Patient safety and the aviation model: Medicine is still learning

In 2006 the Chief Medical Officer for England – Liam Donaldson – announced that the risk of inhospital death due to human error was approximately 1 in 300 [11]. In a more recent study the UK came 16th out of 19 industrialized nations with an estimated 103 patients per 100,000 of the population dying as a result of healthcare-associated error [16]. The UK is not alone in this problem. Up to 98,000 deaths in the US per year are estimated to be due to human error in hospital [3,21], the equivalent number as in 233 jumbo jets [19]. Now, compare this to the risk of death on a commercial airline flight – 1 in 10 million [11] and these rates have been falling over the last ten years: in 2008 there were only 577 worldwide commercial aviation fatalities compared with 1,219 in 1998 [2]. It is important to remember that these fatalities relate to death from all aspects of aviation, however, between 60–80% are related to human error [20] and most of these attributed specifically to skill-based pilot error [10]. The success in aviation’s safety record has only been achieved through targeted and sustained measures to tackle the root causes of error. This article will go some way to highlight: