Healthcare and Aviation ….. Cross Learnings

From the Crucibles of JPS Customer Value Academy
Just Plain & Simple
….. Helping Create Customer Value
14th Issue of HEALTH BIZ INDIA magazine, October, 2011

Recently I came across a very interesting article on the net. It was titled ‘Why Patient Safety is harder than aviation safety and five practices to borrow from aviation’. The author argues that there are a lot of learnings that the health care industry could draw from aviation safety and the rigour and discipline that goes into the same. He also mentions that he does not want to oversimplify the comparison and realizes that healthcare is a lot ‘harder’. The basic reason given for this is related to ‘scale’ ….. number of patients vs passengers, number of pilots vs nurses and types of aircraft vs diseases. The practices listed, that play a role in aviation safety and the ones that healthcare could learn from are ….. usability and safety of technology, crew management, simulation, prediction and root cause analysis (and hence open and transparent exchange of data).

While it is true that there is a difference in ‘scale’ and ‘complexity’ in the two cases, the discipline and learnings can and should definitely flow into ‘speciality/superspeciality/critical care’, where the gap of scale reduces and ‘seriousness’ and ‘speed of response’ maybe equally significant ….. It is ironical that aviation is taking lessons from hospitals and hospitality on aspects of care though !!

However, just stepping back to first principles for a moment and correlating the fundamental dimensions where there may be similarities and differences between the two that we can build on, let us look at the following :

  • Core Deliverables :
    • Healthcare : Good clinical/surgical outcomes
    • Aviation : On time and comfortable trips
  • Essentials to build on :
    • Healthcare : Patient Care; course/accuracy of treatment; Doctors and staff
    • Aviation : Speed/turnaround time; speed of response; Stringent Processes/technology
  • Performance Metrics :
    • Healthcare : Surplus/sq. ft. or Surplus/bed
    • Aviation : Surplus/trip

With ‘cost/trip’ more or less ‘fixed’, there is a concerted effort in aviation, to build on passenger numbers and revenue/passenger (Needless to say, there should obviously be no compromise on speed of response and safety).

If healthcare is to come out of this trap (no matter who pays for the treatments) of chasing numbers and revenues to fulfill a ‘fixed cost or unabsorbed capacity’, the answer lies in (Needless to say, with no compromise on clinical/surgical outcomes and patient safety) :

1) Scale to be achieved through creating reach and accessability to broaden the base (and much needed in the Indian context), alongwith

2)‘Disruptive Technologies’ to reduce cost/sq. ft. or cost/bed.

These answers are available in development/deployment of ‘appropriate technology’ (Innovation) and spreading the cost of technology and doctors (per patient or per bed or per sq.ft.) through initiatives like telemedicine (the doctors deserve to be paid competitively, but the cost implication on the ‘metrics’ per unit of patient or sq.ft. or bed gets enormously spread out)

Having said that, the learnings from aviation can and should be very appropriately and immediately applied in all aspects of healthcare where safety and speed of response is critical. There are examples even in healthcare where such rigour and discipline is followed. As the scale, accessability and reach of healthcare increases, learnings, processes and skils from these centres of excellence in health care and for sure even from aviation, should be weaved into the genetic code of patient care at all levels as the wave spreads over time.

Aviation is definitely a good learning ground as the source article I mentioned, says, but even otherwise, a similar discipline is needed in any field, in the evolution from being a novice to eminence ….. and it will be very helpful to the evolving Indian Healthcare industry to adopt the following practices and catch the wave on the high !!

  • Taking feedback continuously ….. it is said that ‘feedback is the breakfast of champions’.
  • Priority Setting ….. allows effective and efficient utilization of scarce resources.
  • Sharing ‘The Technique/Method’ with trust and openness ….. for any new entrant, learning from scratch and building up a code from first principle is like re-inventing the wheel.
  • Coaching Ability and Coachability ….. To reach high levels of expertise, inputs from a good coach are extremely helpful
  • Practice, Practice, Practice ….. there is no substitute to this ingredient
  • Simulation, ‘Rehearsals’ and Performance ….. this is a practice followed wherever ‘expertise’ is reached ….. sports, dance, science …..
  • Root Cause Analysis ….. to be able to search for, hit and face the truth boldly and correct it

These are very much woven into the DNA of the aviation industry as well. No wonder we are able to see the beauty of aircraft flying in a formation ….. with a shared vision, speed, trust, constant communication, safety, teamwork, and grace …..


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8 thoughts on “Healthcare and Aviation ….. Cross Learnings

  1. Kannan N

    The significant difference between Aviation and healthcare is the expectations.
    In Aviation you are aware, when you would reach with in a specific time if a flight takes off. (Bad weather, bad scheduling notwithstanding). In healthcare the patient expectations are quite different and each patient complications/response to drugs are not very predictable. So in terms of service there are in all likelihood more unexpected happenings during patient care.
    There are significant process rigours that you have pointed out which are quite relevant and need to be adopted suitably in the healthcare space.
    Excellent material with lots of insights. Thanks. Deeply appreciate the effort.
    Kannan N

  2. JP SinghJP Singh Post author

    Thanks Kannan ….. Your comment is very valid ….. in healthcare, the deliverable is accuracy of treatment and in aviation it is timeliness (followed by comfort/convenience in both cases, as an outer layer). Both are subject to Heisenberg’s Uncertainty Principle and hence, ‘Predictability’ becomes the common factor

  3. Sanjay

    Dear JPS,

    Lot of thought has been put behind making comparison between two seemingly diametrically opposite services!

    While healthcare mends people and restores their joys of life, aviation is all about efficiency, taking people from point A to point B and on the way giving some Cheer!

    While outcomes and patient’s/people’s safety is paramount, (you would avoid an airline or hospital like plague if there was a doubt about the safety standards ) efficiency is one thing which is often given different treatment by healthcare and aviation services!

    In aviation you have the SOPs driven right from the top and pilots, crew and ground staff know exactly what has to be done at all times, even emergencies are factored for. While in case of healthcare each patient comes with a unique set of ailment, co-morbidities and health profile. Much as the hospital administrators would like to drive SOPs the specialist and his team know what is best for the patient in those unique circumstances.

    Hence, one would tend to believe that model of continuous innovation and improvement that drives Aviation may not be applicable to Healthcare where flexibility and variability is interwoven in the service stream. One may be led to think there is more similarity between the process in a car repair shop and healthcare as compared to aviation.

    However, there is one common theme that runs through, that is both are dealing with human beings and trying to address each one as an individual. There is a very high degree of human intervention and interaction, such that it is these interactions that sometimes make more difference to the overall service experience.

    Putting people at the center healthcare can pick up quite a few lessons from aviation like,

    – feedback generation, dissemination and complaint resolution process
    – high standards of empowerment and customer care
    – common goal setting and review (including the root cause analysis suggested by you)
    – coaching and mentoring (as already mentioned by you)

    Even if in healthcare we are able to imbibe these processes, we will be able to deliver superior healthcare at possibly lower costs.

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