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Wednesday
Aug312011

FLY THE PLANE

I know it’s been a while since I’ve posted here, and I still don’t have a full post together.  But I would like to write briefly about a book I read recently, Atul Gawande’s The Checklist Manifesto.

In the book, Gawande advocates for the use of checklists as a means of improving outcomes in medicine.  He bases his analysis on three key cases:  The use of coordination checklists to ensure essential communication between the parts of a construction team, the use of “read-do” and “do-confirm” checklists (routine and contingency) in the airline industry (with a particular look at the case of US Airways Flight 1549, the recent “Miracle on the Hudson”), and the design and testing of the World Health Organization’s Safe Surgery Checklist.

The book is a great example of popular nonfiction:  The information is interesting, the narrative is compelling, and the argument is sound.  The tradeoffs involved in the WHO’s design process were also interesting to me as an engineer.  A checklist (in this use) isn’t an algorithm for amateurs, but a tool to help someone who already has a great deal of expertise.  The key is to identify the tasks where a reminder is of greatest benefit; maximize the product of the likelihood that a checklist item will avoid a task being missed by the magnitude of the consequences if it is overlooked.  Extremely high-level goals often end up omitted, since they won’t be forgotten in any case.  On the other hand, sometimes important things are easy to forget in crisis situations; the subject line of this post comes from a checklist for restarting a dead jet engine (the result, one hopes, of some embarassing simulator incidents).  When the tasks themselves are unknown, the key is identifying which communication tasks have the highest probability of identifying serious potential problems before they actually occur, so the risk can be mitagated.

If you’re intersted in medicine or engineering or like reading nonfiction in general, read it.

 

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