Is the Aviation analogy falling short?

Originally posted 7-9-2010:
Healthcare has been looking at the aviation industry for safety inspiration for some time now.  And why not?  Over the last 30 years there has been a reduction in accident rates as the industry culture became safety focused.  (The mystery of where your luggage will end up is another story.)  Patient Safety initiatives such as the use of checklists, Crew Resource Management, and increased use of simulator training are all from aviation. Experts make comparisons to aviation when teaching Patient Safety science.  John Nance wrote an entire book, which I recommend reading, on what the ideal hospital would look like if it followed the same steps aviation did to improve the culture of safety. 

How effective have these techniques and initiatives transferred to healthcare?  This article that was published on the American Medical News website provides a good answer.  The article is a good read as it provides an overview of the aviation techniques tried in healthcare, and discusses which ones have worked.  The article also does a good job summarizing where the aviation analogies are falling short in healthcare.

One of the key things that stood out was the reporting issue.  The article states, "many reporting systems in health care fail to replicate the aviation industry's no-blame model."  The healthcare culture needs to continue to move in a direction where people are comfortable reporting safety issues and mistakes.  How can we learn from our mistakes if no one is comfortable reporting them?

I also liked Dr. Pronovost's quote at the end - "A mistake health care made is to try to take lock, stock and barrel what's been done in aviation and plunk it down in medicine. Health care has to find its own way."  Perhaps healthcare has gotten to the point where it has learned all it can from aviation.  I don't think the lessons learned from aviation safety should be ignored, but is it time for the patient safety leaders to look within for the next set of initiatives?