The best year since 1945

A new report reveals that 2012 was the safest year in air travel since 1945.

I'm not quite sure what accounted for such good performance in 1945, but the report notes that 2012 was even better than 2011, the previous best year since 1945.

An industry expert and observer, Manoj Patankar, says:

Airline safety has been improving in North America, Europe, and Asia as a result of a number of coordinated efforts on the part of international organizations and national regulatory authorities, as well as voluntary safety programs adopted by air carriers and repair stations. The emphasis in safety improvements has shifted from technical improvements to systemic improvements in organizational safety culture.

But Sully reminds us:

“It’s important not to define safety as the absence of accidents,” said Chesley B. Sullenberger III, the US Airways pilot who became a hero when he landed an Airbus A320 in the Hudson River in January 2009 after both engines lost power. All 155 aboard escaped.

“When we’ve been through a very safe period, it is easy to think it’s because we are doing everything right,” he said. “But it may be that we are doing some things right, but not everything. We can’t relax.”

Many doctors and hospital administrators disagree when suggestions are made that there can be parallels between health care and air transport, or between health care and manufacturing, or between health care and virtually any other field of endeavor.  They are wrong.  Those of us who have been involved in quality and safety improvement know that there is much to be learned from other fields.

The big difference to date between health care and other fields is the lack of acceptance by the medical community of Sully's last point:  "We can't relax."  We are too quick to claim victory, or even progress, in the reduction of patient harm.  I made this point last week in my post about central line infections.  With the national and state focus on cost reduction, we are in danger of having a skewed perspective about what matters.

What matters is redesigning the work in hospitals to help avoid the systemic problems that cause harm to patients.  On this front, we are deficient.  The hospitals that have done the best in this area are usually the most modest about their progress.  They are the first to admit that so much more needs to be done even in their own facilities.  The hospitals that have not yet addressed the issue are suffering from a dramatic failure of leadership--from their boards, their administrators, and their clinicians.  If the airlines killed as many people in their care, they would be shut down within days.