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On Saturday, Asiana Airlines flight 214, a Boeing 777, crashed upon landing at San Francisco Airport. The NTSB, the government body in charge of the investigation, has numerous experts on scene. The intense media focus creates a false sense of insecurity, leading many to feel that commercial air travel is risky.
One of the foundational safety principles of modern aviation is known as the Swiss cheese model. Accidents involving complex systems are often the result of the confluence of multiple contributing factors. As opposed to the active errors that occur at the time of an incident many contributing factors are in fact latent errors. Human beings, lacking unlimited concentration, focus and memory, will always be prone to operational errors. Reason summarized his integrated theory of accident causation with an excellent visual known as the Swiss cheese model. Let’s consider the model in the context of an investigation into a a crash landing such as Asiana flight 214.
Reason’s profound contribution was the idea that an unsafe act was simply the hole in the final layer of cheese that allowed the ultimate accident. Since the publication of Human Error, Reason’s Swiss cheese model has been adopted by a number of high-risk industries.
Deaths due to medical errors in hospitals are higher than certain other causes of death in the U.S.
Connectivity means a device can digitally communicate with and transfer diagnostic data to any number of systems, including an Electronic Medical Record (EMR), Hospital Information System (HIS), National Insurance Billing system, Telemedicine, via email, or over the web. In today’s fast-paced healthcare environment, patient safety, clinical workflow efficiency, and cost savings are critically important. Keep your patients safer and improve data accuracy and completeness by eliminating transcription errors and lost diagnostic data.
Capture a more complete and comprehensive set of test results on every patient and enhance your practice’s efficiency by eliminating duplicate patient data recording and several manual printing, scanning, and filing steps. Save time and money by having immediate access to patient diagnostic data anytime, anywhere and allow your staff to focus on patient care and office management. Welch Allyn has the industry-leading products, advanced tools, and knowledgeable experts to help show you the way to a bright, connected future for your practice. Our broad base of connectivity experience and flexible connectivity options can help you find the right solution for virtually any facility. Whether you need to connect to an EMR, HIS, or send your data over the web or through email, Welch Allyn devices provide a connectivity solution for you.


When you are researching devices for your practice, you want to make sure you’ve got an accurate, reliable piece of equipment. Some quick answers to these and more will help you tap into the resources that Welch Allyn has available to assist you in preparing for or choosing the right connectivity solution for your facility’s needs. This powerful software package has a variety of diagnostic tools that make it easy for you to analyze and compare cardiopulmonary data, allowing you to quickly find the information you need. Through a combination of luck and robust aircraft design, only 2 people were killed; a surprising outcome given the photos of the wreckage. Their process is methodical, sometimes taking years to establish a series of root causes and recommendations following a plane crash.
Our need to feel secure fuels a desire for straightforward explanations that bring closure to mysteries.
In truth, aviation safety efforts have produced remarkable results — commercial air travel is an incredibly safe mode of transportation.
It is a concept that was first described by the cognitive psychologist and researcher James Reason. These latent errors lie dormant, waiting for an active error to turn them into a trigger for an incident.
Properly designed systems account for this limitation, expect a level of human error, and ultimately keep these errors from resulting in an actual incident. As a disclaimer, this example is not intended to represent a factual analysis of this tragic event. A classic example in a plane crash would be fatigue, as when pilots on a long flight have had insufficient sleep.
As an example, an organization that has a strong focus on growth may not be as invested in extensive training programs for new personnel. Along with commercial aviation, it has become a key source of guidance in hospitals and nuclear power plants. We have established hundreds of device interfaces and integrations with EMR and HIS companies.
And when you buy a Welch Allyn device, you know that you’re buying products from the industry leader in diagnostic equipment and solutions. Are you a remote site looking to transmit information for review by an expert in a different location?
Welch Allyn has collaborated with dozens of software providers to provide a bidirectional exchange of information between the EMR system and cardiopulmonary device software that creates powerful and efficient diagnostic testing workflows. Please contact a Welch Allyn connectivity specialist or your specific representative with any questions.
Our culture of real-time social media rapidly turns people into aviation experts, investigative sleuths and conspiracy theorists. In his seminal book Human Error, Reason chronicled a number of famous disasters, including Three Mile Island and the Challenger space shuttle accident.


It is simply an example of how the Swiss cheese model can be used by investigators to gain a deeper perspective of the root cause of an accident.
An airline undergoing margin pressures may be disinclined to make investments in state-of-the-art safety programs. Prior to Reason, the predominant focus of an accident investigation was on the operators (e.g. Progressive organizations will take the Swiss cheese model to heart and adopt a more holistic approach to accident prevention and investigation. Hospitals can support entire networks of remote recording sites requiring an expert opinion and data storage for entire network of clinics, no matter where they’re located.
So, no matter which system you choose, you can be confident that your Welch Allyn devices will connect with them.
Even if you don’t have an EMR or HIS today, Welch Allyn cardiopulmonary devices like the CP 50 come equipped to connect to your EMR or HIS today or in the future.
Our rugged, reliable products are the first choice for physicians and clinicians around the world, and our large installed base is backed by an extensive dealer network and best-in-class service capabilities.
The result is a dramatically streamlined process for recording and capturing cardiopulmonary test data. Intense speculation surrounds the cause of the crash, with theories ranging from pilot error to inoperative runway guidance systems to mechanical failure. The remaining pieces of the plane are immediately observable, unlike crashes that happen at sea. Unfortunately, armchair speculation is rarely accurate, and ultimately the contributing factors of a crash can be diverse and complex.
But instead of merely reviewing the underlying factors of each incident, he proposed an integrated theory of accident causation. They will recognize that culture, organization, and process design are all needed to provide adequate defensive layers for inevitable human errors.
What is known so far is that the plane made an abnormal final approach, striking it’s tail against a sea wall that precedes the runway. This leads to inadequate error investigation protocols that frequently focus on the operator.
Much of this is due to the disciplined, evidence-based approach to safety of modern aviation. The crew survived the crash and will be able to provide important information about the final fateful minutes of the flight.
Reason argued that doing so would not solve the deeper organizational issues that led to the problem.



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Comments

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