The Checklist Manifesto

Surgeon Atul Gawande believes that a simple checklist can cut deaths from operating room errors. Atul Gawande, general and endocrine surgeon at Boston’s Brigham and Women’s Hospital, Associate Professor of Surgery at Harvard Medical School, and columnist for The New Yorker, has written “The Checklist Manifesto:  How to Get Things Right”,  a book that describes how miscommunication in the operating room can lead to tragic results.  Currently, Gawande’s book ranks # 10 on the New York Times’ list of best-selling non-fiction books.

The book grew out of work Gawande did for the World Health Organization, which asked him to help them find a way to reduce surgical deaths.  According to Gawande, “We knew we had technology and incredible levels of training, people working unbelievably hard.  But we have more than 100,000 deaths just in the United States following surgery.  Half are avoidable, from our studies.  What could we do?  We have found this idea, this extra tool that others were using in aviation, in skyscraper construction, and thought, well, let’s give it a try.”

Surgeons, according to Gawande, are human.  “We miss stuff.  We are inconsistent and unreliable because of the complexity of care.”  To achieve better results, Gawande brings a simple checklist into the operating room to make certain that everything is in place to assure a successful procedure.  For example, when the operating team is introduced to each other by name, the average number of complications and deaths fell by 35 percent.

Commenting on the success of checklist use in the operating room, Gawande says “I have not gotten through a week of surgery where the checklist has not caught a problem.”

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