What the Aviation Industry Can Teach Healthcare

DALLAS - While it may be surprising, the healthcare and aviation industries have many similarities. Both industries are closely scrutinized for their safety, communication, standardization, and responsibility; however, the aviation industry has a stronger track record of success. 

Medical errors have been one of the leading causes of death in the United States. A 2016 study conducted by Johns Hopkins researchers over an eight-year period showed that more than 250,000 people died each year from preventable medical errors.

Often, such deaths result from errors made by doctors, hospitals, prescriptions, and pharmacies. There are many reasons behind such fatal mistakes, including skills, judgment, and diagnostics.

On the other hand, commercial aviation is much safer than people think and than it is portrayed in movies and TV shows. The most dangerous part of a passenger's journey is driving to the airport. According to Dutch Aviation Consultant To70, in 2021, eighty-one people died in four fatal commercial aviation crashes worldwide.

In the first half of 2022, the National Highway Traffic Safety Administration states that there were 20,175 fatalities from car crashes in the United States alone. While there are obvious differences between aviation and healthcare, understanding what the aviation industry does correctly can provide valuable information for the healthcare industry.

Training

From the second aspiring pilots begin their first flight lesson, safety is the top priority. This is especially true for commercial pilots, as they are responsible for the safety of their passengers and crew.

If the plane goes down, the pilots go down with the aircraft. Compare this to a healthcare worker who accidentally kills a patient during an operation. The worker is still alive and can go home. In the unforeseen event of an airplane crash, investigators look at the system, that being the aircraft, for the fault.

Humans are not perfect, and mistakes will be made, but it is prudent to figure out how to prevent these mistakes from occurring. In the event something goes wrong during a surgical procedure, the patient or family will often blame the doctor and sue for damages. 

The training that pilots and cabin crew undergo is another important aspect of ensuring that everyone is prepared in the event of an emergency. Through their training, they learn teamwork, communication, decision-making, and problem-solving skills. Additionally, every six months, crews have to undergo proficiency evaluations.

Crews have also established protocols they follow for different emergencies, which are the same for every aircraft, so protocol does not change. The training and protocols learned are the same for every airline and aircraft, so even if a crew switches jobs, their training is still relevant. This improves both safety and customer stratification in the industry.

However, in the healthcare industry, little training, and failure to teach new workers unified protocols, especially for temporary workers, contribute to errors. The healthcare industry does not have centralized training that all employees need to pass. In fact, training is often done by each hospital or company individually, and employees at one hospital receive different training than employees at a different hospital. 

Governing Bodies

When an issue arises in the aviation industry, an investigation is done throughout the country and internationally, as seen with the Boeing 737 MAX (see below), whereas incidents that occur at hospitals are addressed locally and do not receive much attention. Internally, doctors and other medical staff receive a lot of criticism that can have long-lasting effects on them.

All incidents in aviation, whether it is an airplane losing a tire on takeoff or a pilot sleeping for ten minutes, receive a great deal of attention from the media. This allows for checks and balances and creates an efficient atmosphere.

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There are also governing bodies that were created to address airlines' issues to provide a smooth and positive customer experience. There is little anxiety in the atmosphere on an airplane for passengers and staff because of the reassurance that safety and comfort are of great importance. While some passengers fear flying, a majority of travelers find it safe and relaxing.

On the other hand, even though healthcare companies and the bodies that govern them frequently carry out significant reforms, no central body is responsible for investing and creating policy. This leaves each company and hospital to develop its policy for patient safety and comfort.

For example, in October 2018, Lion Air (SL) flight 610 crashed in the Java Sea after departing from Jakarta Soekarno-Hatta International Airport (CGK). After takeoff, the Boeing 737-8 MAX aircraft had trouble with its altitude and began an uncontrollable dive, crashing into the Java Sea thirteen minutes after takeoff.

Five months later, in March 2019, Ethiopian Airlines (ET) Flight 302 had just departed from Jomo Kenyatta International Airport (NBO) when the Boeing 737-8 suffered a similar experience, causing the plane to crash six minutes after takeoff. Because of these crashes, 346 passengers lost their lives.

The ET crash prompted the Federal Aviation Administration (FAA) to ground all Boeing 737 MAX aircraft. At that time, more than 350 examples of the aircraft had been delivered to carriers worldwide. This grounding lasted until the problem was fixed in late November 2020. The FAA ensured that the MAX would only enter into commercial service once the MCAS (Maneuvering Characteristics Augmentation System) of all MAX aircraft had been fixed.

This illustrated a precedent that safety comes first, even though Boeing, one of the largest companies in the United States, lost billions of dollars as their aircraft waited for FAA approval.

All aviation is required to uphold the same standards. Rules for an airline based in Texas are the same as for an airline based in California. Having standard rules increases consistency across the whole field. On the other hand, hospitals have their own rules in healthcare, and even specific doctors may have different ones to abide by. 

The National Transportation Safety Board (NTSB) plays an important role in determining the causes of crashes, promoting safety in transportation, and helping the families of victims of accidents. It has jurisdiction over all crashes in the United States.

The NTSB finds out the cause of the accident and determines a solution to prevent the same accident from occurring again. The safety board provides experts in the field of aviation, engineering, and product design to determine the cause.

Additionally, human factors/errors are closely examined. However, the healthcare industry does not have an organization overseeing accidents, nor does the industry provide such a close examination when it comes to fatal errors.

Standardization

Even though the healthcare industry and the aviation industry have many differences, the healthcare industry can learn from the aviation sector's standardization.

As previously stated, the procedures used by airlines are standard, and they are easy to follow. Because all of the information is available, there is no need to second guess any information. This includes factors such as weather conditions that will reduce the risk of an accident.

Even though there are differences between each patient in the healthcare industry, if standardization procedures were implemented, it would help workers and patients. 

In the news, reports of unruly passengers causing problems on planes often occur as of late. Aviation crews do a great job handling these situations and ensuring they do not get out of hand.

Often, when there is an incident in healthcare, it is downplayed for fear of job loss. However, employees are not typically fired when these situations occur in the aviation industry. Instead, they discuss the incident and allow for open communication.

The "Crew Resource Management" is a specifically designed system for training on the job and communicating with passengers and other crew members. This system is where the crew, and anyone involved in the airport or airline, communicate.

From the time the aircraft is fueled up and pushed back to when it arrives at the gate, there is constant communication between the pilots and air traffic control, as well as with everyone involved with the flight. This communication reduces any risks of danger. Additionally, understanding that passenger safety is of the utmost importance is vital, especially since the risks affect the passengers and crew.

Checklists

Lastly, checklists are a great way to make sure that everything is completed in the proper order. For aviation, there is a checklist for everything, from starting the engine to making sure everything is set for landing. Even before the pilot starts the aircraft, they have to do a walkaround and make sure, using a checklist, that everything—fuel, wings, landing gear, and the fuselage—is in proper shape.

These checklists give pilots steps for go-arounds, aborted takeoffs, emergencies, etc. For example, during an emergency landing, pilots will use a checklist and review each item to ensure nothing is missed. These checklists allow pilots to find easy solutions for any problem that may arise.

On the other hand, the healthcare industry does not have a checklist for doctors and other medical professionals. For example, if something occurs during surgery, a checklist with all the correct information and specific drug doses needed for both regular and irregular emergencies would prevent errors and save lives.

Bottom Line

Because the healthcare industry lags behind aviation in terms of safety, it needs to act quickly to improve. Even though the two industries are completely different, safety is the most important priority for both.

Nevertheless, the healthcare industry can learn a great deal from the training, procedures, standardization, and government agencies held by the aviation industry.

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This article is for informational purposes and is not meant to give any medical advice. Featured image: Sydney Airport