Risk and error management. Can medicine benefit from lessons learned in aviation?

Flight safety could be increased by approximately one million times within the last 100 years by rigorously analyzing and correcting system deficiencies. Aviation safety strategies can help to increase patient safety. A few examples: the pilot in command takes critical safety decisions without economical restraints. Safety-relevant decisions should be made as if the captain's family would be on board. Organizational deficiencies can be detected using a non-punitive reporting system. The pilot is encouraged to report errors without the fear of being punished. Well-trained specialists, supporting and correcting each other are an important prerequisite for error detection and error correction. An optimal hierarchical gradient helps to reduce risks. Strategies for risk reduction require more personnel, increase costs and slow down the working speed. Safety is expensive and safety can be bought.