Value of lists (a cautionary tale)
I listen to public radio when I work in the office and I heard an interesting interview with a surgeon this morning as I was doing some analytical work that I think is worth relaying to you.
This senior surgeon has implemented simple check lists into his operating theatres. He is responsible for 8 hospitals and every surgeon that works for him has to use the checklist before they operate to help them diagnose and then deal with the patient properly (and to ensure that mistakes don’t happen). The checklist takes 2 minutes to complete.
His surgeons hated them when they were introduced. They said that they didn’t need them, they already did everything right and that it was important to follow their instincts; the lists wouldn’t help or add any value.
The surgeon that first implemented the checklist went on in the interview to tell a story about a patient who attended casualty with a small stab wound.
His blood pressure was normal and the wound was not visibly bleeding much. 10 minutes later the patient collapsed and when they opened him up they found that an internal organ had been severely damaged. The width of the wound was small; the depth was 10 inches which they had overlooked completely. The checklist would have helped the surgeon diagnose more effectively because it asks the question about the instrument that caused the stab wound (in the event of penetrating wounds). The patient survived but only after a very dangerous operation, intensive care that cost a small fortune and a longer recovery than needed (had he been diagnosed properly in the first place).
6 months down the line the fatalities in the 8 operating theatres that use the checklist have dropped 35%; 80% of the surgeons say that the lists have helped and most interestingly 94% say that if they were to have an operation themselves that they would want it in a hospital that uses the checklist!
Hero’s and lists
"Sully" Sullenberger is called a hero for saving 155 lives when he successfully ditched a plane into the water in New York City. Airline pilots use lists as a crucial component for normal job tasks and also critical parts such as emergencies. Sully says he wasn’t a hero he simply put the landing down to great team work and adherence by the team to the protocols that they followed (the checklists).
So the message
The message to me is a simple one. If you want to ensure that your systems and processes are followed and adhered then simply install a check list to help your staff (and give them a tool to support and drive your process). Your people might not like them at first however check lists are proven to work in just about in situation that is critical to customer, patient or client care. Make sure that they are used, understood and followed and the outcome might pleasantly surprise you.
Cheers
Brian
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