Human factors in anaesthesia: lessons from aviation

Aviation safety has evolved over more than a century and has achieved remarkable results. Applying some of the lessons learned may help make healthcare safer. From the perspective of an anaesthetic background and some thousands of hours of airline flying, I offer a personal perspective, try to give a sense of the place of human factors in airline operations and some of the current problems, and make some suggestions as to what the NHS and anaesthesia might learn from this. Although many of the ingredients for safe operation are frequently already present in our hospitals, and some individual clinical areas and departments achieve high levels of reliability and safety, I will emphasize my firm belief that we cannot expect improvements in human factors training and awareness to be fully effective in the healthcare setting without the parallel development of a simple and strong safety system across organizations. In the process, we may find that the safe hospital turns out somewhat differently to the safe airline.