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Patient and Nurse Safety - Lessons from Captain Sully

December 17, 2015

We talk about 'safety' in healthcare in two distinct, but related, contexts:

1. Patient Safety
2. Employee Safety

A lot of energy has been expended to address patient safety. Less has been aimed at employee safety. The latest "program" may help, but other industries do a much better job developing a pervasive "safety culture" and have nearly eliminated certain adverse incidents.

The following excerpt is from a recent summary in FierceHealthcare:

Although the last airline fatality was in 2001, more than a decade ago, medical errors and healthcare-associated conditions result in 200,000 preventable deaths every year, airplaneaccording to Capt. Chesley "Sully" Sullenberger in an interview with the Stanford (Calif.) University School of Medicine this week.

"That's the equivalent of 20 large jet airliners crashing every week with no survivors," said Sullenberger, the pilot who safely landed US Airways Flight 1549 onto the Hudson River, saving 155 people on board. Like healthcare, aviation was once an industry based on individual crew preferences and a culture of blame, Sullenberger noted.

Today, though, there are formal processes in place to evaluate system problems and implement prevention strategies. The flight industry "transformed the culture of aviation from a blame-based system to a learning-based system" and one of predictability, reliability and regularization of processes, he said.

Still, hundreds of surgeons don't use checklists, including for introductions, despite evidence that it cuts down on deaths, patient safety advocate and Harvard pediatric surgeon Lucian Leape told members of the American Medical Student Association at a patient safety symposium, the Philadelphia Inquirer reported.

How do we transform the culture when important players refuse to use strategies that are proven to reduce errors?! Imagine how the airline industry would respond if flight crews simply refused to use checklists.

In other industries, we know that selection, including behavioral assessments, plays a key role in reducing adverse incidents. Assessments predict at-risk behavior, including those who will not adapt to change. "At risk" individuals are:

  • 1.5 times more likely to file a worker's compensation claim
  • 2 times more likely to be involved in a safety incident, and
  • 35 times more likely to seriously injure themselves at work

An 18-month study with representatives from the oil & gas, construction and manufacturing industries revealed that it is possible to predict - with significant accuracy - the individuals in your organizations who are most at risk of injuring themselves. The co-authors of this study, Matt O'Connell, Ph.D. and Esteban Tristan, Ph.D., recently presented a webinar, "Predicting and Reducing Safety Incidents." In it, the presenters detail finding and the role assessments can play in improving workplace safety.

nursing shortage


Bryan Warren Bryan Warren was the former Director of Healthcare Solutions at PSI. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.