How to Perform an Investigation in Aviation SMS

The Essence of Performing an Investigation

In aviation’s high-stakes arena, where precision is paramount, performing an investigation is your forensic scalpel, slicing through the chaos of an incident to reveal its core truths. It’s a disciplined, systematic process, anchored in ICAO Doc 9859 and FAA AC 120-92B, that dissects hazards, near-misses, or incidents—think runway incursions or maintenance oversights—to pinpoint root causes and prevent recurrence. Whether you’re a new safety manager analyzing a hazard report or an accountable executive ensuring ICAO Annex 19 and FAA Part 5 compliance, an investigation is your strategic tool to transform risks into resilience for airlines, airports, and MROs.

Imagine a safety manager sifting through data after a near-miss, not to cast blame, but to forge a shield against future threats. That’s the essence of an SMS investigation—a relentless pursuit of truth that strengthens your operation with every insight uncovered.

Why Performing Investigations Matters

The Engine of Risk Management

An investigation is the dynamo of your SMS, converting incidents into actionable intelligence that drives continuous improvement. It’s your cornerstone for compliance, your catalyst for a robust safety culture, and your weapon against risks. Without a rigorous investigation process, your SMS is a house of cards; with it, it’s an impregnable fortress. Here’s why it’s non-negotiable:

• Lock in Compliance: Investigations align with SMS manual requirements, slashing audit findings by 75%, per 2025 industry data.
• Neutralize Risks: Root cause analysis reduces repeat incidents by 85%, as seen in a 2024 North American MRO’s SMS.
• Elevate Culture: Transparent processes boost safety culture engagement by 80%, per SMS Pro’s metrics, encouraging hazard reporting.
• Fuel Improvement: Findings feed lessons learned and safety cases, enhancing safety assurance.
• Build Credibility: Thorough investigations signal to regulators like EASA or CAA that safety is your bedrock.

Performing an investigation isn’t just a task—it’s your SMS’s crucible, forging resilience from the ashes of incidents.

Step-by-Step: Performing an Investigation

A Masterclass Process

Performing an aviation SMS investigation is a precise, data-driven process, documented in 300–500 words, that delivers actionable outcomes for audits and safety cases. Here’s your masterclass blueprint, aligned with ICAO and FAA standards:

• Step 1: Initiate the Investigation: Triggered by a hazard or incident, define scope using SMS goals.
• Step 2: Assemble the Team: Include safety managers, vendors, and frontline staff, per accountability frameworks.
• Step 3: Collect Evidence: Gather logs, interviews, and training records from SMS databases.
• Step 4: Analyze Root Causes: Use Bowtie analysis, 5 Whys, or risk matrices to pinpoint causes.
• Step 5: Develop Actions: Propose corrective actions and preventive measures, tracked via KPIs.
• Step 6: Document and Share: Record in lessons learned libraries and share via newsletters.

Each step is rigorous, ensuring findings are actionable for regulators or executives.

Real-World Impact

Investigations That Redefined Safety

In 2025, a European airline investigated a taxiway near-miss, using Bowtie analysis to uncover signage confusion. Their corrective actions—updated signage and training—cut incursions by 75%, bolstering a safety case that impressed EASA. In North America, an airport’s investigation into a fuel spill, integrating vendor data, led to a 80% reduction in spills after new protocols. A safety manager said, “Our investigations are our superpower—they turn risks into triumphs.” These cases prove investigations are the lifeblood of SMS excellence.

Best Practices for Investigations

Elevating Your Process

Want investigations that set the standard? Here’s your strategic playbook:

• Act Swiftly: Start within 24 hours of an incident to preserve data, per emergency response plans.
• Engage Stakeholders: Involve accountable teams and vendors for diverse perspectives.
• Use Robust Tools: Leverage audit software and predictive analytics for precision.
• Focus on Causes: Prioritize root causes over symptoms, using hazard identification.
• Track Outcomes: Monitor control effectiveness and leading indicators.
• Promote Transparency: Share via communications and read files to build trust.

For advanced tactics, explore our safety culture guide, manager strategies, risk mitigation tactics, or four pillars overview.