Like making sure everyone in the operating room knows each other by name. But the study returned some surprising results: "We also found that good teamwork required certain things that we missed very frequently." "We caught basic mistakes and some of that stupid stuff," Gawande reports. "I worked with a team of folks that included Boeing to show us how they do it, and we just made sure that the checklist had some basic things: Make sure that blood is available, antibiotics are there." "We brought a two-minute checklist into operating rooms in eight hospitals," Gawande says. This isn't the route medicine has traveled when dealing with complex, demanding situations. "The pilot's checklist is a crucial component, not just for how you handle takeoff and landing in normal circumstances, but even how you handle a crisis emergency when you only have a couple of minutes to make a critical decision." "I got a chance to visit Boeing and see how they make things work, and over and over again they fall back on checklists," Gawande says. So Gawande imported his basic idea from other fields that deal in complex systems. We are inconsistent and unreliable because of the complexity of care," he says. There are a thousand ways things can go wrong."Īt the heart of Gawande's idea is the notion that doctors are human, and that their profession is like any other. "It's also with complexity: how much you have to make sure you have in your head and think about. "Our great struggle in medicine these days is not just with ignorance and uncertainty," Gawande says. Gawande uses this anecdote, a simple miscommunication with the potential to cause so much tragedy, to illustrate an argument he makes in a new book called The Checklist Manifesto: How to Get Things Right. And if they had understood it was a bayonet, they would have thought about it quite differently." 'How did this happen?' 'Well, it was a Halloween party.' 'What exactly went on?' And then they learned that the guy who had stabbed him was dressed as a soldier carrying a bayonet. And so afterwards they asked a few more questions of the family. "When they got him open they found that the wound had gone - this is a pretty big guy - straight through more than a foot into him, all the way into his back and sliced open his aorta. "About 10 minutes later, he crashed," Gawande says. The man's injuries didn't appear life-threatening, but his condition quickly turned. "It was a single wound, about an inch in size, in his belly," Gawande tells Morning Edition host Steve Inskeep. Speaking about dealing with unexpected challenges in medicine, Atul Gawande - a surgeon who writes for The New Yorker when he's not at his day job at Harvard Medical School - relates a story about a man who came into an emergency room with a stab wound. His other books include Better and Complications. Availability based on publisher status and quantity being ordered.Atul Gawande is a staff member of Brigham and Women's Hospital and the Dana Farber Cancer Institute. ![]() ![]() ![]() The book, The Checklist Manifesto: How to Get Things Right ISBN# 9780805091748 in Hardcover by Gawande, Atul may be ordered in bulk quantities. ![]() An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds. He explains how checklists actually work to prompt striking and immediate improvements. In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. Longer training, ever more advanced technologies‚Äïneither seems to prevent grievous errors. We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face.
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