Apple and orange: comparing patient safety, health data and the airline industry
By David Topps
Over the decades, the airline industry which was already very safe, has made further strides to improve safety. The current trend in patient safety and simulation conferences is to repeatedly draw parallel conclusions, decrying those in healthcare for not emulating the airline industry's carefully regulated practices.
This comparison only applies in limited areas of healthcare. We have made advances by adopting CRM principles in acute resuscitation. Checklists aid some surgical procedures. But running an airline is orders of magnitude simpler than healthcare. The physics of flight is indeed complex but can now be fully simulated. In contrast, we still struggle to simulate the physiome of single cells. Airline business logistics are also simpler. But imagine saying to 200 patients: the appendectomy flight is departing at 1530 - please recline your tables.
It is odd how poor we are at estimating risk. Many fear taking a flight (0.5 micromorts) much more than a general anesthetic (6 micromorts). We are pleased that both are much safer than they were, and yes, there are lessons to be learned from analysis of systems errors.
But let's not go marching blithely down to the orange grove of tightly regulated practices. The comparison has run out of juice.
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