Out of this world: can surgery learn from NASA's approach to leadership and safety culture?

Abstract

The US National Aeronautics and Space Administration (NASA) will be familiar to most across the world. Leading highly dangerous and innovative space travel, NASA has gone from a blame culture in the 1960s to an environment that keeps safety at the forefront and a top priority. NASA culture aims to ensure that staff work safely through balancing challenges and risks, feel comfortable communicating safety issues and learn from both successes and error. Surgery, and healthcare in general, still has a long way to go to embed a safety culture that values staff and looks at why incidents and errors have happened, and what can be learnt from them, instead of who was to blame. NASA's safety journey is a powerful study in learning from failure, evolving culture and leading with humility. From the Apollo 1, Challenger and Columbia disasters, NASA built a more transparent, accountable and resilient safety system and one that continues to evolve with the frontiers of space exploration. In many ways, surgeons can learn a lot from NASA to improve both patient safety and culture.