Atul Gawande is probably the foremost proponent of surgical checklists and in that article is responding to an Ontario study reporting that checklists were not significant---it sounds like a pretty bad study.
Surgeons don't particularly like checklists.
"For starters, the most controversial idea for teams to accept is perhaps the simplest item in the checklist. Require all team members say their names prior to the launch of the procedure.
"'This has been one of the most important things that help people feel comfortable speaking up' if they're unsure or unclear, for example, that this is the right patient, right site, right procedure.
"'It acknowledges that you're part of a team and are allowed to speak.'
"Gawande says that there has been resistance to accepting checklists at another level. 'The concept has forced us rethink what it means to be great at what we do. And I hadn't grasped this until I saw it recur over and over again. There's a set of values in the idea of a checklist, and they're in distinct conflict with some of the values we have in medicine.'
"'We value physician autonomy, which works well when there are just two full time equivalents providing care, but when we have 19.5 FTEs trying to make things work, it becomes a problem.'"[1]
Great reference. That first point relates more to Crew Resource Management (CRM)[1], an important concept making its way from aviation to surgery. After a decade flying F-18s for the Navy, I value checklists but communication is probably even more important and often overlooked. Finding the courage to speak up is more challenging then it seems. It's so easy to assume that the Captain, Surgeon, or whoever is in charge knows what they are doing. One of the worst accidents in history[2] that helped kick off CRM, could have likely been prevented if the co-pilot had assertively told the Captain that they weren't cleared for take-off.
I still remember the Navy's version and believe it's applicable to many places other than aviation.
D - decision making
A - assertiveness
M - mission analysis
C - communication
L - leadership
A - adaptability / flexibility
S - situational awareness
But they most assuredly want you to use a checklist if you're going to do surgery on them. See this telling passage at the very end of Chapter 7 of Gawande's book:
Then we asked the staff one more question. “If you were having an operation,” we asked, “would you want the checklist to be used?” A full 93 percent said yes.
http://theincidentaleconomist.com/wordpress/when-checklists-...
Atul Gawande is probably the foremost proponent of surgical checklists and in that article is responding to an Ontario study reporting that checklists were not significant---it sounds like a pretty bad study.
Surgeons don't particularly like checklists.
"For starters, the most controversial idea for teams to accept is perhaps the simplest item in the checklist. Require all team members say their names prior to the launch of the procedure.
"'This has been one of the most important things that help people feel comfortable speaking up' if they're unsure or unclear, for example, that this is the right patient, right site, right procedure.
"'It acknowledges that you're part of a team and are allowed to speak.'
"Gawande says that there has been resistance to accepting checklists at another level. 'The concept has forced us rethink what it means to be great at what we do. And I hadn't grasped this until I saw it recur over and over again. There's a set of values in the idea of a checklist, and they're in distinct conflict with some of the values we have in medicine.'
"'We value physician autonomy, which works well when there are just two full time equivalents providing care, but when we have 19.5 FTEs trying to make things work, it becomes a problem.'"[1]
Any of that sounding familiar?
[1] http://www.healthleadersmedia.com/page-3/QUA-262159/Gawande-...