Hospitals Learn About Safety From Airlines?

Major U$.$S$.$ passenger airlines have forged a phenomenal safety record largely by relying on pilots, controllers and mechanics to voluntarily report incipient hazards. Analyzing such incident data and then disseminating lessons from it has meant more than a decade without a fatal crash.

Over the same period, the country's healthcare system has tried to mimic some of these air$-$safety principles, but it has made scant progress in eliminating deadly treatment errors. This makes it the fourth leading cause of medical fatalities after cancer, heart disease and Covid$-19.$ Determined to do better, healthcare leaders are now doubling down on aviation's lead.

The heart of the idea is prodding doctors and hospitals to share more digital data and wholeheartedly embrace self$-$reporting of their potentially deadly "near misses," the way that pilots already do without fear of punishment. But as long as hospital equipment isn't designed to guard against human slip$-$ups, as jetliner cockpits are, $"$it will be far too easy to crash the plane in healthcare," says one hospital Chief Quality Officer.

One obstacle is that financial incentives for hospitals are still not aligned around quality and safety. Typical billing practices track the number and complexity of procedures instead of the outcomes. Information sharing in healthcare is pitiful compared to aviation. When medical errors are reported, it's usually well after the fact, and information usually stays within the organization.

One element of air safety that has already made big inroads in medicine is reliance on checklists, in large part thanks to Dr$.$ Atul Gawande's bestselling book "The Checklist Manifesto."

Hospitals in South Carolina that completed a statewide program to implement the WHO's Surgical Safety Checklist had a $22\%$ reduction in post$-$surgical deaths. The study is one of the first to show a large$-$scale impact of the checklist on the general population.

Surgical care requires careful coordination of a variety of skilled health$-$care providers in a complex infrastructure using specialized tools. "Safety checklists are not a piece of paper that somehow magically protect patients, but rather they are a tool to help change practice, to foster a specific type of behavior in communication, to change implicit communication to explicit in order to create a culture where speaking up is permitted and encouraged and to create an environment where information is shared between all members of the team," said the Harvard Medical School professor directing the study.

Source: The Wall Street Joumal $($Sept$.4-5,2021).$

Critical Thinking Questions

Errors in treating patients in the U$.$S$.$ healthcare system

A$.$ are among the leading causes of deaths, following the flu, heart cancer and drug abuse.

B$.$ cause more deaths than all other reasons besides COVID, cancer, and heart disease.

C$.$ have forced doctors to acknowledge their mistakes publicly.

D$.$ result from using airline checklists.

E$.$ are simply impossible to reduce.