The Checklist Mainfesto; Post 2

The Checklist Manifesto
By: Atul Gawande
Post 2

I've read about half of The Checklist Manifesto, and it really is quite fascinating. Time and time again, example after example, checklists, no matter how simple or trivial they may seem, are in fact very, very good at doing their jobs.

Just to give a brief summary, Gawande describes checklists being able to help people in complex or pressured environments (like in hospital Intensive Care Units) with two primary difficulties. "The first is the fallibility of the human memory and attention, especially when it comes to mundane, routine matters that are easily overlooked under the strain of more pressing events," (Gawande 36). "A further difficulty, just as insidious, is that people can lull themselves into skipping steps, even when they remember them," (Gawande 36). Gawande gives several examples of this, favoring the use of his medical experience and connections. One example that really stood out was the use of a checklist when using central lines in surgery (central lines are connections between the patient's body and various medical equipment, in order to track bodily functions. For example, an arterial line gives continuous measurements of the patient's blood pressure).  In many hospitals, there was a consistent problem with lines becoming infected. Peter Pronovost of John Hopkins Hospital proposed that doctors begin following a checklist that gave the basic outlines of how to prevent infection. Nurses were encouraged to remind doctors should they forget or defer from the list. As a result, the infection of lines rate at John Hopkins Hospital was reduced from 11% to 0%. When the study was tested on various hospitals in Michigan, the rate of infection of central lines dropped by 66%.

Overall, I think the reason I've found this book to be so interesting is the idea that something so simple would have such a humongous impact. My dad has actually been trying to get me to read this book for some time now, in the hopes that reading it will encourage me to be more organized and time efficient with my homework, creating a checklist (of sorts) and planning my priorities wisely. Now do I see just how helpful these little lists can be, reducing infections in hospitals by such a significant percentage. I look forward to what else Gawande has to say about this extraordinary power of checklists.

Until next time,
Josh C.