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> Only through proper investigation was it discovered that a key factor was clinicians failing to put sterile dressings over the catheter site; the medical equi

by mryan 11y ago

> Only through proper investigation was it discovered that a key factor was clinicians failing to put sterile dressings over the catheter site; the medical equivalent of not using antibacterial hand gel. > The introduction of a five-point checklist - a marginal change - saved 1,500 lives over 18 months in the state of Michigan alone. If you find this kind of thing interesting I can recommend The Checklist Manifesto. The book describes many other situations where the use of checklists has had similar benefits (particularly in health and aviation).

mikestew 11y ago
> The book describes many other situations where the use of checklists has had similar benefits (particularly in health and aviation). However, and I feel that this is a point often missed about this book: a large part of the improvements in process had little to do with checklists. "Wha-wha-wha-whaaaat? 'Checklist' is in the title!" Checklists don't do you any good if you're dealing with doctor's who are way to full of themselves and don't feel the need to listen to the little people like nurses. No, the key element to that book was that nurses were empowered to knock doctor's off their high horses if the checklists weren't followed. The book isn't about checklists. The book is about: 1. Develop a framework of practices for your tasks at hand. Checklists are often used for this. For software, think release management. Tests pass, UA signed off, etc. 2. #1 won't make a damned bit of difference until, from top to bottom, anyone can call out anyone else if short cuts are taken. You're the director of the hospital? I don't care, you still need to wash your hands before touching that patient. VP of marketing is wanting us to skip those manual tests to save a day? Screw you, it's on the list and we're doing it. The book isn't about checklists, it's about empowerment to make improvements.
- dagurp 11y ago
  I haven't read the book but what you're describing is what's called Crew Resource Management[1] in aviation. It's especially valuable in cultures where second guessing your superior is career suicide. CRM stresses that the captain and first officers are a team and how they should communicate. [1] https://en.wikipedia.org/wiki/Crew_resource_management https://en.wikipedia.org/wiki/Crew_resource_management
  - mikestew 11y ago
    It's been a few years since I've read the book, but if the book didn't specifically mention this in relation to aviation, I recall that aviation was at least was mentioned as an example.
- kwhitefoot 11y ago
  I see your point but I think the point of the checklist is that only a system that requires the checklist to be followed properly actually qualifies. Without the checklist as the connection between the nurses and the doctors we would still have problems with consultants standing on their dignity and the nurses unable to do anything about it.
ggrothendieck 11y ago
The author of the Checklist Manifesto also wrote an article about this in the New Yorker: http://www.newyorker.com/magazine/2007/12/10/the-checklist http://www.newyorker.com/magazine/2007/12/10/the-checklist

by mryan 11y ago

mikestew 11y ago

> The book describes many other situations where the use of checklists has had similar benefits (particularly in health and aviation). However, and I feel that this is a point often missed about this book: a large part of the improvements in process had little to do with checklists. "Wha-wha-wha-whaaaat? 'Checklist' is in the title!" Checklists don't do you any good if you're dealing with doctor's who are way to full of themselves and don't feel the need to listen to the little people like nurses. No, the key element to that book was that nurses were empowered to knock doctor's off their high horses if the checklists weren't followed. The book isn't about checklists. The book is about: 1. Develop a framework of practices for your tasks at hand. Checklists are often used for this. For software, think release management. Tests pass, UA signed off, etc. 2. #1 won't make a damned bit of difference until, from top to bottom, anyone can call out anyone else if short cuts are taken. You're the director of the hospital? I don't care, you still need to wash your hands before touching that patient. VP of marketing is wanting us to skip those manual tests to save a day? Screw you, it's on the list and we're doing it. The book isn't about checklists, it's about empowerment to make improvements.

dagurp 11y ago
I haven't read the book but what you're describing is what's called Crew Resource Management[1] in aviation. It's especially valuable in cultures where second guessing your superior is career suicide. CRM stresses that the captain and first officers are a team and how they should communicate. [1] https://en.wikipedia.org/wiki/Crew_resource_management https://en.wikipedia.org/wiki/Crew_resource_management
- mikestew 11y ago
  It's been a few years since I've read the book, but if the book didn't specifically mention this in relation to aviation, I recall that aviation was at least was mentioned as an example.
kwhitefoot 11y ago
I see your point but I think the point of the checklist is that only a system that requires the checklist to be followed properly actually qualifies. Without the checklist as the connection between the nurses and the doctors we would still have problems with consultants standing on their dignity and the nurses unable to do anything about it.

ggrothendieck 11y ago

The author of the Checklist Manifesto also wrote an article about this in the New Yorker: http://www.newyorker.com/magazine/2007/12/10/the-checklist http://www.newyorker.com/magazine/2007/12/10/the-checklist