Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice?

Petrut Gogalniceanu; Francis Calder; Chris Callaghan; Nick Sevdalis; Nizam Mamode

doi:10.1016/j.jsurg.2021.01.016

Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice?

Petrut Gogalniceanu^*, Francis Calder, Chris Callaghan, Nick Sevdalis, Nizam Mamode

^*Corresponding author for this work

Health Service & Population Research

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

Abstract

Error in surgery is common, although not always consequential. Surgical outcomes are often compared to safety data from commercial aviation. This industry's performance is frequently referenced as an example of high-reliability that should be reproduced in clinical practice. Consequently, the aviation-surgery analogy forms the conceptual framework for much patient safety research, advocating for the translation of aviation safety tools to the healthcare setting. Nevertheless, overuse or incorrect application of this paradigm can be misleading and may result in ineffective quality improvement interventions. This article discusses the validity and relevance of the aviation-surgery comparison, providing the necessary context to improve its application at the bedside. It addresses technical and human factors training, as well as more novel performance domains such as professional culture and optimization of operators’ condition. These are used to determine whether the aviation-surgery analogy is a valuable source of cross-professional learning or simply another safety cliché.

Original language	English
Pages (from-to)	1393-1399
Number of pages	7
Journal	Journal of Surgical Education
Volume	78
Issue number	5
DOIs	https://doi.org/10.1016/j.jsurg.2021.01.016
Publication status	Published - 1 Sept 2021

Keywords

aviation safety
human factors
nontechnical skills
Patient Care
patient safety
Professionalism
quality improvement
surgical simulation
Systems-Based Practice

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jsurg.2021.01.016

Cite this

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title = "Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice?",

abstract = "Error in surgery is common, although not always consequential. Surgical outcomes are often compared to safety data from commercial aviation. This industry's performance is frequently referenced as an example of high-reliability that should be reproduced in clinical practice. Consequently, the aviation-surgery analogy forms the conceptual framework for much patient safety research, advocating for the translation of aviation safety tools to the healthcare setting. Nevertheless, overuse or incorrect application of this paradigm can be misleading and may result in ineffective quality improvement interventions. This article discusses the validity and relevance of the aviation-surgery comparison, providing the necessary context to improve its application at the bedside. It addresses technical and human factors training, as well as more novel performance domains such as professional culture and optimization of operators{\textquoteright} condition. These are used to determine whether the aviation-surgery analogy is a valuable source of cross-professional learning or simply another safety clich{\'e}.",

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note = "Funding Information: The authors report no conflict of interest with respect to this publication. Dr Mamode and Dr Sevdalis have no direct conflict of interests to declare with regards to this publication, but would like to acknowledge the following funding and collaborations: Prof Mamode reports funding for advisory boards and speakers{\textquoteright} expenses from Hansa, Novartis and Alexion. Unrestricted research funding has been received from Shire and Behring, outside the remit of this paper. Prof Sevdalis reports being the director of the London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organizations. Dr Sevdalis also reports grants from the National Institute of Health Research (NIHR) Applied Research Collaboration, grants from King's Improvement Science, grants from Guy's and St. Thomas{\textquoteright} Charity, grants from the Maudsley Charity, grants from the ASPIRES research programme, grants from the NIHR Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, outside the submitted work. Nick Sevdalis is also the director of the London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organizations. Publisher Copyright: {\textcopyright} 2021 Association of Program Directors in Surgery Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

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AU - Sevdalis, Nick

AU - Mamode, Nizam

N1 - Funding Information: The authors report no conflict of interest with respect to this publication. Dr Mamode and Dr Sevdalis have no direct conflict of interests to declare with regards to this publication, but would like to acknowledge the following funding and collaborations: Prof Mamode reports funding for advisory boards and speakers’ expenses from Hansa, Novartis and Alexion. Unrestricted research funding has been received from Shire and Behring, outside the remit of this paper. Prof Sevdalis reports being the director of the London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organizations. Dr Sevdalis also reports grants from the National Institute of Health Research (NIHR) Applied Research Collaboration, grants from King's Improvement Science, grants from Guy's and St. Thomas’ Charity, grants from the Maudsley Charity, grants from the ASPIRES research programme, grants from the NIHR Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, outside the submitted work. Nick Sevdalis is also the director of the London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organizations. Publisher Copyright: © 2021 Association of Program Directors in Surgery Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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ER -

Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice?

Abstract

Keywords

UN SDGs

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