When failure is not an option

Gene Kranz. A recipient of the Presidential Medal of Freedom along with other mission scientists and crew, Kranz led his Tiger Team of experts at NASA in its successful effort to bring three astronauts on a perilous 500,000 mile journey around the moon and back home to Earth. Apollo XIII, launched in April 1970 to be America’s third manned moon landing, suffered a catastrophic explosion of its service module on the way to moon, leaving the command module without adequate power to run the spacecraft’s instruments or life support. Kranz’s lead White team, aided by three other teams of experts, inventoried the available resources and improvised all along the way to bring the three astronauts, James A. Lovell, Ken Mattingly, and Fred W. Haise, back safely. Although inaccurately attributed to Kranz, “Failure is not an option” is now associated with the unwavering commitment by the teams of scientists to find a solution to a seemingly unsolvable problem. This past December marked the 11th anniversary of the release of the landmark Institute of Medicine study, To Err Is Human, which attributed upwards of 100,000 deaths and more than 1 million injuries to medical errors caused by systematic failures of our healthcare delivery system. In response to the 1999 report, accreditation bodies, payors, providers, hospitals, and government agencies launched numerous efforts to reduce the number of medical errors, and in turn the morbidity, mortality, and wasted resourses associated with them. Interventions included implementation of electronic medical record systems with computerized physician order entry,