It's not that no-one is aware of them.

I read at least two different sets of problems in this report. But first, some background. In the following paragraphs you can substitute "safety" with "quality" in every instance to get equivalent statements that might be more analogous to your experiences.

There is big letter "Safety Culture". This is what happens when you study emergent behavior that you want to replicate, and try to systematize it as much as possible. For excample - as noted in the report, "Safety Culture" consists of 5 pillars - this categorization is purely the result of research and analysis and post-hoc reasoning. The point of "Safety Culture" is that we noticed some organizations that have (little letters) "safety cultures" or "cultures of safety" which were able to achieve long-term excellence in terms of safety, and decided to study their common elements. A company "implements" a big letter "Safety Culture" in hopes of inoculating and maintaining an actual "safety culture".

A Safety Management System is a tool used to achieve and maintain the Safety Culture. For those not sure of what "X management system" means - it's basically a stack of documentation that defines a meta-process and processes that all of your other processes need to conform to, and by doing so, your employees will be forced into "doing the right thing", and aligning their actions and outputs with the goals of Safety Culture, and therefore eventually getting you an actual culture of safety.

In the worst case when you fail at actually sustaining a real safety culture, an SMS then becomes a tool to enforce a minimal standard of safety, from even the most apathetic employee. This comes at enourmous cost of course. Anyone who has had to wait for 3 different authorizations to get a replacement computer at work has witnessed an analogous situation.

Another point that's relevant is that the "Safety Culture" model that Boeing (and ICAO) is referencing is acutally quite young compared to Boeing's overall age. The Safety Culture references in the report are from 1997. The first edition of the ICAO Safety Management manual is from 2006. Boeing has been building safe plans for decades before these "new fangled" capital letter things have even existed. It's absolutely possible for an organization to build safe product without formalized adherence to the formalized "Safety Culture".

Back to problems identified in the report:

The first is that Boeing rolled out a new Safety Management System (SMS) in the last 5-8 years, along with adopting "Safety Culture" policies. But they seem to have blotched the roll out. The report notes that Boeing has its legacy policies and processes for dealing with safety, and those continue in parallel to the new policies and procedures defined in their SMS. They also noted that employees were skeptical of the sustainability of the SMS - ie, they were not sure if this was just some management fad. Many of the findings about "lack of knowledge" read exactly as I'd expect from someone who apathetically clicked through an online training module because they assumed it was useless fluff, because all the real work they've ever seen was handled through legacy processes. Note that a blotched roll out is not the predestined result, even in an environment which was previously lacking a real safety culture, or even middling management.

This is a problem, but could maybe be tolerable (from the perspective of short-term safety), except for the fact that it seemed that that legacy backbone has been rotting away in terms of its effectiveness. The dual system surely isn't helping with its effectiveness.

In other words, while this report focuses on Boeing's failure to achieve "big letter" Safety Culture, reading between the lines also implies a general lack of actual safety culture, and a lack of competent change management.