What The Friendly Skies Can Teach Us About Patient Safety

If you fly, you recognize these words…

“Ladies and Gentlemen we would appreciate your attention as we explain the safety features of this aircraft.”

The approach varies slightly by airline but basic information about air turbulence and the importance of wearing your seat belts, the location of emergency exits, and how to use oxygen masks is spelled out in simple language. For those of us who fly often this safety briefing seems humdrum, and can lead us to a complacent attitude about the role we might assume if there is an in-flight emergency. It could be a fatal mistake if we have not identified the closest exit and how we would get there.

Do patients in our hospitals have the same opportunity to hear and see the part they play in assuring their own safety?

I suggest we are woefully behind the aviation industry in showing people they have a role in keeping themselves safe. Perhaps it is our risk-averse culture that stops ideas about patients helping themselves to prevent a medication mistake or an infection. Yet dramatic stories surface routinely in the lay press and television, so our patients are not unaware of complications that occur during a hospital stay.

The aviation industry makes an effort to tell the people who travel there is always a possibility of an accident that would require them to protect themselves. But their statistics in safety are far better than ours, which means most of us who travel often continue to read our papers during the briefing. We assume safety.

Are we managing our risk in hospitals so tightly that we do not want to tell people some of the basics where they could help themselves? Are clinical teams encouraged to provide evidence-based information to patients and families where their partnership could make a difference, such as preventing a CAUTI?

Last month we focused on patient safety awareness, and every busy clinician knows this is the lynchpin in care. But our infrastructures and our culture have not opened the windows to some blunt facts where patient engagement could drive very rapid improvement. Over 400,000 people a year are infected because of a urinary retention catheter. Sadly, a recent review points to the evidence… we are the primary reason because we do not remove the catheter in 48 hours.

“Patient engagement” is the current high profile term but if we do not (1) define this term in our own organizations and (2) use the process to help patients understand what they can do to partner for safety, then we are only giving lip service to improving outcomes despite the diligent efforts of many dedicated clinicians.