Addressing The Greatest Threat To Healthcare

By Peter Edelstein, MD, FACS, FASCRS Chief Medical Officer, ELSEVIER Clinical Solutions

INTRODUCTION: THE DRIVE TO REDUCE VARIABILITY IN OUR LIVES

Consider the route you took when you drove to work today. Are you going to take a significantly different route tomorrow? How comfortable would you be flying on a plane for which all pre-flight safety evaluations were based solely on the pilot’s intuition or experience? Perhaps the pilot doesn’t feel that the fuel level needs to be checked. Or the landing gear. Or the engines. Would you board that plane?

Across virtually all the activities and processes that make up our daily lives, we attempt to reduce variability. You likely take the same basic route to and from work each day because it is the most time-efficient. And requiring all pilots and flight engineers (even the most experienced) to follow pre-flight checklists has reduced the variability in the safety of air travel so greatly that it is now far safer to fly commercially across an ocean than to drive to the airport (0.07 vs. 7.28 passenger deaths per billion passenger miles, respectively). The mandatory processes and guidelines used by the airlines also significantly reduce financial waste by standardizing fuel requirements calculations.