A great week for me, focused on, of all things, checklists. Atul Gwande, surgeon and essayist for the New Yorker, was at Seattle’s Town Hall Sunday night to promote his new book – “The Checklist Manifesto”. While the evening had some of the challenges of a book tour promotion (relatively short talk, limited discussion) the content was great. Maggie Mahar has a great summary of the book on her Health Beat blog – no need to repeat it here.
Then today I was with a team of leaders from our group practice rounding at our Tacoma outpatient surgery center to “go and see” there use of the checklist (and associated processes) implemented to improve safety for our patients there. This is my fourth trip for safety rounds at Tacoma in about 9 months, and there has been real progress. The checklist is reliably used, the team participates, and care is safer. To their great credit they recognize that the benefit from using a checklist is about a lot more than compliance with a list of questions – it is about using a tool to minimize human error, and when teams use it well it helps offer a time for reflection that has many benefits beyond the obvious ones. Teams operate, not individuals (granted, those with sharp tools need to lead the teams and be accountable for the outcome). Clarifying the role of team members and working to minimize any impediments to team members participating (calling out breaks in sterile procedure, concerns about a patient, etc) are important benefits from following the protocol reliably. The teams also had a better way for measuring use of the checklist to minimize the Hawthorne effect.
Now – time to develop a checklist for my bike commuting – I ended up riding home after clinic without one of my key lights the other night – forgot to charge the battery!
It’s Not About The Box is proudly powered by