The Antidote

Counterspin for Health Care and Health News

Friday, January 12, 2007

Lessons for health care from aviation

Interesting article in today's Washington Post about the 1982 Air Florida crash into the 14th Street bridge over the Potomac and its legacy, focusing on the lack of communication among crew members and subsequent reforms to aviation training.
Though some of the lessons may seem simple, such as communication and management skills, it helped break down an authoritarian cockpit culture dominated by captains. Over time, the principles learned from the disaster gradually migrated to other modes of transportation and into businesses, even hospitals.
"Even hospitals." Really? If this ethos of safety has moved into operating rooms, as described by the author, I'd like to know how widespread it really is; it also needs to go way beyond the surgical arena.

The story makes me wonder, or more accurately dread, what kind of equivalent event it will take to shake the foundations of the health care industry and bring safety to a similar level of concern. The body count in health care is a lot higher than that in aviation, but perhaps because incidents are so spread out, they just don't strike us in aggregate as catastrophic in the same way that plane crashes do.

2 Comments:

At 1:03 PM, Blogger Flightfire said...

It may just be my aviation background, but I am constantly comparing aviation and medicine. They are vastly different but also eerily similar. They are both complicated, life-endangering tasks, and both have a lot of ego associated with them due to this fact. Aviation has done a good job of eliminating a lot of human error with standardized procedures and crosschecking. This is something I'd like to see happen in medicine, but I think it will be much more difficult to implement. Diagnostic medicine deals with many more unknowns than aviation. Unfortunately, the human body doesn't behave predictably like an aircraft. The body is a vastly more complicated machine.

There are some areas that I think could benefit from a more standardized team approach. Some surgeries, drug prescriptions, cardiac procedures, anesthesia, ect, are all things that could benefit by another set of educated eyes checking the work. It would be nice if we could apply these systems to diagnostic medicine as well, but I don't really know if that is feasible.

 
At 9:36 AM, Blogger Emily DeVoto, Ph.D., said...

Thanks for your great comment, Flightfire. I agree with you that diagnostic medicine may not be adaptable to aviation-type checking and cross-checking, though team approaches are traditional. I'm thinking not only of House, MD, but the New England Journal's weekly cases feature (forget what it's called).

 

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