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What can Healthcare Sector learn from Aviation Industry?

Abishek Goda

Ever since we spoke to Dr. Rosas, we have been wondering how healthcare safety can learn from the aviation industry – which, despite being nascent compared to healthcare, is reputed for its safety standards. We did much studying, and this article is a distillation of our thoughts. We have included all our references at the end of this article – as it turns out, we weren’t the first to ask this question!


Two seemingly different industries: What do they have in common, and where do the differences begin?


If one looks at it objectively, the conclusion one can draw is that although they are vastly different, they have many mutual lessons that can benefit each other. Over the last century, the aviation industry has seen massive growth, be it air traffic or the expansion of travel to different parts of the world. The sector has also secured a name for itself in terms of passenger comfort, safety, and, in most cases, timeliness. On the other hand, the healthcare industry has existed for more than a century and has seen many changes in treatment methods, care for patients’ wellbeing, and newer scientific discoveries for better health.


So, the question arises then: What can a sector created for transporting people and cargo by air have in common with the healthcare sector that deals with patients and treatment?


To give a fair picture, let us see some areas where we can compare the two, and the healthcare division can imbibe some lessons.

Safety

By and large, the aviation industry had the privilege of understanding what safety is regarding passenger and crew management. Use of Incident Reporting is one of the successful ways this is implemented. IR is a term familiar to many sectors and plays an essential role in preventing safety hazards or repeating errors. The aviation industry follows a standardized protocol for IR, which focuses on the larger picture and does not place all the accountability on the pilot alone.

Both pilots and doctors are professionals that hold the responsibility of safeguarding lives. Often errors have significant, irreversible consequences in either field. Yet, despite the high risks, the aviation industry leads IR with a blame-free atmosphere. A culture that is “open” and focused on learning allows the concerned parties to report incidents without the fear of adverse consequences. In the health industry, the report is often downplayed, leading to the repetition of an error. Healthcare requires an openness to modify policies without shifting the blame onto the staff or the members concerned.

One of the most successful ways the Aviation industry has ensured the safety protocols of its consumers is by adopting worldwide standards of secure transport. Many of us are familiar with the NTSB (National Transportation Safety Board). The NTSB takes on much responsibility when there is an accident. The incident is treated with grave seriousness, immediately catapulting a series of investigative reports regarding manufacturing, operation, and administration. This process guarantees that a quick decision is made and thus, lessens future debacles. When an incident occurs, the NTSB, given its integral influence on Aviation, is eligible to conduct a parallel investigation with the concerned Aviation system. The overall process has been largely effective in reducing fatality rates.

While the NTSB is a U.S-based organization, its standardization works across various countries. This two-layered work on incident reporting, where Aviation Boards work in solidarity with a larger system, has considerably played a critical role in increasing aviation safety.

Communication

In many sectors, employees downplay incidents for various reasons – one of the crucial reasons is the fear of losing employment. When an IR is created in the aviation industry, meetings discuss the incident, and there is no question of terminating employment. This openness to discussion discusses what had taken place and goes a step further in filling up gaps in communication. Aviation has a “Crew Resource Management” system, a system specifically designed for training on the job and facilitating professional communication. This system is where the airline crew, including the pilots and the flight attendants, and the ground crew and anyone involved with the airline communicates, and their cooperation dramatically reduces the risk of imminent danger.

Journaling is another vital aspect of airline staff that has helped the sector blossom. Pilots often write about their experiences of navigating a flight after landing. These journals are first-person accounts, maintained with details that may be both positive and negative, discussing the troubles faced during the flight and the overall journey. The crew are not penalized for sharing the mistakes in the journal. Every meeting is a step to betterment. Sharing the journal with the larger group of employees helps maintain transparency and leads to prevention. 

Understanding that passenger safety is of paramount importance and conceding that risk affects both the passengers and the crew, the open and learning culture of the aviation industry has come a long way in terms of care

Standardization

Indeed, the industries are different in terms of their period of existence, aim, and intricacies of customized caregiving. However, one significant learning that the aviation sector can provide is in terms of standardization. 

For airlines, the procedures are standard. From equipment, training, the language used to the IRS; the essentials are all well-structured and easy to follow for those involved. Most procedures in the aviation industry do not need second-guessing since all the information is readily available, including external factors such as imminent weather conditions, thereby reducing the risk of an unexpected catastrophe.

However, despite the differences that the healthcare sector faces from patient to patient, implementing standardized procedures for IRS or training the staff would greatly add value and be a step towards betterment

Responsibility

The final section is an overview of the workforce involved in either industry. When issues occur, an investigation is often conducted nationwide or even internationally for the aviation sector. However, many of the incidents in hospitals are only locally addressed and do not receive widespread attention unless for exceptional reasons. Doctors and staff are often at the receiving end of criticism, and the effects are long-lasting. Even minor incidents in aviation garner media attention. This attention contributes to an efficient working atmosphere in the aviation sector. Governing bodies created to address issues and almost infallible checklists to verify the smooth functioning of an airline, both on the ground and in the air, has primarily created a positive customer experience.

Aviation ensures an atmosphere of zero anxiety both for the staff and the passenger while placing enormous importance on comfort and safety. While healthcare organizations and national health governance bodies carry out significant reforms frequently, the lack of a centralized body responsible for investigation and policy formation leaves the individual organizations on their own regarding patient safety

To Conclude

There are many reasons why we cannot compare the healthcare industry to the aviation sector. The above are some aspects the two industries are similar. Over the years, the healthcare sector has seen much positive change, and these suggestions can only steadily contribute to a healthier future, mindful of safety and transparency.

References

Beentjes, Bianca (August 20, 2020). “What can the aviation sector teach the healthcare sector about safety?” Accessible here.

 

Dhand, Suneel (April 7, 2016). “Here’s Why You Can’t Compare Healthcare to the Airline Industry.” Accessible here.

 

Hunter, Greg. (September 27, 2017). “Healthcare Can Learn From the Aviation Industry About Safety” Accessible here.

 

Kapur, N., Parand, A., Soukup, T., Reader, T., & Sevdalis, N. (2015). Aviation and healthcare: a comparative review with implications for patient safety. JRSM Open, 7(1), 2054270415616548. Accessible here.

 

Meiners, John (June 13, 2019). “What can healthcare learn from the airline industry?” Accessible here.

 

Parmar, Hemraj (September 19, 2014). “Lessons for the Healthcare Industry from the Aviation Sector.” Accessible here.

 

Rice, Stephen ( February 7, 2020). “What Can Healthcare Learn From Aviation Safety?” Accessible here.

 

Swartz, Martha K. Swartz (2015). “What Health Care is Learning From the Aviation Industry”. Journal of Paediatric Health Care, Vol 29 Number 1. Accessible here.

 

Digitization – A Pathway Towards Digital Transformation

Rohini
Digitization-vs.-Digitalization-Banner

If we look back two and half decades, businesses have to provide input to their computing devices to convert data into a digital format.

Leaping for a few years, businesses gain capabilities to process data over digital technologies instead of the manual or offline system.

This digital evolution is called digitization to digitalization!

Confused?

Like their spellings—digitization and digitalization are insanely interlocked together that anyone can get confused between both terminologies. However, if we try to explain in one line

—‘digitization is information’ and ‘digitalization is a process.’

We know it still doesn’t give away why digitization and digitalization are different when they both deal with processing and interpreting information?

So, let’s dig deeper and understand what lies in the roots of digitization and digitalization.

What is Digitization?

According to Oxford's Dictionary — “Digitization is the process of changing data into a digital form that can be easily read and processed by a computer.”

In layman’s terminology, digitization is a method to turn information into binary digits (1’s and 0’s) so that computers can easily understand and process it.

In this process, the user takes analog information such as photographs, soundtracks, or documents and converts them into a digital form that can be stored and accessed by digital devices.


For example
, a hospital converting patients’ paper records into Excel sheets for better preservation and access. Additional examples—scanning old documents to PDFs, transforming printed reports to meaningful data, turning a vinyl record into an MP3 file, and so on.

 

Whether you wish to preserve old information or capture new information for later use, the information dealing process will be called digitization

Why is Digitization Important for Your Business?

According to a McKinsey report, the pharmaceutical and medical industry shows the least amount of digital frontier gap for 13.4% and travel sector maximum for 51%. In this, if you are still wondering why to take a step towards digitization, reasons are:

Market Trends:


It doesn’t matter which industry you are part of—the digital wave is everywhere. Thanks to cheap internet services and smart gadgets, today, digital technologies are in everyone’s hands. From booking a cab to consulting a doctor, everything is digital—now, it’s up to you whether you want to be part of the trend or not?

Improve Efficiency:


Your paperback business documents are prone to theft, loss, wear and tear—with no way to replace them. Therefore, if you don’t want to reduce your business efficiency due to inefficient information, safely store your data in a digital format.

Better User Experience:


Presently, a fast and smooth user experience is an imperative way to grow your business, which you can’t achieve via manual services. The progressive businesses have completely understood this phenomenon, such as Pizza Hut started taking their customers’ orders through the interactive touch screen in their restaurants.

Limited Growth:


If you haven’t digitized your data yet, you cannot take leverage from the new growth and marketing metrics such as social media.

What is Digitalization?

If you search for digitalization definition on Oxford’s dictionary, you will receive the same definition as digitization.


Wait, what?

Then, how come both terms are different?

Well, they are different—trust us, just let us break the concept for better understanding. Earlier, we mentioned that when a hospital converts patients’ records into Excel sheets, it’s digitization—but, when a hospital receives patients’ records in email and adds them into Excel sheets, records are already digitized; thus, this concept will be called digitalization.

So, digitalization is a process of converting information into different digital equivalents. For instance, recording a patient’s data using a digital registration method is digitalization, but scanning printed records into digital form is digitization.

Digitalization is an ongoing process as new technologies are emerging and expanding the further scope of digital development. Therefore, twenty-first-century businesses can’t avoid digitalization!

Why Is Digitalization Important for Your Business?

Roughly 4.66 billion people around the globe are using the internet at the beginning of 2021—that means 60% of the world’s population has embraced digitalization. However, if you haven’t digitalized your business yet, you should because:

Collaborated Team: When marketing and technical teams collaborate together, they can better understand customers’ needs and find better solutions to satisfy them. Using the analytical tool, the marketing team can effectively analyze market trends and provide correct data to the sales team to quickly convert potential leads into customers.

Improved Data Collection: Nowadays, businesses are busy collecting mountains of data related to their customers, but the real benefit is optimizing collected data for analysis. With digitalization, a system can gather the right data and intelligently analyze it.

Resource Allocation: Digitalization can consolidate business resources into a centralized software for easy access. In 2020, businesses used an average of 900+ applications to run their operations, which makes it very hard to derive information from the various portal. Digitalization can help in streamlining different data silos to provide efficiency across units.

Elevated Profits: Digitization pushes businesses towards better efficiency and profitability. According to the SAP Center for Business Insights and Oxford Economics report, —80% of fully digitalized companies have recorded upward growth in their profits. Now, this fact is sufficient to know to prove how digitalization can improve business profits.

Key Differences Between Digitization and Digitalization

For better clarification on the notion—‘digitization is information’ and ‘digitalization is process’—let’s understand what primarily set both terms apart.

Information Conversion

In both terms, information is converted from one form to another. Where digitization is converting analog information into a digital form, on the contrary, digitalization transfers information to equivalent digital devices. The information might be a common factor here, but the way to deal with it is completely different

Basic Purpose

Digitization is performed to make information highly accessible to a company. Imagine, when a hospital wants to retrieve the gynecologist department’s records for 2012, the manual search might take lots of time—even if all the documents are chronologically arranged. On the other hand, digitized records can be retrieved with one click, which makes it easy to access information.

 

The purpose of digitalization is beyond accessing information; it is a process of analyzing and interpreting information to improve productivity and efficiency. Such as, once the hospital has received information, they can analyze the gynecologist department’s data and interpret comparisons between 2012 and 2021 performance rates.

Functionality

Both terms are polar apart on the functionality grounds—digitization operates to store information permanently, and digitalization focuses on improving data accuracy.

For instance, a healthcare clinic can create permanent data backup digitally so that natural calamities, theft, or other incidents won’t damage their vital information. Next, they can form a correlation between information and arrange systematically to provide solutions. In a way, digitization stores information, and digitalization process that information.

Nature of Data

Digitization is performed to make information highly accessible to a company. Imagine, when a hospital wants to retrieve the gynecologist department’s records for 2012, the manual search might take lots of time—even if all the documents are chronologically arranged. On the other hand, digitized records can be retrieved with one click, which makes it easy to access information.

 

The purpose of digitalization is beyond accessing information; it is a process of analyzing and interpreting information to improve productivity and efficiency. Such as, once the hospital has received information, they can analyze the gynecologist department’s data and interpret comparisons between 2012 and 2021 performance rates.

Tools

Digitization and digitalization aren’t possible without adequate tools. For digitization, input tools are mainly used like Scanner, Digital Camera, Storage & Retrieval Systems, OCR Software, and others.

Multiple software solutions are used to accomplish the digitalization process, such as ERP Software, Messaging & Conferencing Software, Predictive Maintenance Systems, Robotics & Controller Systems,, and more.

Example

Suppose a doctor is conducting a study on traditional chronic diseases. For research purposes, he collected multiple handwritten paper manuscripts of his old patients and converted them into a checklist app to easily access the relevant information for his research.

Next, he used digital technologies to process and analyze data in real-time and draw insightful conclusions to include in his study.

Future of Digitization & Digitalization — Digital Transformation

Digitization was started around 25 years back when computer systems became part of mainstream activities—so we can say that it’s now completed.

After digitization, the digitalization process began and continued to evolve with the introduction of new technologies. Slowly, digitalization is moving towards the digital formation—the future.

Digital transformation is a high-level digital business perspective where strategic decisions are made to take leverage from all digital technologies and change the overall approach of the business to create a resilient environment.

It is a broad framework, which is still evolving with the help of new technologies. It is projected that the global digital transformation market size will expand at a CAGR of 22.5% between 2020 to 2027

Wrap Up


On parting thoughts, digitization deals with information, digitalization manages processes, and digital transformation happens to be a reformation. If we say digitization was the past and digitalization is the present, digital transformation is definitely the future.

 

So, it is step after step, which businesses should embrace to stay ahead of the competition and prepare themselves for the future.

Moving from a paper-based system to a digital system

Rohini
paper digital system

Despite all the advances in medical technologies, Incident management remains a paper-based manual process in many hospitals. We understand that multiple factors drive these decisions. There is no single reason why any hospital continues on a manual process. 

Let us briefly describe the incident reporting process in a hospital. A reporter/witness has to fill in a paper form with as many details as possible. The quality team then reviews the report and collects other witness accounts and additional supporting information from the supervisor(s). Based on the data collected, the quality team performs risk assessment.

At this stage, the quality team also decides whether the incident requires a more detailed, structured investigation. In cases where an investigation is not needed, the record is closed and filed for archival. But when an investigation is required, the quality team identifies a team of investigators: a group consisting of just the quality team or a team of individuals from across functions. This is the standard process followed in most hospitals, with some having variations to cater to their operations. This process can be followed either manually, which we call a paper-based system, or digitally, with the help of a software.

This article expounds on the effects of a paper-based vs a digital document system on the incident reporting process and the various aspects to consider when moving from a paper-based system to a digital system.

Paper-based system

In simple terms, a paper-based system is one where information is kept on paper, rather than on a computer. 

Let us take the example of a hospital that uses a paper-based system for incident reporting. As you can see above, in every stage of an incident, the incident form (paper) is passed around to various stakeholders. Each stakeholder gets a copy of the incident form based on which they create their reports. The quality team collects all these individual reports and then files them together as part of the incident report. Each step involves moving paper, tracking them carefully across many staff. The process usually takes a few weeks until closure.

With paper forms stored in files and folders, there is no simple way to locate a specific report involving a particular patient or generate statistics or identify any patterns. As a quality manager, suppose you want to analyze incidents from the past year and develop a set of guidelines or device process improvements so that some incidents do not happen in the future. There is no easy way to do this when you deal with paper forms. By practice, the quality team identifies common incidents and recommendations for preventing those. But to effect the changes, the quality manager has to collect conclusive evidence and statistics to highlight the pattern. With paper-based incident reports, this is a few weeks of effort to collect the required data and present it to the management. 

Keeping track of paper documents is not only a hassle but a waste of time and resources. Additionally, the data collected is relatively low quality in nature due to legibility issues. Safe storage from various hazards, securing from unauthorized staff only increases the complexity.

Digital system

In simple terms, a digital system is a system that stores the data in a searchable format on computerized storage. This storage could be on a local computer, on a server or the cloud. A Searchable format can be anything ranging from a simple Word document or an Excel sheet, a text document, or an elaborate record-keeping system on the cloud.

The same incident process: collaborating with multiple stakeholders, investigation reports, gathering statistics and identifying patterns become far more straightforward with a digital system. It is also simple to collect and manage all types of incidents – major or minor – leading to identifying issues that otherwise go unreported. 

The quality of the data collected is better, and it is effortless to avoid duplication. The data may be accessed from anywhere while enforcing sufficient levels of security and authorization. It is also possible to restrict access to specific data and get visibility to all the modifications made. Moving to a digital system saves time, effort, resources and enables collaboration. It also helps improve communication and brings in better accountability.

How to choose a digital system?

At this point, the motivations to go digital are quite apparent. The critical question, then, is – how does one choose the right digital system? Our answer is: start small. The transformation process is quite involved and can be daunting if we accounted for all the factors in the first attempt. There are also factors about data storage location and format to use. Our recommendation is to start with the most comfortable and familiar format: Excel Sheets. Manage the sheets on the local laptop/desktop or a network shared folder. Just doing this is already a successful first step to the transition to a digital system.

It is essential to build a habit of collecting the required data digitally using the newly devised system. It is easier to improve the system and the process to collect all the right data with regular use. Having the right data is the first step to identifying the system that suits the process in place. While digital data storage comes with many benefits, there are downsides based on the actual system in place. 

To understand this better, let us take a case where we use Excel sheets for managing incidents. For all the benefits that Excel offers, it is quite challenging to “organize” data effectively. Often it is possible to end up with multiple versions of a file shared over emails leading to merging efforts. Further, charting or pivoting the data requires significant knowledge and skill with Excel itself.

Do watch this blog for an article on managing incident data effectively using Excel sheets.

We can address some of these complexities by using other tools like Google Forms or repurposing project management apps to manage incidents. For the technically savvy, bug tracking systems commonly used in software development companies are also a good starting point for incident management systems.

To conclude, the benefits of a digital system far outweigh the perceived convenience of a paper-based system in almost all aspects. However, transitioning to a digital system need not be a daunting task if it is taken one step at a time. Picking the right tools to aid in the transition by leveraging familiarity is an excellent way to get started quickly.

Digitize, Digitalize and Digital Transformation

Rohini
digitize-vs-digitalize

Yes, you read that right. There is a small but appreciable difference between digitize, digitalize and digital transformation. We’ll try to articulate this as we go

What is Digitization?

A vast majority of small to medium healthcare providers in the region track their safety and quality metrics manually. ‘Manually’ is sometimes as basic as a paper record, sometimes is an excel sheet and some other times it’s a Google form. We categorize all of these as manual. The effort required by a single person to track and maintain this data is significant. Moving from a paper record to a digital record is simply digitization. That is, you made the record accessible as data. But digitization, by itself, doesn’t solve the problem of manual effort involved. It still is an excellent first step to take.

What is Digitalization?

On the other hand, digitalization is to enable an organizational process on top of digitized data. It involves a slight rethinking of how to transform the process to suit an online world.

Digitalization is the use of digital technologies to change a business model and provide new revenue and value-producing opportunities,”
according to Gartner’s glossary.

Digitalization will be a crucial tool in enabling better decision-making and better improvement programs across the organization. This usually federates the data collection across stakeholders with each performing their portion of the workflow. Alongside collecting valuable and insightful data, digitalization can reduce a lot of time for anyone involved in the quality and safety workflow

What is Digital Transformation?

Digital transformation is beyond Digitalization. Digital transformation is not entirely only technology. Although IT will play an important role in driving digital transformation strategy, the work of implementing and adapting to the massive changes that go along with digital transformation falls to everyone. 

Digital transformation is
essentially about the customer and how you fundamentally change your way of operations and deliver value to customers.  It is a cultural change that requires organizations to continually challenge the status quo.

There is no magic formula for the digital transformation project to be successful, as all digitalization projects need to be customized to your specific situation.

Our QUASR imbibes both digitization and digitalization incident reporting system that offers comprehensive features for patient safety industry.