Lessons from aviation safety: “plan your operation – and operate your plan!”

The systematic implementation of surgical safety checklists in the past 5 to 10 years has contributed to a global decrease in morbidity and mortality after surgical procedures [1-5]. What I find intriguing about these data is that the significant reduction in adverse events with the utilization of a simple surgical check list did not require a costly, high-tech solution but rather a simple, almost “no-cost attitude” and procedural change in the operating theater. Going back in history, in response to adverse aircraft incidents, the Army-Air Corps test pilots developed a series of aircraft check-lists to reduce the work load on the pilot of the complex aircraft systems and instrumentation in 1935. The aviation community has adopted these check lists and procedures as standard not only in military, but commercial and civilian aviation procedures as well. Their premier goal has always been the safety of passengers and aircraft. Aviation flight planning consists of four distinct steps: