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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