Wednesday, April 22, 2015

Learning patient safety from the airlines

I was already aware of links between patient safety and techniques employed in airlines to ensure safety of aircraft and passengers.   I heard a story of a junior doctor or medical student (can't remember which, but it doesn't matter) who spotted that an x-ray was being displayed the wrong way round.  No one else seemed to notice.  But they did not feel it was their place to say anything.  The possible consequence was that the wrong bit of the patient would be operated on.

So, I was interested to catch on BBC television a piece on training junior doctors to be assertive and challenge their senior colleagues if they were concerned with what those senior colleagues were asking them to do.  Here is the piece on the BBC website.   The training session that was televised involved very sophisticated mannikins, like the sort you learn first aid on only much more lifelike.  The mannikin was a patient with heart problems, the senior doctor was insistent on one course of action, but the junior was sure that the signs and evidence pointed to a different course of action.   They could have given in to authority, but were learning ways to be assertive and make it clear that they were unhappy with the senior's wishes.

Where do airlines fit into this?   In this televised training session was an experienced pilot, and the techniques being taught to the juniors were the sort of thing that pilots are trained to do, the repetition of certain phrases to put across feelings, and general protocols regarding communication, for example. 

A quick web search turns up these two items, both from 2006:

This article in very similar vein from the New York Times

This report from the (US) Agency for Healthcare Research and Quality

My original search also turned up several things which proved to be about pilot projects, not pilots, so I tried the same keywords as the PubMed search (below), which was better, and turned up this counter opinion

A PubMed search for patient safety AND aviation finds 400+ items, which will help to fill in the many gaps in this post.  

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