Full Report (PDF)

Executive Summary

In early 2007, an incident involving former astronaut, Lisa Nowak, led NASA to conduct several reviews including internal and external evaluations of astronaut behavioral health and medical care. The internal NASA review, led by Johnson Space Center (JSC), focused on two elements: 1) current astronaut behavioral medicine practices and 2) a review of relevant records and information to determine whether any leading indicators that could have averted the incident were missed. The external review, conducted by the NASA Astronaut Health Care System Review Committee (comprised of external experts from the behavioral health and aerospace medical communities), focused on space medicine operations at JSC.

Purpose and Methodology

In response to findings of both the internal JSC review and NASA Astronaut Health Care Committee, JSC decided to gather additional data. JSC collected information directly from astronauts and flight surgeons through an anonymous survey, to understand if changes in current policies or procedures are needed. Based on findings of the two previous reviews, the survey focused on these four key areas:

• the relationship between astronauts and flight surgeons as defined by openness of communication, level of trust, and understanding of safety responsibilities;
• concerns with raising and responding to issues of flight safety and/or crew suitability for flight;
• knowledge and implementation of policies and procedures detailing astronaut performance and crew assignment;
• knowledge and implementation of space flight alcohol policy and determination if there was personal knowledge of a United States astronaut, on launch day, presenting a risk to flight safety due to alcohol use.

From August to December 2007, the survey was developed, deployed, and analyzed through a deliberate and rigorous process (employing both internal specialists and external academic experts) to ensure the assessment was valid and reflective of the unique organizational context in which astronauts and flight surgeons work. All aspects of the assessment were designed to provide diagnostic results to assist in understanding the strengths and weaknesses of the organizational policies and procedures relative to the focal areas identified. This report will be used to develop specific action plans to address any needed changes.

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