To the Editor Freund et al must be commended for their randomized trial showing an association with systematic cross-checking between emergency physicians and reduced adverse events.1
This raises 2 major questions. First, when will cross-checking be implemented so that these findings are not overlooked as previous studies of cross-checking have been?2 Although the airline industry has long been hailed as an inspiring beacon for security, its concepts have still not yet been transferred into the health care system. The airline industry, thankfully, did not perform randomized trials to require 2 pilots in the cockpit. Second, when will adequate training be introduced into the curriculum? Training is a prerequisite that must consider attitudes toward fatigue management, team building, communication, recognizing adverse events, team decision making, and performance.3 In airplanes, 1 of the 2 pilots—regardless of rank—acts as “pilot flying” while the other acts as “pilot monitoring.” Owing to highly competitive selection, cross-checking is far from being our natural mindset.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Braillon A, Bewley S, Ross N. The Health Care System Flies in the Face of Airline Security Concepts. JAMA Intern Med. 2018;178(8):1142–1143. doi:10.1001/jamainternmed.2018.3550
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: