Just Culture – Making ASAPs
Useful and Effective


The concept behind every proactive safety program is a Just Culture. AFI 91-202 says: “In a Just Culture, the immediate response by personnel who become aware of a hazard should be to find ‘what happened and why’ versus ‘who to blame and punish.’” Operations Risk Assessment and Management System (Ops RAMS) conducts a quarterly Trend Review and Action Committee (TRAC) meeting chaired by Lt Gen Jon T. Thomas, AMC/CD, where all the proactive safety program highlights are discussed. Just Culture is an accepted Rule of Engagement (ROE) for the TRAC and is covered in the sidebar below.

We normally discuss Just Culture and how it applies to the handling and processing of the Aviation Safety Action Program (ASAP) and Military Flight Operations Quality Assurance (MFOQA) analysis, but the same concept must apply to the composition and submission of an ASAP.

We have had a few recent ASAPs, primarily dealing with operations and maintenance, which have indicated an adversarial relationship. This tends to erode the mutual trust and respect we need to ensure safe operations. While these ASAPs are needed and greatly appreciated, I ask that ASAP submitters use the same ROE the AMC/CD uses during the TRAC. Be constructive and factual while remaining positive and professional. Your submission is from your perspective and there is likely at least one other point of view. An accusatory TRAC RULES OF ENGAGEMENTBased on Just Culture, participants should:• Focus on improvements and not assign blame.• Constructive, factual, and causal findings are acceptable.• Refrain from specifying units unless absolutely necessary.• Maintain a positive and professional atmosphere.• Make constructive comments, feedback, and recommendations.GOAL: Constructive, positive, and efficient discussions focused on improvement.ASAP places individuals in a defensive position and makes them less likely to collaborate on finding a workable solution.

Again, please internalize Just Culture, remove emotion from your ASAPs, and provide the facts as you know them. If needed, we in the Ops RAMS office will endeavor to resolve any differences in perspective and work with all involved to mitigate the risks that have been identified.

Thank you for participating in our proactive safety programs. With your help and information provided we can all learn from the mistakes and errors of others and contribute safely, effectively, and efficiently to the warfighter!