Wed, Nov 01, 2006
Flight Crews, Surgical Staffs Have Similar Dynamics
For many years it was
common that the captain of an aircraft was never questioned by his
crew -- and many airplanes went down when a simple cross-check
might have averted disaster. Now, the principle of Crew Resource
Management (CRM) is considered one of the best techniques to reduce
pilot error -- and the medical health field has taken notice.
The New York Times reports there is a growing
industry of pilots and aviation experts consulting with hospitals
and surgical centers to apply the same CRM techniques used in
aviation safety to the operating room.
It has been well documented that the majority of
adverse results in health care are the result of human error, just
like in flying. Failures in communication, leadership, and general
decision making still plague aviation, but they are reduced when
checklists are used and all members present are given an
opportunity to voice concerns about what's happening.
The implications are enormous since your odds of
dying on the surgical table are infinitely greater than dying in an
air crash. Last year, nearly 98,000 people died from preventable
hospital errors.
Surgeons, like pilots, tend to be Type A
personalities -- take-charge types who rely on technology and their
own skill -- and sometimes regard questions as undermining their
authority.
But more surgical staffs are discovering that CRM helps catch
errors more quickly and checklists and standard procedures allow
smoother staff interaction.
"The trend is not surprising given the similarities between
health care and aviation," said Dr. David M. Gaba, a dean at the
Stanford University School of Medicine in Palo Alto, CA. "Both
involve hours of boredom punctuated by moments of sheer
terror."
Crew Resource Management on the operating table might be just
about the best way to make sure your surgeon doesn't amputate your
right leg, when you just went in for surgery on your left
knee.
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