Despite the vast amount of work building the foundations of safe operations, aviation accidents still happen, and prior to many accidents and other safety-related events, there was unexpressed or ignored disquiet as the ‘last minute’ approached – the last minute being that time when there is no longer time for discussion or analysis, only ‘safety first’ action. This book aims at the assurance of better outcomes from these time-critical situations whose genesis lies in the time period immediately preceding the ‘last minute.’ This assurance of better outcomes can best be assured by enabling operational managers to adopt new paradigms, in the development of SOPs, building the right culture, and implementation of training programs relevant to good decision-making required as the ‘last minute’ approaches. This book examines the development of the foundations for aviation safety – the things that give foundational support for safety to pilots in particular, but over which line pilots may have little knowledge or day-to-day control. It provides a history of time-critical safety-related events, providing the foundation for the understanding of the reasons why pilot inactivity, indifference, fixation, and incapacitation can so pervade the lead up to the ‘last minute’ as to leave the safe continuation of the flight resting on prompt remedial action. The role of doubt, how it is expressed and how it is heard, is another central thread. Finally, the book addresses the role of flight data analysis as a valuable management tool. Written for aviation managers, line flight crews, and those in similar operational roles in aviation-related operations, this book and its informal discussion style should appeal and communicate across national, age, experience, and language boundaries to create a safer operational environment.
