Georgia Hospital Lands Airline Pilot to Lead Patient Safety

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Northeast Georgia Health System hires Michael Appel, M.D., both an anesthesiologist and commercial pilot, as Chief Patient Safety Officer.

Michael Appel, M.D.: aviation safety expert and healthcare speaker.

Michael Appel, M.D.

Safety is not intuitive. Improvements require a sustained effort in partnership with the right people.

Northeast Georgia Health System, Inc. (NGHS) is pleased to announce it has hired Michael Appel, M.D. as Chief Patient Safety Officer. Combining his expertise in the cockpit with more than 20 years experience in healthcare, Dr. Appel brings the right recipe for innovative improvements in patient safety. “You don’t often get the chance to work with a person who has been an Ivy League professor, has flown thousands of hours for Delta Airlines and continues to practice anesthesiology,” says Carol Burrell, President and CEO of NGHS. “We’re excited by the ideas Dr. Appel brings to the table and proud of how he’s already helped make NGMC a safer place for patients.”

Dr. Appel credits his expertise in aviation safety as the foundation for his passion to improve healthcare. “I began reading aircraft accident reports at a young age, and couldn't afford to fly real airplanes" says Dr. Appel. "So I learned about aviation from a safety perspective first...long before I touched the controls of a real airplane. I read every accident report I could get my hands on."

Appel's deep understanding of aviation safety is what set the stage for his huge disappointment with the healthcare system. “It was chaos...what I witnessed when I first stepped foot into a hospital as a medical student. It was at that moment that I realized my mission in life was to make healthcare systems safer for patients."

During the next few years, Dr. Appel completed his medical degree at Columbia University while also becoming a private pilot. He eventually merged the two careers as a traveling anesthesiologist who flew himself to each facility. Finally in December of 2000, his lifelong dream to be an airline pilot came true when he accepted a position with Delta Connection.

"It was truly a dream come true," says Dr. Appel. "To see, from the inside, how a system extracts the best possible outcomes from hazardous work." It is precisely that level of performance that Dr. Appel expects from healthcare. "It can be done, but safety is not intuitive," says Appel. "Improvements require a sustained effort in partnership with the right people."

When Dr. Appel first came to NGHS in 2008, he took an immediate interest in patient safety initiatives at NGMC. In speaking with other doctors and hospital employees about his experiences in aviation, he was always sure to relate them back to health care. Administration quickly took notice.

“Sometimes it’s easy to get numb to terms and tools you use every day, and forget the real meaning behind those terms and the true reason for using those specific tools,” says Sam Johnson, MD, Vice President of Medical Affairs and Chief Medical Officer of NGHS. “Dr. Appel’s experiences help us all look at our jobs from a fresh perspective and ask ourselves what we can do to improve human performance.”

Having considered other offers from around the country, Dr. Appel chose Northeast Georgia Medical Center because "the climate is right at this hospital to be real pioneers in patient safety," says Appel. He credits a team of world-class physicians, a supportive administration, an involved and progressive board of directors, but most importantly the employees of the 5,000 staff referral center who, he says, "create a unique environment, ripe for groundbreaking improvements in patient safety."

Among the many patient safety projects at NGHS, several encompass techniques borrowed directly from aviation. One example uses "root cause analysis" in a way similar to aircraft accident investigations performed by the National Transportation Safety Board. By identifying a patient safety concern and working backward to fix the process itself, Dr. Appel's team makes errors less likely to be repeated.

Another approach inspired by aviation is the use of standard phraseology. Like aviation, healthcare needs a glossary of sacred terms which have specific meaning. "The word 'STAT' has been so abused as to be rendered meaningless", says Appel. In 2012, NGHS will launch a ‘Minutes Count’ campaign to tap into the efficiency that comes from using standard words with specific meanings. "When lives are at stake, communication needs to be crisp and concise," says Appel. "Listen to the exchanges between air traffic control and pilots. They speak a language created with safety at its core."

But Dr. Appel, who is frequently invited to speak nationally on patient safety, will be the first to tell you there are no short cuts. "No lecture is going to do anything for patient safety. The change we're after is one of culture, and that will take decades of hard work."

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Cathy Bowers, Public Relations Director

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Dr. Michael Appel is author of a white paper on checklist use in healthcare.