An interesting CNN article by Richard Galant featuring Atul Gawande talking about the importance of checklists for Doctors (watch Atul’s recent TedTalk on the topic here, click here for Project Checklist).
While I agree that the volume of information now means we can’t know it all I find all this talk of the growing need for specialists has arisen not because it’s how we get better healthcare but because we’ve continued to have blind faith in a reactive model that is focused on fixing sickness. Sadly the fundamentals remain rather basic, boring, less profitable and involve changing behaviour: eat well, exercise more, have a family Doctor relationship, don’t smoke, etc.
For the record I don’t think checklists are new (despite Atul’s TedTalk claims I got a tour of Lord Ara Darzi’s surgical suite at St Mary’s Paddington nearly a DECADE ago and they had these as well as black box recorders!) and I’m a total checklist convert as I think anyone would be if they understand the story of how the Boeing B17 Flying Fortress (a plane declared “too much airplane for one man to fly”) in 1935 won orders and flew 1.8 million miles without an accident because of a checklist short enough to fit on an index card that was full of all the boring dumb stuff like “be sure all the doors are closed”.
But I firmly believe that we’re going to see the real disruption – and the opportunity to impact quality of patients lives – is going to originate from giving patients access to clinically validated checklists…
Sadly Doctors checklists don’t get the scrutiny of their counterparts in the aviation industry, where it’s very hard to cover up a mistake, it’s your own life at stake, there are effective whistleblowing systems in place, etc. As a result I can only see change happening and the workings of the healthcare system being called to account once patients are empowered with interactive checklists.
Now you could give billions in state funding to encourage Doctors to adopt checklists but they’ll only really do this when they have to. It’s obvious to me that patient access to their information and documentation of their encounters is what will make them have to.