IMG_4665This book was authored by a surgeon and based around the idea that a simple checklist can act as the solution to all the problems faced within life’s complexities, particularly within medical procedures. He argued that having a checklist can prevent us from making silly mistakes or forgetting basic steps. They provide a basic, but effective protection against failures. This is something I was able to relate to and understand on a day to day basis. Many people make checklist of things they have to do, but this book highlighted the effects that this act could have on a greater level. He gave numerous examples of this proving to be successful in many different settings and industries.

One of the parts of the book which really interested me was the description of a study which was carried out in the John’s Hopkins Hospital. Atul Gawande mentioned that there was a five step process that doctors were supposed to follow when inserting lines in the Intensive Care Unit. The doctors in the hospital were watched for a week and it was noticed that steps were skipped. As part of the study a checklist was introduced for 10 days where nurses were asked to watch doctors to ensure that they followed all five steps of the checklist. This simple five day checklist had incredible results…the 10 day line infection rate dropped from 11% to 0%. Implementing this saved 43 infections, 8 deaths and $200 million. This study really amazed me, I was able to ponder on the miraculous effects the introduction of something so simple across the healthcare board could have. However,  in reality there would be some difficulties to introduce a very simplistic and unpersonalised checklist for treating patients as each patient is quite unique in their reactions to different  drugs and illnesses. One patient may have more than one health issue which would require their treatment to be slightly different. The patient’s ages and previous health records will  also be different so it would definitely be more difficult to apply to other cases.

I did find Atul Gawande’s argument to be quite overwhelming. Some of the statistics and examples used were very successful. However, I also found the book to be slightly repetitive in the way long examples were explained one after the other. I had also expected that the book would have a greater medical twinge to it, speaking about how current produces run within hospitals and how they could specifically be improved. It was we routes from a fairly general perspective, which I was slightly disappointed by.


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