What Causes a Plane to Crash?

With the crash of Air France flight 447 still fresh in many of our minds, I thought it was a coincidence that an entire chapter of Malcolm Gladwell's Outliers: The Story of Success (an audiobook I'm currently listening to) would be devoted to discuss plane crashes.

The chapter investigates the causes behind the Avianca flight 52 crash and here are some interesting points that were discussed:

Plane crashes are more likely to be a result of an accumulation of minor malfunctions and extenuating circumstances. Characteristics of a typical crash include:

• Poor weather (causing a little more stress than usual)
  
• Planes are behind schedule (causing pilots to be rushed)
  
• The pilot has been awake for over 12 hours (meaning the pilot is tired)
  
• In 44% of crashes the two pilots have never flown together before (communication difficulties)

Crashes are usually not a result of problems in knowledge or flying skills. The kinds of errors that do lead to crashes are almost invariably errors of teamwork and communication. Is this beginning to sound familiar to anyone? The health care lights were definitely flashing in my mind!

What led to the Avianca crash was a series of crucial misunderstandings. Communication between the flight crew and air traffic control and communication between the captain and first officer was not clear and effective. In the chapter, Gladwell highlights excerpts of the black box transcripts. The conversations that took place just minutes before the crash are disturbingly calm and ambiguous. There was no sense of urgency or emergency, until it was too late. There were several apparent examples of mitigated speech, communicating in deference to higher authorities.

The conclusion Gladwell comes to is a result of human factors research. Successful flights often require skills that fall out of the normal piloting skill set to include the ability to communicate and share information in the clearest most transparent way possible.

The lessons of the Avianca crash extend beyond aviation. Good medicine also requires effective communication. Doctors, patients, nurses, pharmacists, residents, and health professions students all could use a good lesson in communication, so that medical errors are caught and resolved, processes improved, and most importantly, lives are saved.

If you haven't read Outliers yet, here's a good health care reason to do so!