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AEROSPACE REPORT NUMBER: TOR-2011(8591)-19, FAILURE REVIEW BOARD (FRB) GUIDANCE DOCUMENT (10-JUN-2011)., There is a significant benefit to having consistent Failure Review Boards (FRB) and processes across the space enterprise. Strong root cause determination and strong remedial actions that address the specific failure cause, other corrective and preventive actions to mitigate the likelihood of similar failures, as well as a common baseline failure review process and expectations benefit the entire industry base. Wide variability in the conduct of FRB activities across the space enterprise, in particular a lack of effective root cause determination and follow on corrective/preventive action implementation, has been a continuing concern that this guidebook is intended to help mitigate. A successful FRB depends upon several factors including a comprehensive, structured, effectively managed and well-documented investigative approach. A multi-discipline team composed of representatives from different organizations has developed the following industry best practices to provide guidance to the practice of conducting consistent and successful FRBs. While the desired, successful outcome of a failure investigation and FRB process is the conclusive determination of root cause and the implementation of effective and lasting corrective action, this guidebook also addresses the realities of complex system failures and technical/programmatic constraints in the event root cause is not determined.



06-2011982.52 KB TOR-2011-8591-19

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