de Korne Dirk F, van Wijngaarden Jeroen D H, Hiddema U Frans, Bleeker Fred G, Pronovost Peter J, Klazinga Niek S
Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital, Erasmus University, Netherlands.
Jt Comm J Qual Patient Saf. 2010 Aug;36(8):339-47. doi: 10.1016/s1553-7250(10)36051-x.
Many authors have advocated the diffusion of innovations from other high-risk industries into health care to improve safety. The aviation industry is comparable to health care because of its similarities in (a) the use of technology, (b) the requirement of highly specialized professional teams, and (c) the existence of risk and uncertainties. For almost 20 years, The Rotterdam Eye Hospital (Rotterdam, the Netherlands) has been engaged in diffusing several innovations adapted from aviation.
A case-study methodology was used to assess the application of innovations in the hospital, with a focus on the context and the detailed mechanism for each innovation. Data on hospital performance outcomes were abstracted from the hospital information data management system, quality and safety reports, and the incident reporting system. Information on the innovations was obtained from a document search; observations; and semistructured, face-to-face interviews.
Aviation industry-based innovations diffused into patient care processes were as follows: patient planning and booking system, taxi service/valet parking, risk analysis (as applied to wrong-site surgery), time-out procedure (also for wrong-site surgery), Crew Resource Management training, and black box. Observations indicated that the innovations had a positive effect on quality and safety in the hospital: Waiting times were reduced, work processes became more standardized, the number of wrong-site surgeries decreased, and awareness of patient safety was heightened.
A near-20-year experience with aviation-based innovation suggests that hospitals start with relatively simple innovations and use a systematic approach toward the goal of improving safety.
许多作者主张将其他高风险行业的创新引入医疗保健领域以提高安全性。航空业与医疗保健行业具有可比性，原因在于它们在以下方面存在相似之处：（a）技术的使用；（b）高度专业化专业团队的要求；（c）风险和不确定性的存在。近20年来，鹿特丹眼科医院（荷兰鹿特丹）一直在致力于推广多项源自航空业的创新。
采用案例研究方法评估医院中创新的应用情况，重点关注每项创新的背景和详细机制。医院绩效结果数据取自医院信息数据管理系统、质量与安全报告以及事件报告系统。有关创新的信息通过文献检索、观察以及半结构化面对面访谈获取。
引入患者护理流程的基于航空业的创新包括：患者规划与预约系统、出租车服务/代客泊车、风险分析（应用于手术部位错误）、暂停程序（也用于手术部位错误）、机组资源管理培训以及黑匣子。观察表明，这些创新对医院的质量和安全产生了积极影响：等待时间缩短，工作流程更加标准化，手术部位错误的数量减少，患者安全意识提高。
近20年基于航空业创新的经验表明，医院应从相对简单的创新入手，并采用系统方法以实现提高安全性的目标。
