GlobalHealth Asia-Pacific Issue 5 | 2024 | Page 54

Patient Safety

Patient Safety : The checklist and other lessons from the aviation industry

Dr . Vincent Chia argues that healthcare professionals can learn from the safety procedures implemented in the aviation industry to reduce medical blunders

Pilots and healthcare workers operate in extremely complex and often stressful environments where teams interact and interface closely with technology . Safety is paramount for both passengers and patients in each domain . While aircraft accidents are infrequent , they are highly visible and involve massive loss of life . Adverse medical events happen to individual patients but very seldom receive national publicity . For every aircraft accident , investigation work into causal factors is exhaustive , most often along with intense public attention and remedial actions , while in adverse medical events , investigation methodology , documentation and dissemination are often scarce , not standardised , and may vary widely across different countries and cultures .

Comparisons have been made between safety management in aviation and healthcare , particularly in recent decades . This comparison and emulation stems from major achievements in the aviation industry : despite the number of world-wide flight hours doubling over the past 20 years ( from approximately 25 million in 1993 to 54 million in 2013 ), the number of fatalities has halved to less than 300 per year . This stands in stark contrast to healthcare , where in the US alone , there are an estimated 200,000 preventable medical deaths every year , the equivalent of almost three fatal airline crashes per day . Chesley Sullenberger , a renowned US airline pilot , once commented that if such a level of preventable fatalities was to occur in aviation , airlines would stop flying and airports would close . All flights would be grounded and no one would be allowed to fly until the problem had been solved .
In 1977 , a series of human errors caused two Boeing 747s to collide on a foggy runway in the Canary Islands , killing 583 people . After the incident , the National Aeronautics and Space Administration ( NASA ) convened a panel to address aviation safety and came up with a programme called Cockpit or Crew Resource Management ( CRM ). This programme required all commercial and military airline pilots to undergo training that taught , among other things , to recognise human limitations and the impact of fatigue , to identify and effectively communicate problems , to listen and support team members , to resolve conflicts and develop contingency plans .
Many anaesthetists have witnessed preventable errors in the operating theatre . Wrong site surgery has asdf been the focus of international attention , but still occurs . High profile cases of death resulting
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