Here is an example that Gawande cites on the impact a simple checklist had in the ICU of Johns Hopkins Hospital in the US. A critical care specialist, Peter Pronovost, decided to use a checklist of one aspect of ICU management- controlling central line infections. It was a 5 step process. Provonost made the nurses the custodians of this process and they tracked how rigorously doctors followed the 5 steps. It turned out after a month that doctors skipped at least one step in a third of the cases. The nurses were now authorized to ensure that the doctors did not skip any step. A year later, the results were great- the ten-day line-infection rate, which they had sought to control reduced from 11% to 0%. In one hospital the checklist had prevented 43 infections, 8 deaths and saved $2M!
Spurred by the success, Provonost introduced checklists for other areas too with similar success. Gawande also adds that Provonost is no average joe- he is described by colleagues as brilliant, a genius. He has an MD & a PhD!
I will write about another example or insight in my next post on this.
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A checklist logicaly is supposed to compensate for the limitations of our memory. A brilliant genius MD PhD too can have these limitations I guess ! —)). Jokes apart, checklists ensure a strict adherence to the process in this case,instilling a sense of consistency and completeness. Very interesting example and waiting for somemore !
The knee jerk reaction to checklists could be that they hamper creativity. But the more constructive way of looking at this would be:
With checklists, you take care of the basics, the hygiene issues, the areas where there can be no compromise, the must-haves.
This gives one the free mind space to explore and innovate and go beyond the minimum.
Hope the creative types agree with this reasoning!!