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Hospital Care '3,000 Times Less Safe Than Air Travel,' Says TJC Chief

Cheryl Clark, for HealthLeaders Media, December 20, 2012

Brave hospital quality chiefs, a few hundred strong, sat before The Joint Commission president last week as he meted out some deflating news: They've got to do a better job of preventing death and injury in patient care.

In fact, said TJC President Mark Chassin, MD, U.S. airlines, military aircraft carrier flight decks, and even amusement parks—with their potentially dangerous fun rides—do a better job of recognizing and reporting process problems long before they cause harm. The healthcare industry needs to do that too.

Chassin made his remarks at the Institute for Healthcare Improvement 24th National Forum in Orlando, arguably the nation's amusement park capital. And during his talk, he urged hospitals and doctors to work harder to move their systems to "High Reliability," a phrase he used about 50 times within the span of an hour.

Consider these numbers, he urged:

The airline industry in the United States between 1990 and 2001 averaged 129 deaths per year, out of 9.3 million flights a year. Or 13.9 deaths per million flights. "In the 1990s, US air carriers were the safest air carriers on the planet by a large margin."

But in the next decade, 2000-2010, airlines became much safer, with only 18 deaths per year out of 10.6 million flights per year, for a death rate of 1.7 per million.

That decline, greater than eight-fold, was accomplished "in an industry that was already the safest on the planet.  A characteristic of high reliability [is that] they are never happy with where they are today. They are always pushing the envelope for safety."

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