A Story About Teamwork in Aviation

Last Tuesday, I took a United Airlines flight from San Francisco to Philadelphia.  It was a beautiful day and happily the flight was on time, boarded smoothly, and the doors closed and we were ready to go.  Then a surprising thing happened.  Just before leaving and before the safety announcement, the captain came out of the cockpit, stood at the front of the plane where everyone could see him (it was a pretty small plane), took the PA and welcomed us to the flight.  He told us it looked like we’d have good weather and smoothe flying the whole way and that we should be on time.  Then he left and went into the usual cockpit lock down.

Everyone around me, including my fellow seat mates, looked at one another.  “That’s really unusual,” people commented.  “Is this personal welcome, in full view, from the captain a new United policy?” we all wondered.  We, of course, had no idea, but we were all quite pleased to get this pleasant introduction to the flight from the guy in charge. 

When we taxied out to the run way for take off, we heard from the captain again.  This time the news was equivocal.  He informed us that we had to wait for take-off until the computer digested material about the weight of the bags etc and that he hoped all would be well but wasn’t entirely sure it would be.  “Great!” we all thought, we hope so too.  A few minutes later, back he came to tell us the news was not good.  Turned out someone had put the bags in incorrectly and the weight was not properly distributed, which messed up the center of gravity of the aircraft, which was a safety hazard.  We would have to go back to the gate and check it out.  This was definitely not good news and was, not surprisingly, greeted by a collective groan.

Taxi back we did and when we got back to the gate, the flight attendants asked us to please remain on the plane and told us we would be notified of what was going on. After they spoke, the captain again came out of the cockpit, took the PA and personally told us that he hoped this would not be serious problem and repeated the flight attendants request that we stay on the plane. He also invited anyone who wanted to to come visit the cockpit.  This was now the fourth time we had personally heard from the captain updating us on the status of the flight.

Of course, I jumped at the chance to visit the cockpit.  As I was passing through the first class cabin,  I overheard the captain talking to a first class customer who was complaining about delays.  The captain was utterly unflappable and did everything just right.  He acknowledged the passenger’s frustration and then reminded him about how many flights take off and land each and everyday and how few problems there are.  Having just spent the prior day in a tower at San Francisco International airport filming a video about our new book Beyond the Checklist: What Else Health Care Can Learn from Aviation Safety and Teamwork, I added my voice to the captain’s.  It was amazing watching flight after flight land or take off in a perfectly orchestrated ballet.  I also repeated to myself a mantra I have learned from my pilot and flight attendant friends.  “It’s better being down here worrying about being up there, then being up there worrying about being down here.”

I then went into the cockpit and chatted with the first officer, told him about my work in aviation and healthcare he told me his wife was a nurse.  We chatted briefly about Crew Resource Management (CRM) training and healthcare and then the captain came in and evicted me from his seat because things had checked out and we were ready to go.  The flight proved to be, after this glitch, a smooth one, just as he predicted, and we landed only a half hour late.

What was so impressive about this flight was the captain’s leadership style. Not only was he charming, accessible, and constantly updating us, so was the crew.  Everyone seemed to be in a good mood, in spite of the delay.  I don’t believe this was a coincidence — a matter of a crew made up only of good apples.  I believe it had to do with years of the teamwork/communication training that this captain had gone through he gone through at United Airlines (training which is a Federal Aviation Administration requirement for all commercial airlines).  Yes, he was clearly an experienced pilot.  Perhaps he was unusual in the extent to which he communicated, but I know his actions were the result of years of work and practice.  He included everyone on the team, which meant not only flight attendants but also passengers. What it produced was a group of people who weren’t just frustrated and furious but who were in the loop.  He was calm and so were we.  When we landed in Philadelphia, there he was again next to the flight attendants at the door of the aircraft, wishing us goodbye and apologizing for the delay.

While all this was going on, I could only think about the contrast with healthcare.  The rule in healthcare is not information sharing with all involved.  The rule in healthcare is not constant updates by the head of the team.  Nor is it acknowledging the frustrations of the patients and family members.  As for apologies when something goes wrong?  When was the last time, you got one?

This captain was amazing.  There was nothing touchy feeley about him.  He was clearly in charge — the king of his realm if you will.  But he was a totally different kind of king and his relationship to his subjects had been  totally transformed by years of training in the aviation safety model.  I don’t know if there were any doctors or health care administrators on board, but I wish someone could have filmed this guy because this is precisely the kind of behavior we need from those in charge in healthcare.  It’s a behavior that can be learned.

His name was Captain Jim Leech and I hope he reads this. Thank you for a fabulous flight!