Is the Aviation Model Overplayed in Healthcare?
On August 5, the Sorry Works! Blog and linked in posted an offering asking “Aviation and Medical Errors…This Hand Being Overplayed?” The author, wrote that, “I seriously wonder if the whole approach of comparing/contrasting aviation safety versus medical safety is being overplayed and will have detrimental consequences? I worry how many docs and nurses are tired of hearing how wonderful pilots are and become jaded or resistant to all patient safety initiatives?…
These different fields are dealing with different “input.”
When “Sully” entered a cockpit he was always taking control of a ship that was expertly maintained by highly skilled mechanics. When a doctor gets a patient in his/her care, the ship isn’t always in the greatest shape because the mechanics – us – don’t eat right, don’t exercise enough, smoke and drink too much, don’t listen to doctor’s orders, etc, etc. I recently got myself into trouble with some patient safety advocates by suggesting there are “bad patients” and “bad families.” Never mind that these same patient safety advocates freely labeled doctors and nurses as “bad,” “sloppy,” “arrogant,” etc…how dare I say some patients and families are not so good?!? Again, medicine has different “input” versus aviation.
The fact that people who work in healthcare are flying the patient equivalent of broken planes (i.e. sick patients) only makes learning all of this more important, not less.
One of the barriers to patient safety is an attitude that argues that those in healthcare don’t have anything to learn from other industries because healthcare is so so different. Of course it is. That’s not the point. We all can learn from safety methodology no matter where it originates or in what setting it is successfully utilized. When I hear healthcare professionals insist that the aviation model is not relevant to healthcare because healthcare is so much more complex, I worry about the implicit competitiveness here. I don’t want to speak for Captain Sullenberger, who was kind enough to write the foreword for our book, but I think I am safe in saying that the first thought that entered his mind in the 3 minutes and 28 seconds he had to land his plane in the Hudson was not, “Oh, God, this could be so much worse. I could be a neurosurgeon.’
When recommending learning from the aviation safety model, no one is saying that pilots and flight attendants are so much better than physicians or nurses. They are not, which is why they are trained in safety methodologies over and over again throughout their entire careers. This recurrent teaching reminds them and us that they are fallible human beings who can and do make mistakes and thus need to learn everything they can in order to keep everyone safe.