05 February 2010

Checklists: surgeons, the mentally-challenged and me

It was a bit of a shock, all those years ago, channel surfing and falling on a checklist with items such as

wash your hands
bring keys
bring bus pass
make sure the door is locked
make sure your fly is up

Et cetera. "That's my list!" I thought. Ok, my list was a bit less basic but bringing key and bus pass were certainly in there.

The next few seconds filled me with pure dread. These lists were for mentally-challenged people deemed capable of living alone but who needed a little help with their forgetfulness.

I never made a "basic list" again. I continued making lists for groceries and particularly hectic days, but I was thoroughly and utterly shamed. Damn you Life network.

I later learned Albert Einstein was just as forgetful as I am but that factoid failed to provide any solace. It's not as though I forget my keys because my brain is too busy pushing boundaries in the world of physics. And I never read about Einstein having to resort to lists.

Enter Atul Gawande. He's been everywhere this week from the Today programme on the BBC to The Daily show with Jon Stewart, flogging his new book, The Checklist Manifesto.

One hundred thousand people die from post-surgeons complications in the U.S. each year. With the help of Boeing, Gawande and his team devised a two minute checklist for surgical teams to go use before every procedure. Gawande says the death rate from complications could be reduced by one third. Surgeons resisted at first, some still do.

It is believed that the checklists saved two hundred lives in a programme covering eight hospitals in the U.S.. When polled, eighty percent of surgeons from those hospitals said they loved the checklist, twenty percent said they hated it. When that twenty percent was asked whether they would want their surgeon to use the checklist if they were to be operated on, ninety four percent of them said yes.

I'm not sure one needs to shell out money to be told how to make checklists for everyday life, but Gawande certainly deserves a plug here for validating my need for lists. And basic steps such as "wash your hands" is on the surgeons' checklist.


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