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Three Lessons the Airline Industry Can Learn from Health Care

By Mike Briddon | Monday, November 5, 2012

The quiet elderly couple stared off into the distance. "How long has it been? This can't be right," said the woman, slowly trailing off. The man, tan from a tropical vacation, paced and looked at his phone for the fifth time in the last two minutes. The crowd grew larger around them. Everyone looked hopeful, but very tired.


"This is really getting ridiculous," said the man. "There must be something wrong. And how come there is no one around to ask?"


Were they waiting for news about a loved one? Was it someone in their family? A close friend?


Nope. They were waiting for their luggage at baggage claim area No. 10 in Miami. They'd been there for 90 minutes. Ninety minutes. And they were there when I grabbed my bag 15 minutes later and headed for customs.  


In health care circles, the airline industry is often seen as the gold standard. It's exactly what health care should be -- safe and collaborative. Pilots use checklists, pilots sleep before operating heavy machinery, and crew members are urged to speak up if they see anything out of the ordinary. There are countless articles and studies about how our hospitals would be much better if they used the system known as crew resource management, and, well, operated like airlines. (In fact, one of the first books I read when I became a health care editor several years ago was "Why Hospitals Should Fly" by John Nance. It's quite good.)


Fresh off a flying experience -- I went to a sunny resort in Mexico with my new bride, Bridget, last week -- I'd like to share three reasons why the friendly skies aren't always so friendly. And why the airlines can maybe even -- gasp -- learn a few things from health care in the future.


1. Flying isn't a very passenger-centered experience. The seats are too small -- and getting smaller. The food has been gone for years. And on some airlines, water is evaporating. (I understand that Spirit is trying to help people with low prices, but no free water? Come on.) I heard a lot of questions about purchasing food, beer, and wine on our flights, but never heard a simple: "Can I get you anything else, sir?" Now, I'm not saying that health care is completely patient-centered. There's still a long way to go. But innovators such as the University of Pittsburgh Medical Center's Tony Digioia and innovations such as shared decision making show that things are changing.

2. Airports are not very good at flow. From Boston to Miami to Cancun and back, it was one snaking line after the next. (I realize that I just returned from paradise and my complaints are probably not high on your list of priorities, but I'm just trying to paint an accurate picture.) First, we had to check in. Then we had to go through security. Then customs. Then security. Then customs. Then a rickety bridge over a 3,000-foot chasm. Okay, I may be exaggerating and I appreciate the need for heightened security in a post 9/11 world, but there has to be a better way. As we sat in one mammoth check-in line, four other agents - designated as business-class agents -- stood idly by just in case a business-class passenger arrived. Forgive me if I think that's silly. Again, health care clearly doesn't have flow solved. There are waits for appointments, waits at the pharmacy, and waits in the emergency room. But type "hospitals improving wait times" into a Google search and just see all the great work that's being done. Conversely, when was the last time you were in an airport and noticed any improvement? 

3. Costs continue to rise in the sky. Between pricey tickets, baggage fees, grabbing an overpriced morsel of food on a dinner-time flight, and $2 headphones (that I can keep!), flying is getting more expensive every minute. My wife and I entertained the idea of flying in first class, but decided we'd rather pay our next 30 years of heating bills instead. And while health care costs aren't exactly under control in every sector, projects such as the IHI Triple Aim are showing it's possible to provide great care without breaking the bank. (Here are a few success stories.) 


The door is open for the health care industry to be a leader in some key areas. These aren't small problems and they won't be solved overnight, but with some hard work and innovation, health care may finally be in a position to mentor the airlines.


And clearly, it's time for a little help. Just ask the couple that by now, I hope, has left baggage claim area No. 10 in Miami.

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