Culture Change: Aviation Safety in Healthcare Across Air Force
The Air Combat Command Surgeon General's office pioneered a program bringing operational risk management and flightline safety procedures into hospitals and dental squadrons across the Air Force.
Brig. Gen. Daniel Wyman, the Air Combat Command Surgeon General and a team of ACC aerospace physiologists, well-versed in operational risk management and medical risks of flight procedures, have introduced flightline processes that will unify procedures inside Air Force operating rooms across the globe.
"We are setting up our operating rooms to a single standard," Wyman said. "In hospitals, you might go to two different operating rooms and experience two different ways of doing things. Our goal is for any doctor, or any surgical technician, to PCS from one base to another and be able to jump right in."
The program focuses on several key concepts of aviation safety including standardization, team-based accountability, and mishap investigations. The concepts are being adapted from the principles of operational risk management. This enables Air Force members in the medical field to determine the best course of action for any given situation.
The goals of the enhancements are to preserve patient health and enhance mission effectiveness at all levels while preserving assets.
The procedures also aim to minimize the risks that come with working in medical facilities that judiciously use the best current evidence in making decisions about the care of individual patients to prevent mistakes or infections.
"There is always a risk for infection, whether it be after surgery or something as simple as placing an IV," Wyman said. "By providing step-by-step standards on how to perform a task, we can be sure it is being done in a way that prevents infection."
Another aspect of the program is team-based accountability. At any time during a procedure, team members are encouraged and expected to speak up if something is wrong. TeamSTEPPS, which stands for Team Strategies and Tools to Enhance Performance and Patient Safety, enhances attitudes toward teamwork, develops participant knowledge about effective team practice, and improves team skills within the unit.
"By utilizing programs like TeamSTEPPS, we are slowly building a culture to change behavior with a new emphasis on team dynamics." said Lt. Col. Thomas Massa, the Headquarters ACC Surgeon General aerospace physiologist. "Every member of the team is empowered to speak up and say 'Hold on, we are doing this wrong.'"
Communication is encouraged among the team so Airmen know their roles and the roles of others going into a procedure. If everybody knows the plan, Massa said, "Everyone will know if it goes awry."
Medical investigations will now focus on a lessons learned approach for correcting future mistakes instead of levying punishments for human errors.
"We don't want our Airmen to be afraid to tell us what went wrong," Wyman said. "At the end of the day, we just want to know what happened so we can fix it."
Joint Base Langley-Eustis, Virginia, was the test bed for the programs, which all fall under the umbrella of a culture change, Wyman said. The results were briefed to Air Force Medical Operations Agency, which then set the procedures in place Air Force-wide.
Airman 1st Class Tory Cusimano, Headquarters Air Combat Command Public Affair for Air Force News Service. (Staff Sgt. Steve Stanley contributed to this story)
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