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.

FMI: www.psychologymatters.org/crm.html, www.faa.gov