Wednesday, September 7, 2011

Aviation and Healthcare Compared in Review Article

In a paper* published ahead of print in the American Journal of Surgery (no abstract available), five cardiothoracic surgeons from the University of Miami compare both the similarities and differences between aviation and medicine.

Without simply reprinting the entire three pages of text and risking infringing on the AJS’s copyright, I can say that it is one of the most detailed and balanced analyses I have seen.

It includes some of the points I have made in previous blogs on the subject such as the heterogeneity of teams, simulators and systems in healthcare as compared to aviation and the lack of a true non-punitive culture regarding errors and near-errors in medicine.

The authors note that even checklists, which are relatively straightforward in aviation, can be much more complex in medicine. They also point out that protocols and practice guidelines are nether necessarily agreed upon or followed as commonly in medicine.

If you are interested in this subject, I urge you to obtain a copy of the paper from your medical library.

*Ricci, M et al. Is aviation a good model to study human errors in health care? Am J Surg. 2011 Sep 2. [Epub ahead of print]

Thanks to @DublinDoc for alerting me to this paper.


Anonymous said...



Citrome L. Evidence-based flying: a new paradigm for frequent flyers.Int J Clin Pract. 2010 May;64(6):667-8. Epub 2010 Mar 30.

PMID: 20370839 [PubMed - indexed for MEDLINE]

Skeptical Scalpel said...

Thanks for the interesting reference. I did obtain a copy of the editorial.

Here's one for you. The parachute has never been subjected to a randomized clinical trial.

Felix said...

Dear Doctor, I have not read the article but in my mission critical industry the issue of "punitive" vs "non-punitive" approaches in managing complex issues is ever present. My anecdotal field experience tells me the punitive approach does not allow for an environment of "continuous incremental improvement". The challenge is we are now dealing with large populations of humans with intense media scrutiny. Every issue is magnified and therefore amplified with unintended consequences; there is no room for error and thus no room for incremental improvement.

Furthermore, as a manager I see such management terms as "accountability" as the code word for the punitive approach.

Thank goodness Paracelsus, Cavendish, Tesla, and our very own Thomas Edison didn't operate under the punitive environment of today. We wouldn't have modern medicine, chemistry, the electric light!!

Mission Critical Coordinator

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