The Checklist Manifesto #3

Gawande did a project for WHO, developing and putting into place in 8 hospitals around the world a 19-item surgical checklist. Over a 3-month experimental period and for all surgeries in these 8 hospitals, a member of the surgical team (not the lead surgeon) walked the team members through a series of questions or procedural steps, including checking information about patients' allergies and potential blood loss. There were basic questions that asked for verification of patient consent to the surgery and equipment checks to verify the working order of the operating room machinery. After the 3 months the experiment's results revealed a 47% decrease in deaths and an almost 50% drop in the number of infections. Serious complications as a result of surgery fell 36% after the introduction of the checklist! The operating rooms in hospitals in rich countries experienced the same results, pretty much, as those in poor countries, though admittedly the starting points were different. This is amazing and leads me to think about a checklist for teaching. Of course many such checklists exist, but how about something as simple as writing goals on the board so that students know what we want them to learn? We teachers can do that!

Checklist Manifesto #2 2/22/2011

I felt pride when I read that it was not doctors but nurses who began using checklists in hospitals, checklists for giving medications and taking vital signs and checklists for gauging pain. How amazing that instituting checklists in ICU's brought down dramatically the infection rate among patients on central lines and also reduced the occurence of pneumonia among patients on ventilators.

There's a connection to education. This speaks to the importance of written lesson plans with goals. Of course I'm a veteran who knows what I'm teaching, but like these experienced physicians and airplane pilots that Gawande writes about, I am human and I get off track and I forget what I meant to do or say. Nobody's life is at risk in my classroom, but my students' time w/ me is limited, and I mustn't waste it!

The Checklist Manifesto by Atul Gawande Blog #1

I'm asking all of the students in the best sellers class to create blogs to share their responses to their advice/ self-help books. I'll do the same about The Checklist Manifesto.

My first impression is that Gawande uses an accessible writing style. Yea! I was able to grasp what I think is the main idea of the book, as he describes it in the introductory chapter. Gawande writes of a shift in the big problem confronting the medical profession today as opposed to that of the medical profession of, say, fifty years ago. Doctors used to face the problem of ignorance; they didn't know what was wrong with their patients and didn't know what to do for them. Now, however, the problem is ineptitude; there is--and really it's amazing-- a wealth of knowledge about over 13,000 identifible diseases, syndromes and injuries. Doctors have approximately 6,000 medications and 4,000 medical and surgical procedures from which to choose in planning for their patients' treatment. The problem now is how to get it right. Doctors have to manage the complexity of what they have come to know.