to support their decision making process. Therefore, these documents have to be initiated, developed, and evolved parallel to the life of the project. Technical preparation and safety compliance of these documents require a great deal of resources. Updating these documents after-the-fact not only requires substantial increase in resources - Project Cost -, but this task is also not useful and perhaps an unnecessary expense. Hazard Reports (HRs), Failure Modes and Effects Analysis (FMEAs), Critical Item Lists (CILs), Risk Management process are, among others, within this category. A positive action resulting from a strong partnership between interested parties is one way to get these documents and related processes and requirements, released and updated in useful time. The Space Shuttle Program (SSP) at the Marshall Space Flight Center has implemented a process which is having positive results and gaining acceptance within the Agency. A hybrid Panel, with equal interest and responsibilities for the two larger organizations, Safety and Engineering, is the focal point of this process. Called the Marshall Safety and Engineering Review Panel (MSERP), its charter (Space Shuttle Program Directive 110 F, April 15, 2005), and its Operating Control Plan emphasizes the technical and safety responsibilities over the program risk documents: HRs; FMEA/CILs; Engineering Changes; anomalies/problem resolutions and corrective action implementations, and trend analysis. The MSERP has undertaken its responsibilities with objectivity, assertiveness, dedication, has operated with focus, and has shown significant results and promising perspectives. The MSERP has been deeply involved in propulsion systems and integration, real time technical issues and other relevant reviews, since its conception. These activities have transformed the propulsion MSERP in a truly participative and value added panel, making a difference for the safety of the Space Shuttle Vehicle, its crew, and personnel. Because of the MSERP's valuable contribution to the assessment of safety risk for the SSP, this paper also proposes an enhanced Panel concept that takes this successful partnership concept to a higher level of 'true partnership'. The proposed panel is aimed to be responsible for the review and assessment of all risk relative to Safety for new and future aerospace and related programs.

Duarte, Alberto↗