The once lofty goal of achieving zero preventable adverse outcomes has now, thankfully, been proven to be possible at multiple clinical sites and across multiple clinical measures. However, much work has yet to be done to ensure ongoing success. Transparency in outcomes, communications and reporting have all helped facilitate this achievement, but further initiatives are needed to change the model of physician autonomy to a ‘collaborative/collegial interactive team.’ There should be an expectation of mutual feedback and transparency between peers, colleagues and inter-disciplinary teams. We are currently working on fostering this culture in my program and it is something I aim to dedicate time to next year.
The lessons learned from the aviation industry and eloquently presented by John Nance, serve as a reminder that success through transparency, principled integrity and culture change is possible, though these changes take time. In medicine, we must remember to be patient while we put our sights on “zero.” Having said this, we must continue to remind ourselves of the fact that we must change, as the current model is unsustainable.