Twin Proficiency: Procedural Noncompliance

Twin Proficiency: Procedural Noncompliance

Twin Proficiency: Procedural Noncompliance

When I was a young officer in the U.S. Air Force, we often discussed the difference between “doing things right” and “doing the right thing.” If you’ve ever been a small part of a large bureaucracy (and the military office corps is nothing if not a large bureaucracy), you can probably understand the distinction: “doing things right” means following directives and procedures, regardless of their effectiveness or outcome, and “doing the right thing” means working to achieve a desired outcome, even if that means taking a shortcut or stretching the limits of formal directives. Whether you value doing things right or doing the right thing is a matter of your personal viewpoint, and often determines your level of success in the organization. As you gain more experience, you probably find, as have I, that the line between the two is not always easy to discern.

In flying a single-pilot airplane, we are challenged to do things right, and do the right thing, every time we fly. Luckily, in flying, the result of not meeting the goal of a safe flight and a safe arrival is pretty obvious, so those procedures and guidance that exist are overwhelmingly realistic and easy to follow. Doing things right means doing the right thing, and vice versa – as they say, the “regulations are written in blood,” i.e., most flying rules and limitations came from situations that resulted in a crash. Troubles (and mishaps) usually occur when the pilot does not follow established procedure. The National Transportation Safety Board (NTSB), FAA and industry call failing to do things right procedural noncompliance.

NTSB Member and pilot Dr. Earl Weener recently spoke at a Commercial Aviation Safety Team (CAST) meeting, where he highlighted “a safety problem [NTSB] sees emerging from our accident investigations: failures of procedural compliance.” Procedural Compliance is on the NTSB’s Most Wanted list of critical transportation safety improvements for the current year. “During investigations,” Dr. Weener states, “we too often find that pilots have deviated from or failed to follow procedures related to flying stabilized approaches,… maintaining a sterile cockpit [environment], monitor[ing] critical flight parameters, including airspeeds, or heed[ing] aircraft limitations. Our investigations have discovered missed or incomplete preflight briefings, checklists and callouts.”

At the recent NBAA convention’s National Safety Forum, NTSB Chairman Chris Hart cited the investigation of a Gulfstream G-IV crash on May 31, 2014 at Bedford, Massachusetts that killed all seven aboard. Investigators blamed the crash on the crew’s attempt to take off with the control lock engaged. Analysis of the flight data recorder revealed the crew had not moved the flight controls through a pretakeoff control check in 173 of the 175 most recent flights. Clearly, this is an example of procedural noncompliance, according to Chairman Hart.

Although the NTSB’s focus on procedural compliance (and noncompliance) is targeted specifically at the airline and corporate aviation community, it has direct bearing on single-pilot operators as well. If the full-time professionals acting in two-person teams are failing to do things right (and therefore, to do the right thing), I suspect those of us flying without another pilot providing oversight are even more likely to deviate from standard operating procedures.


Standard Operating Procedures, or SOPs, are any routine and repeatable way to accomplish a task. SOPs naturally evolve for two main reasons:

They’re the simplest or quickest way to do something, and

They cover all the necessary tasks in the proper order, with little chance something is left out.

SOPs minimize workload and ensure that the results of our inputs are predictable. They ensure you both do things right and do the right thing.

Here’s an example of flying with an SOP. Flying a Model 58 Baron, I’m on vectors for an ILS approach. After briefing for the approach and setting up the cockpit, I reference an approach checklist I wrote to make sure I’ve not forgotten anything. Given the final vector to intercept the localizer inbound, I enter an “approach configuration”:

Manifold pressure: 16 inches

Propeller speed: 2500 rpm

Mixture: As required for field elevation

Flaps: Approach (15˚)

Airspeed: 120 knots indicated

Trim: Set

When the glideslope centers, I extend the gear and establish the proper pitch attitude and rate of descent to track the glideslope. Two outcomes result from using this SOP:

I don’t have to “make it up as I go,” so my workload is much lower, and I’m mentally freed up for the navigation tasks without having to work hard on basic aircraft control.

The resulting approach performance is extremely predictable, so I can quickly detect the effects of winds and turbulence and make minor changes to keep the needles centered. This sounds like a good way to fly an airplane: low workload, with high predictability.

You might do things differently. That’s fine, as long as you have some standard procedure. The technique will differ with different types of aircraft. The important point is to do things in a way that the airplane’s performance is very predictable. This lets you concentrate on the larger picture of navigation and situational awareness while flying an approach.

Middle-Of-The-Envelope Safety

You might say that a main function of standard operating procedures is to keep the airplane safely in the middle of the flight envelope. With rare exception, most of us never need to squeeze the maximum performance out of an airplane. A good set of SOPs, well used, should ensure a safe flight. For example, a fuel management SOP might include:

Confirm, through multiple means, fuel on board before takeoff.

Monitor fuel burn in flight, and regularly re-compute fuel remaining at the estimated time of arrival (ETA), and

Divert and land for fuel if that computed figure ever dips below one hour’s worth at cruise power.

A landing gear SOP might be to:

Extend retractable landing gear at the point you descend from or through traffic pattern altitude when flying a VFR traffic pattern.

Confirm through multiple means the proper extension of the landing gear, and

Re-confirm gear extension on short final, immediately going around if the gear cannot be confirmed to be down and locked.

If you follow these SOPs every time you won’t fall victim to a fuel exhaustion crash, and you won’t have a gear-up landing simply because you forgot to extend the wheels. Procedures like these keep you solidly in the middle of the airplane’s safe flying envelope.

Beyond Standardization

There are times, however, when you may need to fly closer to the edge of the flight envelope. Only by knowing what you must do to safely complete a flight task, and how the airplane predictably responds to changes in attitude, power and configuration, can you safely venture away from the safe, middle-of-the-envelope center. In other words, you can’t safely experiment with new ideas and new techniques unless you are very firmly grounded in the SOPs.

Here’s a real-world example: I’m flying that same Baron 58 into a busy airport, and controllers ask me to fly “best speed” to the outer marker … a very common request. My approach SOP won’t work because that’s too slow for the turbine traffic behind me. Ultimately, I want to transition to approach SOP before I reach decision height so I can make a normal landing and clear the runway as quickly as possible. Since gear extension is necessary under this SOP, and putting down the landing gear is the quickest way to decelerate, I pick a power setting that keeps me just under the Baron’s maximum gear extension speed in level flight. As I’m intercepting the glideslope, I’ll transition to the approach SOP and decelerate down the glideslope until I’m flying a normal approach. It meets the speed restriction and my safe-landing goals; I can accurately predict what the airplane will do, so it is not a huge increase in workload that might distract me from landing safely.

In other words, I use my knowledge of the airplane’s performance under SOP conditions to extrapolate what it’ll do if I change any of the variables. I then experiment with a new plan, adjusting my inputs if actual performance varies from expectations. In effect, I develop a technique “on the fly,” fine-tuning it on subsequent flights until it becomes a new SOP for use in this special circumstance.

Writing your SOPs

How can you go about developing a set of SOPs for the airplane(s) you’re flying? Start with:

Airplane checklists. Almost all airplanes have written normal, emergency and (in some types) abnormal procedures checklists in an Approved Flight Manual (AFM) or Pilots Operating Handbook (POH). These are the basis of a good set of SOPs for the actual operation of the airplane. There are several aftermarket sources for checklists for the most popular types of airplanes as well, often more detailed in some areas than those from the manufacturer.

Supplemental checklists. Most additions to the basic airplane – for example, autopilots and GPSs – have a POH supplement that contains additional checklists. Educational programs should give you ideas for customizing your operations. There’s nothing that says a specific checklist is mandatory, so most pilots eventually create their own SOPs that are a synthesis from POH, supplements and other sources.

Regulatory sources. Weather minima, fuel requirements, oxygen use and all manner of other decisions are made easier if you compare your alternatives to those you have under aviation regulations. Remember that most rules were written because of an accident, or the strong likelihood of a mishap.

Instructor and/or type club guidance. Ask the experts in your airplane type – often an owner’s group (“type club”) or a CFI or MEI experienced in your aircraft type – what they use as SOPs.

Your own experience. What works for you? As you gain experience and knowledge, you’ll undoubtedly update your personal SOPs to reflect your greater ability.

Your personal SOPs are a best-practices guide based on all available information. Follow them and you’ll avoid repeating the procedural noncompliance history the NTSB warns us about.

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