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Patient safety lessons from an astronaut

Alan Willson
Alan Willson
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Looking back over 2012, one of the highlights of my year was meeting an astronaut, Dr Dafydd Williams.

Known as Dave rather than Dafydd in his native Canada, he was delighted to visit the land of his Welsh ancestors to talk about the similarities between healthcare and spaceflight at a special event organised by 1000 Lives Plus. The event expanded concepts explored by Dave in ‘Achieving Peak Performance’, a white paper published with the support of the Health Foundation.

Quality improvement in healthcare is full of learning drawn from the aviation industry. I like to think that by inviting an astronaut to introduce us to what he has learned, we went one step further (or one giant leap further!).

Dave has also worked as an A&E consultant, and is now the CEO of a healthcare organisation in Ontario. So, he can draw the parallels between what he has seen running the ‘ER’ and being the mission commander on the space shuttle. In particular, he talked about making critical decisions where that decision can’t be reversed and where the wrong choice can lead to a devastating outcome.

His main point was that the attention to detail given to safety in spaceflight is something that healthcare providers should emulate. Accidents do happen in space – often with fatalities – but the response to them is markedly different. The investigations are conducted non-punitively, drilling down into the root causes of errors to learn how to prevent them re-occurring.

Does your organisation have a ‘just culture’? Do you feel safe working there? If something went wrong are there processes in place to find out what happened without immediately searching for a culprit to blame? What do we need to change in how we respond to error?

The second theme covered was that healthcare organisations fail their patients by not taking into account the human factors at work in the services we offer. Does your team communicate well? Is everyone pulling together?

Accidents and errors usually have human causes. But many errors could be prevented by understanding how much the way we work impacts on what we do. What is safe-guarding you from making a mistake when you are tired, stressed, frustrated, busy?

When we make a diagnosis, administer a drug, make a surgical incision or discharge a patient, we are making critical decisions that often cannot be reversed. We need to get them right – for our patients, for our organisations, for ourselves.

NASA, Dave’s former employer, is now apparently aiming for Mars. It’s ambitious, and it will take years to get there. We are in a better position – we can begin to improve our services today and see the difference within weeks, or even days. The question is, do we have the ambition to make it happen?

Dr Alan Willson is a director of 1000 Lives Plus, Wales’ national healthcare improvement programme. www.twitter.com/1000LivesPlus





 
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Dr Daf is a top chap and a really interesting and inspiring person. I've seen him walking the talk on the shop floor in Ontario.

It does make me a little uncomfortable taking safety advice from an industry that has virtually unlimited resources and deliberately designs layers of redundancy into their systems. Redundancy is essentially a resource or a working capacity that for most of its existence, remains unused. Safe systems in other words, seem to require a high degree of inefficiency, an interesting message for our masters in Whitehall.

By the way there have been 530 astronauts, 22 died in their spacecraft and a further 11 died in training. So, it is a dangerous industry no doubt and responds with huge resources, fabulous technology and thousands of the worlds cleverest people to get a mortality rate of roughly 1 in 20. The NHS in comparison, don't seem quite so bad!

A great blog Mr Wilson with excellent insight on a thoroughly important issue.
Thank you Arthur. You make a some great points about comparisons between industries. Another might be that you should expect a higher risk from sending folk into outerspace compared with carrying out routine healthcare.
Like you I have been inspired by Dafydd. While it is often difficult to draw lessons between sectors, he has adapted and applied learning about teams, leadership, reliability and quality improvement - as you say he walks the talk. That has been so much more powerful than learning from folk who lack his cross-sectoral experience.
He's good looking and modest too - a rarity among Welsh astronauts
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