Gawande on Checklists: Why Don't Hospitals Use Them?
"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."
His three values that he thinks providers should embrace are these:
1. Humility. "Recognize that no matter how smart we are, how well-trained, no matter how much experience, you will fail. You won't have it all together every time, every day.
2. Discipline. The way you overcome failure is by doing the same thing the same way, every time, over and over. Appreciation of that second value, he says "could save us."
3. Teamwork. "The belief that other people, no matter their station or specialty or background, can save you from an error."
Gawande is not slowing down. Now, he's busy developing more checklists for various procedures in neurosurgery, and then there's another project for checklists when surgeries start to go wrong. Anaphylactic allergic reactions, cardiac arrest, malignant hypothermia, hemorrhage are a just a few of the things that can and do go wrong.
He's also working on a checklist to help physicians and other care providers know how to discuss end-of-life care with terminally ill patients, perhaps the one topic physicians are most likely to avoid having, even when it matters most.
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