Saturday, January 30, 2016

Review of "The Checklist Manifesto How to Get Things Right" Instaread summary

Review of

The Checklist Manifesto How to Get Things Right by Atul Gawande, Instaread summary

Five stars

It made me want to read the book to learn details of the resistance against what seems to be a good idea

The value of basic checklists in the reduction of errors has been demonstrated many times and in many areas. Aviation is one of the most significant examples and the summary opens with the example of aviation as an area where the mandatory workthrough of a checklist has prevented deadly accidents.
 Gawande is a surgeon that has explored the role of human error in critical actions and is an advocate for their use in an operating room. This is a summary of his book presenting the evidence in favor of using checklists in medicine. A data point put forward strongly in favor of surgical checklists is that 150,000 people die from surgery every year and approximately half are due to error. The potential to save 75,000 lives is a powerful inducement to change.
Yet, change in any profession is hard and medicine is no exception. As is pointed out in takeaway number 8 in the summary, while the introduction of surgical checklists would seem to be a way to reduce errors there is evidence that indicates otherwise. Therefore, the debate continues. While there is strong evidence in favor of the value of surgical checklists institutional resistance to change and the somewhat contradictory data keep the procedure from being universally and enthusiastically adopted. 
 The law of unintended consequences is cited in key takeaway 2, pointing out that even the best of intentions can create unanticipated problems. When it was clear that the use of condoms dramatically reduced the transmission of HIV, free condoms were distributed to sex workers. The consequence of this very logical and effective way to improve public health was a dramatic increase in the price of unprotected sex.  This is an excellent example to demonstrate that one must always be cautious and studious when implementing new and effective programs.
 This summary covers the different angles regarding what would seem to be a way to create an obvious improvement in the quality of health care. It was a valuable introduction and leads me to want to read the complete book, generally because I am interested in learning about the resistance and arguments against. 

This book was made available for free for review purposes

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