Inside Nodus

Nodus Medical meets Swiss Air Force

FA18

It is a cold cloudy day and one feels that this year’s summer is definitely coming to an end. We are on our way to the Air Force base Meiringen in central Switzerland to meet one of our founders – Swiss Air Force pilot and MD Marc Studer. The goal of this field trip is to gain new insights from military aviation and learn how fighter jet pilots are taught to handle risks and unexpected issues arising in the cockpit.

First things first – Mission briefing
While walking through the main building where walls are covered with fighter jet pictures from all over the world, Marc explains us that every flight effectively starts with a mandatory mission briefing. Briefings are an essential part of flight preparation and represent a key moment for team building, leadership establishment and an opportunity to gather all relevant data on the upcoming flight. Moreover, it is one of the most critical moments as vital and often irreversible decisions will be made during the briefing (e.g. fuel loading). At this point, I can’t help but wonder how many procedural incidents could be avoided in operation theatres worldwide if surgical teams would start each patient case with an effective mission briefing to create a shared understanding of the operation and discuss possible critical events that may arise.

The importance of checklists
We are standing in front of the entrance to the famous underground hangar caverns of Meiringen while three F/A-18 Hornets are being prepared for take-off. Marc explains the “Before Take-off Checklist” and how paramount it is to have all ground crew members and pilots complete their checks in order to avoid fatal accidents. I am astonished by the harshly disciplined crew following a meticulous ritual: Everyone is fully focused on the functionality checks on the aircraft, even though they have repeated the procedures a thousand times. At this point the official WHO surgical safety checklist comes to my mind and I imagine how morbidity and mortality rates could look like if all surgical teams were to follow preoperative security checks in a similar way.

 

Continuous improvement & team culture
We watch the three fighter jets taking off, then move on to the debriefing room. Marc shows us their video equipment and how it is used to evaluate the performance of each pilot. Watching the videos and looking at the presented data reminds me of the video analysis software we see in football games. In the end, he mentions the unique culture among fighter jet pilots and how they strive for continuous improvement instead of perfection. I pause for a moment before we leave the debriefing room, and again, I ask myself what tools or metrics surgeons use to regularly evaluate their performances.

Key takeaways
Visiting Marc on the air base in Meiringen gave us a lot of insights from aviation and new ideas for our product. However, my top three takeaways are:

  • Briefings are critical for avoiding irreversible decisions and bad outcomes.
  • Zero incidents should be a team vision rather than an individual target or performance goal.
  • There are many analogies between pilots and surgeons, but how they manage risks could not be more different.