I'm @SafetyNurse. Fly me?

Over the past decade, healthcare has borrowed a number of engineering strategies widely used in commercial aviation to improve safety. Barriers, redundancies, and opportunities to uncover errors inadvertently set in motion are increasingly used to help prevent patients from "going off the runaway."

In the aftermath of the US Airways flight that safely landed a planeload of people in the Hudson River earlier this year, a pilot's words about the investment the flight deck has in safety stuck with me. "We're first up and last down on every flight." His words resonate because they so clearly align with a jet's nose-up take-off and wheels-down landing, an image indelibly etched in my mind after flying hundreds of thousands of miles.

We don't have reinforcers like that built into healthcare. But there are signs that the stakes are going up for leadership engagement in patient safety. Last week, The Joint Commission issued a sentinel event alert describing safety-sensitive beliefs and actions required of leaders--many that challenge healthcare's historic "Just Do It" approach to safety.

The Joint Commission's bulletin stresses the importance of matching what leaders say is valued with what's visible to front line professionals during routine and high-stakes junctures of care, particularly in the aftermath of high-profile error. Once again, we'll be borrowing from aviation.

So here's a nod to modeling transparency, an essential element of a culture of safety. I'm @SafetyNurse. Fly me!