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Atul Gawande’s ‘Checklist’ For Surgery Success

Brilliant article by NPR on Atul Gawande’s new book, The Checklist Manifesto. Gawande has written an entire book on how checklist and other reminders help in complex situations. Here is a good quote:

There was about 80 percent who thought that this was something they wanted to continue to use. But 20 percent remained strongly against it. They said, ‘This is a waste of my time, I don’t think it makes any difference.’ And then we asked them, ‘If you were to have an operation, would you want the checklist?’ Ninety-four percent wanted the checklist.”

I’m waiting to read Gawande’s new book but right now I’m in the middle of another book that talks about the same checklist culture from a very different angle. This book titled Streetlights and Shadows and is written by the brilliant Gary Klein. Both Klein and Gawande are my favourite authors. I’ve read all their previous books. So, this is interesting for me to see how their worlds collide. In his book, Klein spends an entire chapter debunking the use of checklists in complex scenarios. His idea is that checklists are wonderful in well-structured and predictive environments and do not work that well in ill-structured and unpredictable environments.

Here’s the question I want answered when I start reading Gawande’s book: are the checklists just for mechanical tasks or are they for complex procedures? The surgical safety checklist mentioned in the article looks quite general. Maybe that is the point: even the ‘general’ stuff in surgery can lead to a life or death situation.

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