Health care can take more safety lessons from aviation industry

An article in the Milbank Quarterly suggests that the health care industry could take more concepts from aviation in order to improve patient safety.  One current success of a concept that was adopted from aviation is the World Health Organization’s Surgical Safety Checklist, which has been found to reduce surgical deaths by over one third. 

Other aviation concepts that the article suggests could improve safety in health care include:

  • Standard layout of health care devices – In aviation, the instruments in the cockpit are arranged in a standard way to minimize user error.  This principal could be applied in health care to operating rooms, resuscitation trolleys, monitors and IT systems.
  • First-names only rule – This rule is used in aviation to flatten the social hierarchy, which may make people feel more comfortable questioning a superior about a potential safety issue.
  • Sterile cockpit rule – During critical times in flight, non-essential communication is prohibited to allow for concentration with non-essential interruptions.  Some hospitals are using a modification of this rule by having nurses who are administering medication wear colored vests to indicate that they may not be interrupted. 
  • Corporate responsibility for training – In aviation, airlines arrange and pay for all safety training for pilots.  In health care, clinicians are responsible for keeping up to date on their own time with their own money.   

(Sources: The Advisory Board Daily Briefing,, March 28, 2011; Milbank Quarterly,,  March, 2011)