Can medicine learn from aviation?
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Can medicine learn from aviation?
Hi, I hope this is right forum...
I'm interested in the views of aviation experts about what medicine/ healthcare can learn from aviation in order to improve patient safety.
Thanks DH
I'm interested in the views of aviation experts about what medicine/ healthcare can learn from aviation in order to improve patient safety.
Thanks DH
Last edited by dochealth; 14th Mar 2010 at 20:45. Reason: Spelling
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A number of threads have canvassed this topic and there are various publications in the public domain on similar matters. Suggest a search both in PPRuNe and on the net, generally. If you are in the field, then your professional sources should have many references.
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dochealth as a Pu I do not consider myself an aviation expert. As a registered nurse qualified for many years I do not consider myself a healthcare expert either. I do however have insight into both fields 
Medicine and aviation are very simular in their application to safety of the "service users". We both do an excellent job......most of the time.
We could both however be a little more proactive. In the NHS we "learn lessons" as a result of something nasty happening and we then change policies and procedures. In aviation we do the same.
beachbumflyer we do have checklists in the OR...swab counts,instrument counts and they are the minimum. My duty period as an RN are below what they are for a Pilot yet we both potentially hold lives in our hands.
Maybe aviation could learn from medicine here?
Medicine and aviation are very simular in their application to safety of the "service users". We both do an excellent job......most of the time.
We could both however be a little more proactive. In the NHS we "learn lessons" as a result of something nasty happening and we then change policies and procedures. In aviation we do the same.
beachbumflyer we do have checklists in the OR...swab counts,instrument counts and they are the minimum. My duty period as an RN are below what they are for a Pilot yet we both potentially hold lives in our hands.
Maybe aviation could learn from medicine here?
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Do doctors and nurses have regular, rigorous proficiency checks like pilots and air traffic controllers? It has always baffled me how doctors retain such a huge amount of information in their heads - considerably more than I had to as a controller.
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Rene Alemberti (France) and Chappell, Weigmann, Merritt and others (US) have expanded their investigations of human decision making/error management from aviation to medicine.
If you need specific citations, drop me a PM and I'll see what I can do.
J.
If you need specific citations, drop me a PM and I'll see what I can do.
J.
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I have long been interested in this topic. Here in the states, I know of a few firms that are trying to institute SMS’s into the medical field using proven aviation safety programs.
I have more than a passing interest in this subject. I recently entered a hospital after a fall off my bike for a hip replacement. I was put in a virtual coma for 12 days due to prescription drug interactions. I obtained my full medical record and was appalled at the lack of procedure, oversight, etc., that we have all become accustomed to in the aviation world.
Climb into the cockpit of (for example) a B-757 anywhere in the free world, and it will be operated in essentially the same manner.
At least in the U.S., enter a hospital, and you have entered the world of fiefdoms. Every one has different procedures, protocols, and quality of care.
Safety is cost effective in aviation....it would be in medicine also.
I have more than a passing interest in this subject. I recently entered a hospital after a fall off my bike for a hip replacement. I was put in a virtual coma for 12 days due to prescription drug interactions. I obtained my full medical record and was appalled at the lack of procedure, oversight, etc., that we have all become accustomed to in the aviation world.
Climb into the cockpit of (for example) a B-757 anywhere in the free world, and it will be operated in essentially the same manner.
At least in the U.S., enter a hospital, and you have entered the world of fiefdoms. Every one has different procedures, protocols, and quality of care.
Safety is cost effective in aviation....it would be in medicine also.
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HeathrowDirector good question re the checks. The answer is basically our checks are nowhere near as vigourous as those of a Pilot....and they should be.
Senior Surgeons have to submit their mortality stats on a regular basis. If these make for a grim read then Trusts start suspending operations in that field until investigated. Thank God we don't have the same approach in aviation
As for their Senior Physician colleagues and all grades in between I've no idea what pases for clinical supervision. Junior Docs practice their practical procedures on live patients under the supervision of a Registrar. When somebody last checked the Registrars competence I wouldn't know.
For me as a Nurse? Well I have to sign a form every 3 years that says I've completed 450 hours of clinical placements and 35 hours study/training relevant to my field. Nobody ever checks this out....it relies on my integrity.
Shoreguy in the UK at least you would not be allowed to take up a bed for 12 days post op hip replacement. We need the beds and your stay is free over here
Finances may have made a difference to your experience. If you were a straightforward hip replacement I cannot think of any prescription drugs you would need that would literally keep you on your back and unconscious for 12 days
Over here you are up on day 2 following post op X ray as we want to clear the bed for the next punter. In the US they may just want your money for a 12 day stay and who knows you may develope a DVT or chest infection that needs treating......
As for universal protocols well over here at least we could certainly do better. We could learn from aviation in this respect.
Senior Surgeons have to submit their mortality stats on a regular basis. If these make for a grim read then Trusts start suspending operations in that field until investigated. Thank God we don't have the same approach in aviation
As for their Senior Physician colleagues and all grades in between I've no idea what pases for clinical supervision. Junior Docs practice their practical procedures on live patients under the supervision of a Registrar. When somebody last checked the Registrars competence I wouldn't know.
For me as a Nurse? Well I have to sign a form every 3 years that says I've completed 450 hours of clinical placements and 35 hours study/training relevant to my field. Nobody ever checks this out....it relies on my integrity.
Shoreguy in the UK at least you would not be allowed to take up a bed for 12 days post op hip replacement. We need the beds and your stay is free over here
Finances may have made a difference to your experience. If you were a straightforward hip replacement I cannot think of any prescription drugs you would need that would literally keep you on your back and unconscious for 12 days
Over here you are up on day 2 following post op X ray as we want to clear the bed for the next punter. In the US they may just want your money for a 12 day stay and who knows you may develope a DVT or chest infection that needs treating......
As for universal protocols well over here at least we could certainly do better. We could learn from aviation in this respect.
To answer the posters question, they already are.
I was speaking to a chap who is involved in changing current (UK NHS) procedures. He attended a seminar where a former airline captain gave an address explaining the accountability and procedures throughout aviation that are designed to reduce errors. The intoduction of human factors training was also high on the list.
The chap I spoke to was very impressed with the way aviation deals with all aspects of safety awareness and reporting.
It ain't perfect must we must be doing something right.
I was speaking to a chap who is involved in changing current (UK NHS) procedures. He attended a seminar where a former airline captain gave an address explaining the accountability and procedures throughout aviation that are designed to reduce errors. The intoduction of human factors training was also high on the list.
The chap I spoke to was very impressed with the way aviation deals with all aspects of safety awareness and reporting.
It ain't perfect must we must be doing something right.
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lowcostdolly,
My situation was an interaction with meds I was taking and meds administered in the hospital. I gave them my list of meds upon entry, and cautioned them about interactions.
I always thought I could be my own advocate in a hospital setting. I did not count on "being off the planet" during what should have been a simple, normal, three day hospital stay. Privacy (HIPPA) laws cut both ways....my "significant other", who was there the entire time, had no rights or authority.
It is over....now mending well.
Shoreguy
My situation was an interaction with meds I was taking and meds administered in the hospital. I gave them my list of meds upon entry, and cautioned them about interactions.
I always thought I could be my own advocate in a hospital setting. I did not count on "being off the planet" during what should have been a simple, normal, three day hospital stay. Privacy (HIPPA) laws cut both ways....my "significant other", who was there the entire time, had no rights or authority.
It is over....now mending well.
Shoreguy
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Shore Guy good to hear you are on the mend despite everything
I Obviously don't know what your admission meds were but it sounds to me that either they should not have been prescribed during your stay or if you cannot do without them then alternative aneathesia and post operative drugs should have been prescribed other than the ones which interacted.
I don't know what US protocols are but over here it is unlikely you would have experienced what you did. Your meds would have undergone the scrutiny of the admitting RN, F1, pharmacist and the aneathetist. We would all be held accountable in some ways. The F1 for prescribing the wrong drugs, the nurse for giving them without querying the prescription and the aneathetist and pharmacist for not noticing a potentially dangerous situation.
If this doesn't happen in the US then I would say that not only could your system learn from aviation it could also learn from us. If it was meant to happen and didn't because the hospital did not follow protocols you may have a case for litigation.
I Obviously don't know what your admission meds were but it sounds to me that either they should not have been prescribed during your stay or if you cannot do without them then alternative aneathesia and post operative drugs should have been prescribed other than the ones which interacted.
I don't know what US protocols are but over here it is unlikely you would have experienced what you did. Your meds would have undergone the scrutiny of the admitting RN, F1, pharmacist and the aneathetist. We would all be held accountable in some ways. The F1 for prescribing the wrong drugs, the nurse for giving them without querying the prescription and the aneathetist and pharmacist for not noticing a potentially dangerous situation.
If this doesn't happen in the US then I would say that not only could your system learn from aviation it could also learn from us. If it was meant to happen and didn't because the hospital did not follow protocols you may have a case for litigation.
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Its been touched on but to emphasise, the major difference is annual licence renewals. In other words a test of competency once a year. Plus and this may also be relevant, an annual medical.
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Further debate here... http://www.pprune.org/jet-blast/4094...s-blunder.html
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Left or right?
Hi Dochealth,
Very interesting thread. Am I right in assuming that surgeons in general look to operate as a cohesive team in a controlled ebvironment? If so, the many lessons of multi-crew interaction (e.g checklist use, briefings, communication loops, allocation of roles, leadership/followership, DODAR & NITS, confirmation baias & error chain avoidance etc...) can be applied to the surgical environment.
I seem to remember recently that a UK hospital was taking some of these aviation learnings and applying to their surgical methodology (sorry havent got the article). After all there are similairites to amputating the wrong leg and shutting down the wrong engine... which has happened in both professions.
PP
Very interesting thread. Am I right in assuming that surgeons in general look to operate as a cohesive team in a controlled ebvironment? If so, the many lessons of multi-crew interaction (e.g checklist use, briefings, communication loops, allocation of roles, leadership/followership, DODAR & NITS, confirmation baias & error chain avoidance etc...) can be applied to the surgical environment.
I seem to remember recently that a UK hospital was taking some of these aviation learnings and applying to their surgical methodology (sorry havent got the article). After all there are similairites to amputating the wrong leg and shutting down the wrong engine... which has happened in both professions.
PP
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Surgeons To Use Safety Checklist Before NHS Operations To Reduce Deaths And Complications | UK News | Sky News
p.s he's still current as a Captain and off to sunnier climes I'm led to believe
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Well worth a look KYJelly. That report states there were 179,000 errors made in the NHS in 2007. Do medics also undergo 6 month checks (OPC/LPC) as we do in the aviation industry?
PP