Creating a culture of safety: From the cockpit to the operating room, the same principles apply

When boarding an airplane or being rolled into surgery, we place our lives in the hands of experts, trusting they know best what to do in an emergency. But how does this look from the perspective of the attending team? AO President-Elect Florian Gebhard talked recently with human factors experts, pilots, and surgeons about how the right team, the right leaders, and a culture of trust are fundamental in creating a safe and efficient working environment.

Gebhard believes his generation will be the first to recognize that old hierarchies may not be ideal, and that leadership and hierarchy will change dramatically in the years ahead. He suggests a more standardized approach to developing the skills that create a culture of trust in the operating room.

People need to be seen

The pandemic hit many industries hard, and none quite like the aviation industry. Martin Egerth, a senior human factors expert at Lufthansa Aviation Training Switzerland, says it is heartbreaking to see grounded aircrafts, and the fear and uncertainty that this creates for the crews.

"But we all know that the future is out there. We will fly again one day, and medicine too will return to some kind of ‘normal,’" he says.

The pandemic has also highlighted the importance of empathy. A few months ago, Egerth asked 100 people what is important to them as patients in hospital.

"First, they mentioned expertise and competence. They then spoke about being taken seriously, having trust in their medical team, and not being treated like a number,” he explains. “Empathy is a simple concept but not everyone is empathetic. Some things can be learned and often it’s the small things: saying hello, saying thank-you, really seeing the other person."

Trauma surgeon Matthias Muenzberg agrees. He is part of the COVID-19 crisis team in his hospital in Ludwigshafen, Germany, and has seen it closely. 

 "This crisis has highlighted where we lack in interpersonal competencies like leadership and communication. In medicine we tend to focus on perfecting our technical skills, but our patients need communication and information,” he says. “They look for leadership to get us through this."

 

Leaders are also team players

Henry Ford is famously quoted as saying that coming together is a beginning, keeping together is progress, and working together is success. Lufthansa pilot Leila Belaasri reminds that trust and teamwork do not happen automatically.

"We work hard on it every single flight of every single day. It’s the task of the leader in the cockpit to promote this to the whole crew, to invite them to speak honestly about everything, starting with mistakes,” she says. “We are human beings and have limitations in performance and we address that and accept it."