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Letters Checklist culture

We need a safety system (and an operations manual)

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c917 (Published 23 February 2010) Cite this as: BMJ 2010;340:c917
  1. Nicholas J Toff, airline pilot1
  1. 1Cambridge CB22 4XU
  1. nt{at}toffmail.com

    The recent editorial by Vincent and colleagues struck a chord as I have experience as an anaesthetist and an airline pilot.1 All high reliability organisations have a safety management system, featuring basically the same requirements as clinical governance, with one important addition—an operations manual, which provides concise but authoritative information and instructions on who does what, when, and how. When backed up by …

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