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909 Flying Lessons for Healthcare

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Click the arrow to play audio file:

click here if you cannot view audio player: PP-909aviation.mp3

Bonus Interview:
Kathleen Bartholomew, RN,MN, and John Nance, JD, discuss how the principles of high-reliability industries, such as aviation, could keep patients much safer.

click here if you cannot view audio player: Bartholomew-NanceExtended.mp3

Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here's what it's about:

Preventable errors kill far too many people in our nation's hospitals, clinics and nursing homes. We would never tolerate such a toll in any other arena. Why is it so hard to change the culture of healthcare to put patients' safety first?

Tune in to hear from experts on the front lines about how aviation changed its safety practices and embraced a team approach. Would this work for healthcare, too? What needs to change to make it possible?

Guests: Kathleen Bartholomew, RN, MN, is a national consultant and speaker on patient safety. Her books include Speak Your Truth: Proven Strategies for Effective Nurse-Physician Communication; Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other; and Charting the Course: Launching Patient-Centric Healthcare, co-authored with her husband John Nance. Her website is

 John Nance, JD, was a Lieutenant Colonel in the Air Force and a pilot in commercial aviation. He is an internationally recognized broadcast analyst and advocate for both aviation and health care safety. His books include Why Hospitals Should Fly: The Ultimate Flight Plan to Patient Safety and Quality Care and Charting the Course: Launching Patient-Centric Healthcare, co-authored with his wife Kathleen Bartholomew.

 The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.



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Did you enjoy this radio show? Average rating: 4.5/5 (62 votes)
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Your show is wonderful. I listen every Saturday morning at 7. Great topics. Today's show was about the best yet. WOW!! Very shocking the lack of patient care in this country. Seems like this country is just about money. The rich people seem to be in a frenzy to accumulate more and more and more. Where will it all end? Unbelievable.

Thanks so much for letting us know the truth about so much.

I was listening to the show this morning driving thru W.V. mountains. I heard part of the story the Lt. Col. was telling about an AC of a C-141 but I lost the signal....was hoping you have a transcript of show...would love to read it!! Thank You!! Pete


You will want to listen to the full (FREE) expanded "bonus" interview with both our guests. John Nance shares other stories you will find equally compelling!

Oh dear, maybe you should file this show under home remedies for constipation--enough to scare the you know what out of anyone. :)

I love love love your show. You have made me aware of so many things that have impact on my life. Please keep up the good work.

I recommend your show to all my friends.


Your program on medical safety was very interesting and very useful. Everybody communicating effectively and looking for safety issues is important.

Nevertheless, humans inevitably make mistakes, and we turn to technology to help in all industries. In aviation, for example, the safety of transport aircraft has been improved dramatically by systems such as the enhanced ground proximity warning systems (EGPWS), traffic collision avoidance system (TCAS), and the minimum safe altitude warning system (MSAW). Systems such as these monitor various aspects of flight and alert pilots (EGPWS and TCAS) or air-traffic controllers (MSAW) to circumstances that might threaten safe flight.

Even though the pilot has the ultimate authority when making decisions, these support systems (which are entirely technological) have enabled extraordinary advances in aviation safety.

Healthcare benefits now from advances in technology, but there remain many opportunities for supporting both healthcare workers, patients and their families by exploiting safety technology to enhance the best efforts of the humans involved. As well as the ideas proposed in your program, a comprehensive safety program in healthcare needs to be initiated that has a significant technological component.

About 40 years ago, IBM began the introduction of manufacturing quality control to software development. Initially, all code was inspected by small groups. Defects were recorded, but no one was blamed. Analysis resulted in the recognition that the earlier a defect is inserted, the more costly it was.

Eventually, the inspection process spread backwards from code to the earliest stages of concept and design. Even test plans were subject to the process. Some people resisted because it slowed them down individually, but the overall benefit was clear and quantifiable. There was regular feedback as to the types of defects being inserted, both to help the individual creating each phase and to help inspectors. BTW, inspectors were colleagues working on the project, some a group of outsiders.

By the time I left 20 years ago, it was a different place. Every software lab had methodologists who were dedicated to improving how we did things. I remember one of the leading experts discussing a problem. He was aware of an individual in his lab whose defect-insertion rate was high but who wasn't penalized. The whole ethos that no one was blamed was so strong that he could be counseled, but his career progress was measured by his overall value. It was a tricky management issue, but it was manageable.

At the beginning, it was typical for each hotshot programmer to consider himself a "master of the bit". The most important thing we did was to do what the pilot described, ie, allow everyone to focus on quality and allow everyone to slow things down when needed.

With this background, I have often questioned why health care hasn't been able to adapt any of these approaches. I hear anecdotal information from other countries where there is better collaboration and the malpractice bugaboo has been solved. There are things we can do. The solutions must come from within.

If the health care professionals - all of them, medical doctors, chiropractors, acupuncturists, etc. - can come together, they can get the support they need from lawmakers and the insurance industry. But it has to come from people willing to stick their necks out and do what it takes to focus on the goal, which isn't proving an individual is "master of the scalpel".

This is possibly the most important interview you have ever released. My son and his wife are both nurses, one in cardiac care and the other in home health care, and I am forwarding this to them immediately. Thank you.

All of your programs are excellent. Some like this most recent one about reducing preventable errors in hospitals deserve to be heard far beyond your usual audience -- in this case by the hospital board of directors, medical directors, and key administrators. Do you have a means of contacting them directly with the link to list to the taped broadcast and recommend that they listen and share the broadcast with key administrators? Would be great if you could develop this kind of outreach and networking capability.

People's Pharmacy response: We agree completely, and welcome any readers with those connections to pass the links along.

I agree that this show was the best yet. Your guests' description of mistakes in hospitals was frightening. Her findings should be published in every newspaper and features done on every network and cable TV. The American public should be up in arms over this. We spend huge amounts of hard earned dollars to what seems to be ever increasingly greedy hospitals, trying to keep ourselves well. Entering a hospital today is like Russian Roulette!

I am facing a very serious and very invasive surgery. The prospect of the aorticbifemoral bypass surgery already terrifies me and now I am really spooked!

I really enjoy the show and I listen every saturday morning on the way to the office. As a past member of a hospital's Board of Diretors, I found this show very informative, and relative, to what is happening within the medical field and patient care today.

I'm a soon-to-be a fifty year old woman who has maintained my RN license over the past twenty two years that I've been out of the field. I took a refresher course to decide whether or not nursing is something I'd like to get back into, in some capacity.

I've never felt more sure of a decision to "not" do something before. The sloppiness, indifference, and passing-the-buck that I observed was unsettling.

The diagnosis and "treatment" of disease is what's fueling the mega medical complex. We have to change our culture to be one of prevention. My generation is the first to be raised on that notion. As well, it's the first to question doctors and seek second opinions and utilize adjunct medical approaches.

This couple has revealed a clear cut comparison of the aviation industry that's easy to apply. I ordered the ebook and look forward to learning more about it.

This information is pertinent and extremely important for all consumers to know. I have been in the healthcare field since 1968 (45 years). There is too much secrecy and too many bad habits that are costing patients their health and even lives. My friends, colleagues, and family have heard me rant and rave for years. I'm so glad Kathleen is being heard by a larger audience.

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