Friday, April 8, 2011

Atul Gawande

From a TIME magazine Q & A with Atul Gawande, author of The Checklist Manifesto: How to Get Things Right:

How can medical schools encourage doctors to be more willing to talk about failure?

We don't equip people who are about to be doctors for the idea that they're going to fail and that they have a responsibility to build a plan for that understanding. We don't prepare people for the idea that you really work in teams nowadays. [In medical school] you learn the physiology of the body. And then you learn the diagnoses and the treatments. You could get all of those first steps right and your patient will still die. Because you weren't able to get the radiologist and the nurse and the rest of your team working in sync. Who's going to teach that? We don't have the senior medical people who really understand how to do this.

Your focus is on checklists in surgery. Can checklists help a doctor working alone?

I had a patient just the week before Christmas who had a tumor found in his abdomen. It was on multiple spinal X-rays he'd had, but they were just looking at the spine and they forgot to check the other images. It's a kind of basic mistake radiologists can make. But if you have a checklist, you make sure you've looked.

You mention that some doctors object on the grounds that checklists take too long. Do they?

If they're badly designed. One of the fascinating things to me was going to visit Boeing's checklist factory, where they make over 100 checklists a year and design them in ways that pilots can actually use them in a time crush. They helped us design ours. We set a target that...[read on]
--Marshal Zeringue