Streams

The Checklist Manifesto

Monday, January 04, 2010

Atul Gawande, general surgeon at the Brigham and Women’s Hospital in Boston, staff writer for The New Yorker, and an assistant professor at Harvard Medical School and the Harvard School of Public Health, explains how more training and advanced technologies don’t seem to prevent experts from making costly mistakes, but a simple checklist can. His new book, The Checklist Manifesto: How to Get Things Right looks at how innovative checklists are being adopted in hospitals around the world and how the checklist revolution can expand into fields beyond medicine.

Event: Atul Gawande will be speaking and signing books
Tuesday, January 5, at 8:15 pm
92nd St Y
1395 Lexington Avenue, at 92nd Street
Tickets: $27.00
More information and tickets here.

Guests:

Atul Gawande

Comments [21]

Amardeep Karodakar from India

Great Idea!!!!! This will help to reduce harms to humans body. I think by making chealkist you can control your body in proper way to be fit anf fine all the way, This will also help to lead toward good and healthy climate> I wish all the best to this dr. gawande for his great efforts and wish yu best luck
byee

Oct. 28 2010 08:16 AM
Jan McLaughlin from North NJ

Have been troubled by my professional 'fail rate' of 2% for a long time. I'm pretty darned good @ what I do, but the nearly daily little missed things had me scratching my head. When I thought of this imperfection relative to health care -- and surgery particularly -- it made me curious. This show answered a lot of questions, and gave me some personal solutions.

Here's to finding more ways to approach perfection more nearly.

Thanks for a great show.

Jan. 12 2010 10:39 PM
Denise Long from Montclair, NJ

Wonderful show! Wish it could have been longer. I've been a nurse for over 30 years and the idea of a checklist is fabulous . . . everyone is rushed, no one is perfect, and the small piece about people stating their names and being recognized really respects the fact that people need to have a voice in order to really help. I'm hoping this book revolutionizes medical practice. I've been there. I've seen the mistakes. We need this.

Jan. 05 2010 08:47 PM
Peter Capek from Ossining, NY

David - #14 - It sounds as if the building was designed with insufficient stiffness, perhaps in order to save on the cost of steel. It is possible (and done, e.g., in the Citicorp Center)
to use a large mass at the top of the building to make it more comfortable for occupants and save the steel as well.

Occupant comfort -- not checked!

Jan. 05 2010 04:32 PM
mc from Brooklyn

David:

It depends on how you structure the single-payer system. If you put doctors on salary and budgets then it would probably get to the root. Many people refer to a possible single-payer system in the US as "Medicare for All." Medicare is largely fee-for-service, so if that model were used it might not get to the root of the problem. That's why I said may or may not, in my earlier post.

Jan. 04 2010 01:13 PM
Scott from Baltimore, MD

MC:

I think a single payer does get at the root of the problem re: incentives. A single payer system is the exact opposite of the fee-for-service system we have now. Doctors are salaried and hospitals have to keep tight budgets. There are no incentives for doctors to order multiple tests and unnecessary procedures. Doctors think about the best interests of their patients, and that's it.

Jan. 04 2010 12:57 PM
SuzanneNYC from Upper West Side

This could also be applied to our apprach to the terrorist threat. Acknowledge that something can happen at any time -- so concentrate on the details rather than a comprehensive model that no one can manage day in and day out. Develop a series of checklists specific for each part of the whole -- Dept of HS, CIA, State Dept., etc. -- as well as the big picture for the WH. It's got to be better than what we've been doing.

Jan. 04 2010 12:44 PM
David from montclair nj

I worked in the Gulf and Western bldg on Columbus Circle, now the Trump International. On a windy day, we all felt drunk because the bldg swayed so much. It sounded like a creaky wooden ship. After a windy day, the emergency stairwells we took between floors, instead of waiting for elevators, had huge pieces of concrete chunks tossed about because the bldg twisted so much. What list was neglected to make that happen?

Jan. 04 2010 12:44 PM
MichaelB from Morningside Heights

Great segment. As a long-time IT pro, we've used checklists when we do major migrations of software. Checklists and walk-throughs to develop the lists. Invaluable.

Jan. 04 2010 12:40 PM
Amy from Manhattan

Can we find out if a hospital has a checklist ahead of time, so we can choose a hospital (or a doctor who has admitting privileges at that hospital) before we need to go there?

Jan. 04 2010 12:39 PM
Eric from B'klyn

What a great concept... it seems that this complexity threshold has been reached by policymakers and politicians on climate change and even simply governing a modern society.

Jan. 04 2010 12:36 PM
mc from Brooklyn

Scott #4:

My best guess based on what I have read of Dr. Gawande is that the extraordinary expense of health care in this country coupled with its lack of coordination is the root of our overspending and bad results. A single-payer system may or may not solve the problem. It does not go to the heart of the problem, which is that the incentives are in the wrong place.

Jan. 04 2010 12:33 PM
Karla from Inwood, Manhattan

Thank you Atul Gawande for doing this work and writing this book. Thank you producers and Leonard for interviewing him.

I'm a LEED AP working on making new and old commercial buildings green and we've had to develop elaborately detailed software checklists to deal with all the information involved. Actually ends up being part of the construction field.

It's made me a recently converted a big, big fan of checklists.

Jan. 04 2010 12:31 PM
Amy from Manhattan

Is this the checklist that was not allowed to be implemented on the grounds that it needed to go through an FDA approval process, like a new drug? What's the status of that issue?

Jan. 04 2010 12:25 PM
Shelly from Albany

This sounds like an article that was in the Times magazine a few months back. Where a hospital (in Denver, I think) used a kind of group-oriented approach to medicine, and then researched the results. Instead of doctors making individual choices. Sorry that's vague -but does that sound familiar to the guest at all?

Jan. 04 2010 12:24 PM
Amy from Manhattan

1. When it comes to machines, as in the case of the patient whose oxygen wasn't turned on, can a "checklist" be done at a mechanical level? Can a control be set up to turn the oxygen & the anesthetic (& anything else) on at the same time istead of having the anesthesiologist turn each one on separately? I'm thinking of the way a power strip can turn on a computer & all its peripherals together.

Jan. 04 2010 12:21 PM
Mary Fran from NYC

As a patient, can you ask people who come to treat you if they have a check list?

Jan. 04 2010 12:20 PM
Scott from Baltimore, MD

Two questions for Atul Gawande:

1) What does Dr. Gawande think about Intermountain Healthcare and their pioneering work in evidence-based care?

2) Dr. Gawande has written about health care reform in The New Yorker, and seems to think that pilot programs in the Senate bill will somehow reform the extraordinarily dysfunctional system we have. Does he oppose a single payer system? And, if so, why, considering this form of health care's success in keeping costs down and covering all citizens?

Jan. 04 2010 12:15 PM
Kim from Harlem

This is a great guest. I can't wait to read his book. I spent the holidays coming up with a checklist for my MD. I've been struggling to get a diagnosis for a complex of conditions that have affected me for about six years. I recently discovered that my MD had not conducted a basic test that I assumed had been done years ago. It feels like she only looks at the last visit rather than thinking about the longer course of the illness.

Jan. 04 2010 12:12 PM
Hal from Crown Heights

Would you trust a commercial airline pilot who does not use a checklist?

Jan. 04 2010 12:09 PM
Gabrielle from Brooklyn

great guest!

Jan. 04 2010 08:52 AM

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