Human error is inevitable. Although society's sense of justice is satisfied by counselling, retraining, suspending or dismissing defective perpetrators and compensating victims, healthcare professionals have been slow to adopt alternative strategies to address iatrogenic morbidity and mortality. In recent years, the concept that human factor techniques validated in the aviation industry may be relevant to medicine has gained some momentum1 2 3. In this issue of the journal, Dr Gordon reminds us that 75% of aviation accidents have human error as a co-factor with poor interpersonal communication, decision making and leadership as major themes. She explains why standard operating procedures, crew resource management, incentivised no-fault reporting and the confidential human factors incident reporting programme have become an integral part of pilot training and how the concepts could be applied to the National Health Service.

Implementation of the WHO surgical safety checklist …