Horizon Air article about pilot safety culture

DE727UPS

Well-Known Member

In an urgent internal message on the eve of Thanksgiving, Horizon Air’s head of flight operations warned that a lax safety culture among the airline’s pilots had led to multiple potentially dangerous incidents in recent days. He called for urgent action to prevent a serious air accident.

“We should be very uncomfortable with what has happened over the past two days,” wrote captain John Hornibrook, Horizon Air’s vice president of flight operations, in a Nov. 27 email message to handful of top managers and pilot leaders. “If we sit back and do nothing, we will have an accident. Nothing good can come of the trajectory we are currently on.”

“We do need to use the past 48 hours as a (wake-up) call before we have a more serious event,” added Hornibrook, who oversees about 800 pilots flying to more than 45 cities for the regional airline owned by Seattle-based Alaska Air Group. “The leadership team needs to get the pilots heads in the game before we have an accident.”

The incidents Hornibrook listed ranged from pilots going over the airspeed limits to aircraft approaching a stall, and also included weather-induced threats that perhaps could have been avoided.

Though the email suggests some alarm about pilot safety standards, in an interview Wednesday both Hornibrook and Horizon president Joe Sprague downplayed its significance and declared it a sign of Horizon’s high safety standards.

“The memo was meant to respond to the spike we saw in irregular events,” said Hornibrook. “I’m not sitting back and waiting for something bigger … I wanted everybody to take a pause, take a hard look at what was going on, refocus, and get back to the Safety First philosophy.”

Sprague added that “a safe airline recognizes a spike and takes proactive action.”

“That’s a positive from a safety culture standpoint,” he said. “Horizon is a safe airline. This internal communication was a good sign of that.”

In contrast, a Horizon pilot — who declined to be identified out of fear of losing his job — said he thought the memo was “incredibly melodramatic” and evidence of a disconnect between Horizon management and its pilot cadre.



A litany of safety incidents


Horizon Air pilots fly Bombardier Q400 turboprops and Embraer E175 jets on routes that link smaller cities into a feeder network for Alaska Airlines.

The only serious accident in the airline’s passenger service was in 1988, when a De Havilland Canada DHC-8 — a precursor model to the Q400 — crash-landed at Seattle-Tacoma International Airport after an engine fire. Four passengers suffered serious injuries.

In Dec. 2017, another Horizon Q400 inadvertently landed on a taxiway instead of the runway at Pullman in eastern Washington. The taxiway was unoccupied and the aircraft rolled out without further incident.

The only fatality on one of Horizon’s planes came in August 2018 when one of the airline’s ground-crew employees, Richard Russell, stole a Q400, then crashed the plane into a wooded area of Ketron Island in south Puget Sound, killing himself.

In 2017, a major pilot shortage at Horizon caused hundreds of flight cancellations. In response, Horizon raised pay, added signing bonuses and boosted recruitment. Since then, there’s been an influx of new, young pilots.

As major U.S. airlines have begun to expand rapidly since then, more experienced pilots have jumped to those much higher-paying jobs. As a result, all regional airlines are finding it harder to hold onto experienced pilots. This year, 90 longer-serving pilots have upgraded from Horizon to Alaska Airlines.

An Alaska Airlines pilot who moved up from Horizon said that while the vast majority of the pilots hired are very professional, Horizon has been forced by the shortage and the competition for pilots to recruit people with only the minimum flying experience. “They are hiring people they would not have hired 10 years ago,” he said.

Sprague said that Horizon’s pilots have average experience of about 3,000 flight hours, twice the minimum required by the FAA to fly for an airline. The average time for Horizon captains who command aircraft is more than 4,000 flight hours, he said. They are “a very professional group of qualified pilots,” he said.

Still, Hornibrook’s email cited the two days before Thanksgiving as “the most difficult 48-hour period I have seen in my tenure with Horizon Air” and listed a series of safety-related incidents.

One aircraft had exceeded its maximum operating speed. Another had exceeded the maximum speed allowed with the wing flaps deployed. Exceeding those speeds for an extended period would stress and damage the airframe.

“We have set speed limits of 10 knots below any maximum speed and this rule needs to be followed,” Hornibrook wrote.

He wrote that pilots need to be reminded that anytime the pilot flying the plane lowers the flaps or the landing gear, the co-pilot must say “speed check” to ensure such a check is done. And he urged his team to remind pilots of the speed limitations, particularly coming in on the Q400 turboprop airplanes at an altitude of around 8,000 feet when speed is supposed to drop in case of bird strikes.

In other incidents he cited, two pilots had experienced “stick shakers,” a noisy vibration of the control column that warns pilots the plane is close to a stall.

And one flight out of Paine Field in Everett had discovered a 4.5-ton discrepancy in weight after take-off. Pilots must enter the total weight of their aircraft — including passengers and luggage — into the flight control computer before take-off because the weight affects the plane’s performance. It determines, for example, how quickly the plane could climb away if the pilot had to abort a landing at the last minute or how much runway it will need to come to a stop.

“Thank god this airplane was 9000 pounds under weight and not the other way around,” Hornibrook wrote.


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AdvertisIn addition, in the same two days, pilots had failed to avoid dangerous weather. One flew into severe turbulence near Palm Springs and two more aircraft were hit by lightning strikes. Hornibrook ended his litany of safety incidents by noting that one passenger was transported to the hospital after falling on the ramp in Spokane.

“We have a problem. Most of these mistakes could have been prevented if our crews would have followed process,” Hornibrook wrote, adding that stick shakers and excessive speed “are caused by the pilot’s lack of attention to the state of the aircraft.”



Penalizing pilots


Apologizing for sending out such a downbeat message the day before Thanksgiving, Hornibrook said the situation was dire enough that he didn’t feel it could wait until a mandatory meeting already scheduled for Dec. 9 “on safety and the current culture of our pilot group.”

The Horizon Air pilot who spoke anonymously said he and his peers work hard to fly the planes according to procedures and with “good airmanship.” He said standards are high enough that about 5-to-10% of those inducted into Horizon’s training program flunk out and never become line pilots.

And he said none of the incidents listed by Hornibrook “struck me as on the precipice of a disaster.”

He said no pilot would intentionally fly into severe turbulence or lightning and that most such encounters are not the fault of the pilot.

And he said pilots provide only some of the data for the calculation of the plane’s weight. They have little control over other input supplied by flight attendants and baggage handlers, with no ability to cross-check the final number that’s sent to them electronically.

The pilot also questioned Hornibrook’s citing of incidents of excessive speed, saying that slight overspeeds for short periods are not uncommon and not very significant. He said Horizon changed its policy so that any pilot exceeding 10 knots below the posted limit is now penalized, even though a gust of wind or wake turbulence could easily increase air speed by more than 10 knots and lead to a momentary overspeed.

“You cannot start penalizing pilots for flying the aircraft in a normal state,” the pilot said.

A veteran captain with Alaska Airlines backed up the Horizon pilot’s account. He said airplane manufacturers have built in a margin of around 15 knots beyond the posted limit, and that going a few knots over the posted limit for a few seconds “happens routinely and is in general not a big deal.”

When it does happen, never intentionally, the relevant overspeed data has to be reported after landing, and the maintenance technicians then take a look. Usually, depending on the altitude and flight condition when the speed passed the limit, no action is needed, the Alaska captain said.

On the evidence of Hornibrook’s memo however, Horizon management is feeling the need to tighten control over pilot performance.

He urged the pilot leadership team to sit in the jumpseat whenever possible when flying Horizon so they could point out to the flight crew any mistakes and “remind the pilots to strictly adhere to procedures.”

“Our pilot group needs to be more professional and this team needs to hold the pilots accountable,” Hornibrook wrote. “I am concerned we continue to make these mistakes as a group.”

Dominic Gates: 206-464-2963 or dgates@seattletimes.com; on Twitter: @dominicgates.
 
So instead of changing potentially systemic issues with regard to flying airplanes, we are wanting pilot leadership to sit in the jumpseat and point out crew mistakes? WTF planet are we on....

I will flat out blame AAG's culture for the issues that the VP of flight ops points out. I don't work for, nor have I ever worked for Horizon, but working for the mothership, it is evident that they are far more concerned about the Excel spreadsheet and that is pushed and often threatened by management, gate agents and ground crew.

This airspeed thing is quite odd. On one hand, I have never busted an airframe limitation grossly. In the Bus it is procedure to add flaps 10kts below vFE next. Not to say flap overspeed events don't happen, or other overspeed events don't occur but to punish pilots for stuff like that without considering context or conditions, is very odd.
 
I will flat out blame AAG's culture for the issues that the VP of flight ops points out.

Really? That can only reach so far. Management and leadership set the tone and culture, decide who gets hired, when discipline must be handed down.

At the end of the day, it’s the professional line pilot who flies standard — the real standard and not Joe’s, Mike’s, or Karen’s way — and stays in the moment and focused on the task at hand. That professional wouldn’t need a jump seater to pick nits.
 
In the Q SOP was to fly Vmo-5 a lot which of course results in the clacker a lot, which is no big deal because the FSM doesn't even require a writeup unless you exceed it by 6kts above 10k or 20kts (!) below 10k.
 
Vmo -10, all phases and any overspeed = write up, period

if you’re in the training dept, you get one freeby...that’s it. If you want to be in the training dept, you best not have had one in the past year.

One of the issues I had with this was a few arrivals into PDX and SEA had published speeds that would put us pretty close to that red bar. So I would brief anticipating the bar dropping and slow it down prior to the fix at times, as beyond that fix the vpath would change and sometimes kicking into VS was the only way to save an over speed if you didn’t slow it early.

After the emphasis on overspeeds that particular arrival and Seattle saying “keep the speed up” would make me a bit nervous. The only reason for the drop in the red bar was better likelihood of a bird strike and it was usually around 8500 at 235ish if I can remember. So being 230 at a fix below that just became a known risk that some would still try, but I never did because it didn’t take long especially in some chop for that bar to creep down. Then they amended the book saying -10 at all times, this made it hard to comply with that particular arrival and even with our type 1 climb (which I think later changed as well)
 
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From a procedural standpoint, what's the point of a limitation that's not a limitation?
It's a bandaid, basically. Flap/Gear overspeeds...well, we need a "Speed Checked" call to fix that! More talking always solves issues.

The Q400 has an AWFUL airspeed indicator...it barely met certification standards (FAA Flight Check pilot that flew the Q4 during our RNP certification said "I can't believe we certified that POS"). Bombardier didn't certify the Q400 with the windshield heat on, at all times...so at 8600', the high speed cue goes from about 260KIAS to 245KIAS, for bird strike protection.

You mix that in with low experience levels and you get overspeeds. Those used to not be an issue...but with new management team who's mantra is "Well at Alaska...", and you see where we are today.
 
From a procedural standpoint, what's the point of a limitation that's not a limitation?
From a flying standpoint, what's the point of not flying the plane according to the AFM? Sheesh, this stuff really isn't that complicated. All the local custom hocus-pocus seems rather counterproductive and confusion inducing. It's an airplane, fly it accordingly.
 
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