The Journey Home: Witnessing Aviation’s Transparency in Action

Normally when flying I like to be seated at the window to watch the mechanisms of the wing and observe the scenery. This time I decided to apply some mindfulness to my flight home. As the plane got closer to Chicago-O’Hare, I noticed a United airplane lateral to us also descending. I thought how near they were, yet relatively incident free on a daily basis. I observed the United plane land on a runway adjacent to ours at no more than say a minute before us and thought what great communication had to have taken place to prevent the two airlines from colliding. Moreover on landing, there were multiple other planes entering the airport. There are so many opportunities for things to go wrong and thus mechanisms had to be in place at a systems level to prevent these in addition to individual level interventions. It is this greater emphasis that is needed within health systems to focusing on the structures and process of healthcare delivery to overcome human fallibility that make produce medical errors.

The flight home from Chicago was even more remarkable. It really cemented for me what was taught during the AELPS program about the aviation industry that could truly be emulated by healthcare. As we waited to taxi down the runway for take off, the pilot announced that the plane was not balanced and the computer was not working and that they would need to do manual calculations. This was conveyed simply and in a clear manner with even a slight humor as the pilot said they were basically going back to the eighties. I immediately said a prayer though as it was nerve wracking. I watched through the window, as some 25 pound blocks were loaded into the baggage compartment. One of the pilots stepped out to seemingly check the weight with the team loading the weights placed on the plane. We eventually safely left Chicago and I arrived home without incident. I thought this was transparency in action by the pilots: they declared the issues that arose and kept us informed. The only question that arose in my mind at the time, from a nursing perspective, was the double checking of the calculations hoping they used a similar methodology as we do with high risks medications – double verifying.

On arriving in Charlottesville, the flight attendant apologized for the late arrival and then when the plan of disembarking the plane changed from using the jet bridge to using the stairs, she share the change in plan and apologized. I thought every leg of this trip were moments that could truly be emulated in healthcare to improve patient safety and quality. Being transparent to our patients and each other, communicating in real time and sharing solutions, apologizing when things go wrong or deviate from the expected plan and sharing with our patients changes in the plan of care as soon as they arise.

I observed the pilot checking the plane as we waited for our baggage. I approached him when he was finished and thanked him for his transparency. I shared with him that I was a nurse and about my experience with AELPS re using elements of aviation to model where healthcare needs to be. This pilot looked no older than 25 years old, he was humble and thanked me for my patience. I felt like it was about us the passengers just as how we need to make what we do about the patients. I thought how great that this culture of safety and humility was likely being passed on to younger generation of pilots. And definitely as was said at AELPS, we need to educate the young to help to change our culture in healthcare.

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