Thursday, April 10, 2008

The Industry We're Trying to Emulate

Recently, I had the pleasure of escaping the still-frigid early Spring in Chicago for a warmer climate and flew south for a few days. I found it interesting, to say the least, to observe what happens when price pressures are added on the highly-regulated airline industry - much like what is about to happen in healthcare. You see, many have advocated that we should emulate the airline industry to improve patient safety and healthcare delivery.

Here's what we experienced:
  • The wrong luggage sticker was placed on my wife's luggage. Fortunately, poor "John Doe" was going to the same airport we were.
  • The center bathroom of our packed 757 was sealed shut with a sticker "out of order" and appeared to have been like this for quite some time. Only the forwardmost and aft bathrooms were available.
  • No check of seatbelt fastening occurred at takeoff nor landing.
  • The seat in front of me was unable to stay locked in its upright position
Now it's so easy to criticize, but the implications of what happens to an industry when price pressures mount were certainly plain to see. The "safety checks" and maintenance of our plane had clearly suffered cutbacks.

I remember the days when hot meals were served on planes in coach, not just first-class, leg room was more than an afterthought, and the flight attendants took interest in the passengers and gave their kids those cool little flight wings to wear. Sadly, now we are hearded onboard in "Groups," have to buy a box of carbohydrates called a "snack" for five bucks, and laminate ourselves next to our fellow passenger to improve capacity while the very plane we're flying is poorly maintained.

Is this the industry we're trying to emulate?

-Wes

8 comments:

  1. I'm not sure if you do memes/tags or not but I wanted to flit over and give you the opportunity. I hope you will participate.

    You've been royally tagged by Mimi Queen of Memes. Have fun!
    Message In a Bottle

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  2. On this side of the pond our Chief Medical Officer also tells us we should emulated the airline industry. By comparison their tasks are relatively simple but they still can't get it right.

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  3. unfortunately that's what happens when industries are left to regulate themselves.

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  4. Take what you like and leave the rest. One could argue that concepts from the airline industry have revolutionized anaesthesia for the better. Other concepts such as using an ergonomic enviroment to decrease the chance of error apply across many industries but have been adopted by both medicine and aviation. Time outs, checklists, etc... all have ties. But at the end of the day is the airline industry better organized than 10 yrs ago? Lower fatalities? Better service? No on all accounts from what I read.
    http://www.aopa.org/asf/publications/06nall.pdf
    But is the health care industry doing much better than 10 years ago? If for no other reason that lower morbiidity and mortality I'd say yes. Maybe they should be emulating us.

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  5. The airlines lead when they standardize safety issues like no alcohol for pilots before flights,standardized seat belts, required sleep for pilots, time-outs and checklists, required maintenance schedules (which we are seeing have been missed!). But they have fallen way behind Medicine in service. I think they have taken the customer for granted and to make profits have cut services to the bone. The service oriented airlines will thrive in the future. I already avoid the ones that cram me like a sardine and will always chose another country airline for international flights.

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  6. Many years ago I took a hop across the pond from NYC to London to visit my english cousins. Upon complaining about my flight -- my English Uncle replied -- you yanks, you shop for the cheapest seat and complain. I know its simplistic, but how do you buy a ticket on service, on leg room, on decent grub -- or even any grub??? We a consumers need to demand and being willing to reward -- that is pay appropriately when our demands are met.

    We need search engines that we can look at leg room, ontime record, safety record, food service etc.

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  7. You've been Meme'd. Get over it.


    http://thehappyhospitalist.blogspot.com/2008/04/six-word-memoir-meme.html

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  8. I couldn't agree with you more. In the OR, the "timeout" process now seems to have a longer checkoff list than a space shuttle launch, and there is a palpable lack of confidence in the whole thing.

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