Monday, August 20, 2007

NASA learns to avoid its worst practices in safety

The New York Times today includes an article on how the NASA culture has changed since the Columbia disaster of 2003. By dissecting how the agency has approached the tile-damage problem with the Endeavor shuttle, reporter Kenneth Chang shows how thoroughly studying and understanding what went wrong with Columbia has led to better practices and, more profoundly, an improved "safety culture." An excerpt:


For both the Columbia and the Endeavour, the falling foam did not initially worry mission managers. The day after the Endeavour’s liftoff, John Shannon, chairman of the mission management team, said that three small pieces of foam might have hit, but “nothing significant.”

What changed in the last four years is how NASA managers handle an event they do not consider serious. Michael D. Griffin, the NASA administrator, said he and managers listened to all of the data before making decisions.

In order to get at that data, mission engineers took many steps to examine the damage, including having the shuttle perform a back flip to get a good photograph of the damaged area. Maybe most importantly, the NASA culture had begun to change since Columbia, with one shift being that "senior managers began to make sure that dissenting voices could be heard." Writes Chang in the Times article:

John Allmen, program manager for shuttle support at the NASA Ames Research Center, said the pre-Columbia culture of NASA was sometimes intimidating for an engineer to bring up a concern. “The general culture was that, ‘What are you talking about? Prove to me it will fail,’ ” he said.

Arrogance and confidence in one's own abilities must take a back seat to humility and openness to the opinions of others, especially when people's lives are on the line. It's probably not unexpected that NASA, the product of the "Right Stuff" test pilot and Mercury program culture, would be late to the game when it comes to carefully examining its own mistakes and addressing the root causes. But at least they appear to have made that change now.

UPDATE 21 August 2007: The shuttle lands safely.

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