Excellence in all we do is key Published Feb. 12, 2016 By Col. Rawson Wood 60th Medical Group TRAVIS AIR FORCE BASE, Calif. -- I want to talk about how our Air Force Core value of "excellence in all we do" is applied to ongoing change at David Grant USAF Medical Center. I believe all Airmen, and indeed all Americans, want to be excellent, but are sometimes unsure what level of excellence is required for the day's mission. If it is a Physical Training test, then an excellent is defined by Air Force Instruction as a 90, as in 90 percent, but in baseball 30 percent or a .300 batting average is considered excellent. Civilian industry has a standard called Six Sigma. Wikipedia says the definition of a Six Sigma process is a process that produces 3.4 defective parts per million opportunities. I think of it as how many decimals of nine there are; as in 99.9999 percent of the time we get it right. Businesses focus on their level of performance because it can mean the difference between profit and loss and, ultimately, on their corporation's survival. In 2005, Motorola attributed more than $17 billion in savings to Six Sigma processing. The United States airline industry has applied Six Sigma and other certifications to enhance safety. Amazingly, this industry has not had an accident related death in more than three years, even while flying millions of people millions of miles, 35,000 feet in the air at 500 mph, every day in all kinds of weather. This is much better than Six Sigma reliability. In fact, many people have studied high-reliability organizations, which are those that do potentially dangerous work, without having any major mishaps. I just read an awesome book on this topic called "Managing the Unexpected: Assuring High Performance in an Age of Complexity" by Karl Weick and Kathleen Sutcliffe, which is an excellent book for those interested in process improvement. The Six Sigma and high-reliability organizations research is being applied to many industries, such as health care. You might think that hospitals are a very safe place to be, since there are so many motivated, educated and compassionate professionals at work. However, the sad situation is that American hospitals are estimated to make errors that contribute to more than 500 preventable deaths a day. This does not count those who die from their heart attacks, cancer or other diseases, but only those who would have lived were it not for medical professional mistakes. This has been studied and verified during the past decade. Think of how stunning this number is. It is the equivalent of a large jumbo jet crashing every day killing everybody onboard, due to human error. We can do better. Studies have shown that military hospitals are safer, on average, than their civilian counterparts, but errors still occur. In our relentless drive to remedy this, DGMC is the Air Force lead for implementing high reliability in a program called "Trusted Care." This initiative uses enhanced communication programs, such as morning safety huddles, new team training, improved data flows and better safety metrics. The bottom line is we are not looking to score a 90 when it comes to avoidable harm to patients. Moreover, we are not striving to score a 99.9999, but we want to reach a state where not a single person is harmed by preventable errors. We often get the results we seek. So if you expect to barely pass your PT test, you will probably be happy with a 70-something. If you strive for a 100 and work diligently and achieve your score, it will be no accident. The Air Force calls us to excellence, which is what our world requires for success. So, I ask you, what level of excellent will you settle for?