Hospitals Apply Procedures Airlines Learned the Hardway

Lorain - A hospital staff in Lorain is learning how to operate like an airline crew.

Dr. Matthew Cooper, who is also a commercial pilot, is teaching the staff at Community Health Partners Hospital how to conduct debriefings, empower junior staff members and prepare pre-operation checklists.

The aviation industry has reduced accidents caused by human error dramatically in the past 30 years using such techniques, said Cooper, an instructor with LifeWings training program based in Memphis, Tenn.

It's a lesson that the health care industry needs to learn. A 1999 Institute of Medicine report found that as many as 98,000 people die each year in the United States from preventable medical errors.

"Who cares if it's 10,000? It's too many," said Dr. Donald Blanford, the hospital's chief medical officer.

The hospital is one of about 50 health care systems to hire LifeWings but only the second one in Ohio - Children's Hospital Medical Center in Cincinnati was first. This week Cooper is training 125 doctors and nurses in the obstetrics/gynecology department, but he has been working with medical leaders and administrators since October.

Blanford said they've learned a lot about the role of junior staff members, who traditionally are not encouraged to speak up. That will change, he said.

"You won't get into trouble for speaking up. You might get into trouble for not speaking up," he said.

For instance, if staff members suspect a mistake is being made during an operation, they must speak up. They have to say, "I'm concerned" to a specific doctor, who must stop and listen.

A major hospital trained by LifeWings fired a surgeon and the operating team for failing to follow that procedure, Cooper said. The doctor removed the wrong organ and no one spoke up.

The world of medical care and aviation have striking similarities, said Cooper, a cardiovascular and thoracic surgeon in Las Vegas.

"They both have highly professional and motivated individuals," he said. "They are complex environments that require teamwork. They are time critical and highly stressful."

Accidents in both industries are caused by fatigue, workload, poor communication and flawed decision making. Also, too many procedures are done by memory or vary from doctor to doctor, which makes it difficult for staffers to follow, he said.

LifeWings stresses written checklists and consistency, whether it's counting equipment before and after a surgery or phoning information late at night to a sleeping doctor.

In the six years LifeWings has been in business, the results are impressive. Hospitals report a 50 percent reduction in count errors, improved mortality numbers and reduction in staff turnover.

Community Health Partners would like to expand the training to all employees involved with patient care, Blanford said. The first phase, paid for by two foundations, cost $78,000.

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