What my daughter's harrowing Alaska Airlines flight taught me about healthcare

Almost nine months have passed since I thought I might lose my only daughter, Natalie.

As she boarded a flight to Ontario, California, we exchanged text messages: “I love you,” I said. “I love you too,” she replied.

Fifteen minutes later, Natalie texted again. The oxygen masks had fallen off. She saw a gaping hole in the side of the plane. Thin, ice-cold air flowed through the cabin. The pilot announced that an emergency landing was necessary.

Natalie was aboard the infamous Alaska Airlines Flight 1282, whose door plug flew 16,000 feet into the air.

I reached for my phone and thought about holding Natalie as a baby. Now she felt far out of reach. Still, I tried to comfort her, even though I was afraid to blink for fear I would miss something.

Sixteen minutes later the plane landed. Some passengers suffered minor injuries, but Natalie was unhurt.

As a parent, it was my worst nightmare. As a leader who has dedicated much of his career to improving health care—an industry that holds the lives of millions of people in its hands—I derived a new guiding principle from this terrible incident. Healthcare must strive for a zero error rate.

When I worked in manufacturing, we realized that small, seemingly insignificant failures could have devastating consequences. In some sectors, the impact is repairable. In others, such as aviation and healthcare, this is not the case.

That's why I believe in using data to create a framework that hospitals and health systems can use to work toward zero failures.

Some may say this goal is unreasonable. Why pursue something so ambitious that it may be unachievable? But it is the status quo that is unreasonable.

We have known for decades that up to 98,000 people die every year from medical errors. That's almost the equivalent of a 300-passenger jumbo jet crashing every day for 365 days. This country would never tolerate a spate of daily plane crashes, but we have resigned ourselves to it in healthcare.

There are also business reasons to strive for perfection. Just as I trust an airline to transport me and my children safely, patients trust healthcare providers when they need care. Natalie and I have learned that four missing screws are enough to destroy that trust. As consumption increases, patients are choosing organizations that primarily send people home alive.

With such high stakes, the question is not whether to aim for zero failures, but how.

Technology has driven healthcare to vast improvements, even as the consequences of long-standing problems such as fragmentation, friction between different stakeholders and transactional relationships continue to grow. The dissonance becomes clear when dreams of technology- and data-driven care collide with the reality of widespread health disparities, physician shortages and, yes, medical errors.

But technology alone will not stop patients and their families from paying the price when we get it wrong. This became clear when I monitored the Find My app during Natalie's flight and had no influence on the outcome.

Healthcare must take a methodical approach to continuous performance improvement and unite behind leading practices to collectively strive for zero failures. So, despite my daughter's extraordinary experience, major airlines achieved a fatal accident rate of zero per 100,000 flight hours in 2022. Imagine if we did the same thing.

One problem is that too few of the leading ones Practices are standard practices. In healthcare, it takes about 17 years for clinical innovations to become mainstream.

Another stumbling block is physician burnout. Although the effects are difficult to quantify, there are 14 studies in the literature linking burnout to medical errors. Mayo Clinic Proceedings published findings suggesting that physician burnout and fatigue appear to be as responsible for medical errors as unsafe working conditions.

These challenges arise from systems, not from individual people.

This means healthcare organizations must think systematically in their pursuit of zero failures. I have seen firsthand the results we can achieve when we collectively engage in comprehensive improvement efforts.

For example, looking only at Medicare performance data, if all acute care providers operated at the level of the nation's top 100 hospitals, we could save an estimated 350,000 additional lives and save $17.6 billion in inpatient costs, and more More than 607,000 additional patients receive complication-free care. When we looked deeper, we found that implementing just one performance improvement technology—clinical monitoring—in nursing homes led to a 92 percent reduction in adverse drug events among some of the country's most vulnerable patients.

You can read these as impressive numbers on a page or look deeper and see the beloved grandmother who spent another day with her family.

When I think of zero defect rates in an industry, I think of my daughter Natalie. I see her holding back tears as an oxygen mask covers her mouth, clutching an armrest with one hand and texting me with the other.

Every patient we lose to a preventable medical error is someone's Natalie. You are someone's mother, father or daughter. You are worthy of our pursuit of a zero defect rate.

Photo: Spooh, Getty Images

Michael J. Alkire is President and CEO of Premier Inc. Premier. As Premier's leader, Alkire leads the continuous integration of Premier's clinical, financial, supply chain and operational performance improvement offerings, helping member hospitals and health systems deliver higher quality care at better costs. He oversees Premier's quality, safety, labor and supply chain technology apps, as well as data-driven collaborations that enable alliance members to make decisions based on a combination of health information. These performance improvement offerings access Premier's Comparison Database, one of the nation's largest results databases.

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