By Megan M. Krischke, contributor
What can medical personnel learn about their jobs from pilots and others in aviation? While there are not a lot of obvious similarities between flying a plane and performing a surgery, the contexts in which they happen can be quite similar: high stress environments which require quick, accurate decisions with life or death consequences and the ability to communicate those decisions effectively to everyone on the team.
Stephen Harden, a captain for a major international airline, is also the president of LifeWings Partners, a company that trains medical staff in safety techniques used by the aviation industry.
With an impressive safety record, it turns out that aviation experts have a lot that they can teach to their medical counterparts in the area of reducing errors.
The connection between the aviation and health care fields was first noted in 1999 when the Institute of Medicine published an article entitled, “To Err is Human.” The article reported that between 44,000 and 98,000 people die annually due to medical errors. This report initiated research of other professions where critical decisions have to be made under stress. The aviation industry rose to the top of the list because of its enviable record of dealing with millions of passengers with minimal mishaps. Some members of the medical profession began asking, “What measures are they taking to have this safety record that we can adopt?”
According to Stephen Harden, a captain for a major international airline and the president of LifeWings Partners (LWP), LLC there are several methods in aviation training that can be used to reduce errors in a medical setting. LifeWings is one of the first companies to train medical staff in safety techniques used by the aviation industry. The LWP staff is composed of physicians, nurses, pilots, former NASA astronauts and risk managers.
Harden says that there are five key components to LWP’s training:
“The first is to work very intently and closely with hospital leadership because they must lead a cultural change, determine what structures will be implemented and decide on policies for participation in the training. Then, as the second step, we train the doctors, nurses and staff in the required skills. The third piece is to hardwire the system with safety tools—protocols, checklists, standard operating procedures, communication scripts, briefing guides. Fourth is determining a system of measurement: what data needs to be collected and analyzed to show that you are making progress. Finally, we train a trainer, so that the health care organization becomes an owner, not a renter, of the methodology.”
This training program typically takes four to five months to complete per department.
One of the basic steps that Harden and his team train hospital staff to accomplish is to put together a set of keywords that have a common standard meaning, allowing for brief, but highly accurate communication.
“Imagine the OR during a lengthy procedure,” says Harden. “The music is going, nurses are talking, and the surgeon reaches a critical point and needs everyone to pay close attention. The key phrase might be ‘Heads up’ or ‘Let’s go head’s up.’ That means someone turns off the radio, all non-essential conversation stops, people assigned to monitoring a piece of equipment are focused on that and everyone is watching and backing up each other to make sure all goes as it should.”
The results of LifeWings’ training are impressive.
“The hospitals we work with eliminate wrong surgeries and we see clear decreases in the rates of observed-to-expected mortality. In one hospital their observed-to-expected mortality decreased from 1.2 (i.e. their observed mortality was higher than expected) to .7. In real numbers, that is 200 patients walking out of that hospital in a two year period who wouldn’t have if the hospital hadn’t participated in our training,” Hardin said.
“We’ve also seen a dramatic decrease in nurse turnover. Most of the hospitals we work with now have less than a 5 percent annual turnover. One hospital observed a zero percent turnover and another went from a 15 percent annual turnover to two percent. The organizations we work with also see a decrease in malpractice payout, because they are making fewer errors and offering better care. We’ve seen as much as a 32 percent decrease in claims payout. There are also decreases in post-surgical infection rates.”
Harden attributes the decreased nurse turnover rates to their program offering nurses the skills they need to be more effective advocates for their patients and providing more clear and open communication with physicians and administrators.
To date, LWP has worked with over 85 clients, primarily hospitals, but also clinics, insurance carriers and hospital management companies. Their innovative training program can be customized for facilities across the country.
For more information, visit the LifeWings Partners web site.
[link to http://www.saferpatients.com/]
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