Getting buy-in for a patient safety or quality improvement initiative isn't a political skill—it's a leadership skill. Here's the framework that I've seen work inside healthcare organizations. In aviation, there's a concept we take seriously: a perfectly sound tactical plan briefed poorly is a plan with a high probability of failure. The mission brief must build understanding, confidence, and alignment, or the mission objective is not likely to be met even before the wheels l

Healthcare doesn't lack for protocols, checklists, or credentialing standards. What it sometimes lacks is structured support for how clinicians actually decide, communicate, and recover from error under pressure — and that gap can cost lives. Two high-stakes industries with one shared problem. In aviation, we spent decades learning that checklists, procedures, and technical proficiency alone could not prevent catastrophic failure. The missing ingredient was always human. I sp

People often ask me what I teach in healthcare. I know they are often expecting a description of how someone who is not a clinician came to be teaching about high-reliability performance to physicians, staff, and administrators. Once they understand the pathway that led me to do what I do, they get very curious about the specific techniques, skills, and processes I provide to clinicians, and how I learned to teach those things in a way that clinicians find meaningful and use

Lancair 4 Propjet in Flight When I'm behind the controls of a carbon fiber experimental airplane powered by a 750 shaft horsepower turboprop engine, I don’t always have the luxury of perfect information when making split-second decisions. Despite my best efforts at preflight planning, I'm sometimes making decisions in environments that are complex, uncertain, and constantly changing. This is not only true for me when flying a high performance airplane, it's also true for anyo