When we discuss the feasibility of team training in health care, many medical professionals insist that the aviation safety model can never be applied to the healthcare workplace. Why? Because those who work in hospitals and other health care institutions may never have never worked together before and the time constraints of much healthcare work makes teamwork difficult if not impossible.
Well, Patrick Mendenhall and I just had an experience, which shows how well strangers can create teamwork in a short of amount of time, if they have a good team leader and have rehearsed it in other settings.
On Wednesday April 24th, Patrick and I were guests on the Leonard Lopate show, on WNYC/NPR radio talking about our book Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety . Leonard Lopate has been a radio interviewer for 28 years and Patrick and I have had a lot of experience working with teamwork. As I sat in Leonard Lopate’s New York City Studio, Patrick was patched in from Tacoma, Washington and was thus a disembodied voice coming over the airwaves. Continue reading
One of the greatest accomplishments of the Aviation Safety Model (ASM), Crew Resource Management (CRM) has been the creation of what Schein and Bennis and Edmondson have called “psychological safety” in the airline industry. Moving from a culture that was characterized by the authoritarian (rather than authoritative) exercise of power, to one in which it is safe to tell someone — even someone higher up — that they have made or are about to make a mistake, was central to the creation of airline safety. As my co-authors airline pilot Patrick Mendenhall and medical educator Bonnie Blair O’Connor and I have written in our book Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety, creating a psychologically safe environment takes a lot of work — both initially and over time. Because of this work, aviation culture has moved, as former Vice Chairman of the National Transportation Safety Board Robert T. Francis has described it from a culture in which the captain would convey, implicitly or explicitly that “I’m captain, I’m king. Don’t do anything! Don’t say anything! Don’t touch anything! Shut up!” to a culture where the message is “I’m captain, I’m king, please tell me if you see me making a mistake!” Continue reading