[danpalmer]

> It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?"

It turns out that while it's a good idea to check things this "low-hanging", the value is far larger than catching wrong patients, so don't worry too much!

Much of the value comes from essentially disrupting routine with an opportunity to stop, and from creating a culture of speaking up. I think the NHS was the organisation to trial having the nurse run the checklist, which had the effect of empowering the "lowest level" person in the operating theatre. Studies showed that even just having everyone in the room speak once increased the chance of subsequent communication, and ultimately improved patient outcomes.

Atul Gawande was one of the key people in designing and rolling out these checklists and wrote a book about it that I'd recommend – The Checklist Manifesto.

[tomxor]

That's excellent! it never occurred to me it could have such a positive effect in a team situation. Empowering the supporting members is very insightful, they may be supporting but they are just as critical, they need to feel appreciation for the value they provide to stay sharp and motivated - I hope this can be applied to other contexts, thanks for sharing this.

[ZeroGravitas]

If I remember the anecdotes correctly, the focus on nurses wasnt as cheery as this. Basically, the nurses often knew when the surgeon was in the process of making a mistake, up to cutting the wrong leg off a patient, but kept quiet because surgeons had the power to ruin their careers if they "embarressed" them. So the innovation was really about forcing surgeons to not terrify their nurses into silence.

[tomxor]

Ouch. This reminds me of the problems nurses faced in the 80s as described in "Pragmatic Thinking and Learning". From that book it made it sounds as thought the issues were mostly historic, I guess there have been a number of different battles fought.

[Privacy846]

/delted/

[danpalmer]

Well it was about this. Empowering them against surgeons in a position of power is still empowerment.

[FabHK]

+1 on Atul Gawande's book The Checklist Manifesto. It's an interesting read if you're into aviation or healthcare or anticipate being in hospital one day.