Monday, March 5, 2012
Checklists for Surgeons
I heard a great talk last week by Atul Gawande, health care journalist and author of The Checklist Manifesto. Atul has been exploring how to improve the US health care system. He had a simple yet powerful insight: doctors are performing all sorts of procedures without checklists. No pilot would think of flying a plane (no matter how large or small) without going through a pre-flight check-lists, yet surgeons perform heart and brain surgery without it! Atul (who is also a physician) developed a basic pre-surgery checklist and tested in a few hospitals. The result? Infections, complications and even mortality dropped dramatically. Why are physicians resisting this? Decades ago we had standard treatments for very few deseases. Physicians needed creativity and independence to try to help their patients. Doctors didn't used to be specialists with a limited set of well understood procedures to perform. I guess most surgeons don't see themselves like pilots of 747s, who follow checklists, put the plane on autopilot, and only used their extensive experience and expertise if something goes wrong. Hopefully they soon will.