The Checklist Manifesto. Chapter 2 The Checklist

Following our reading calendar, here is a short explanation of the contents of chapter two.

It starts with a very impressive example on how the humble checklist saved Boeing for a great financial loss, and how using a checklist allowed pilots to fly a plane slightly more complicated than those that were common in the 1930s. Now checklist are commonplace in aviation.

This is the main aim of this chapter: to convince us of the power of the checklist. He points out the two main psychological situations in which checklists can be of great help: first there is the “fallibility of human memory and attention, especially when it comes to a mundane, routine matters that are easily overlooked under the strain of more pressing events” (p. 36)

The other one is how you can skip steps that you already memorized because usually don’t matter. Until they do, of course.

The thing that most called my attention was to realize that we have to wait to 2001 to see the first attempts to introduce checklists in medicine (besides the basic constants which, as the author stated are a sort of proto-checklist). I was imagining that checklists were in operating rooms since decades ago, and as common in the medical world as in the commercial or military flying. But not at all. As the author explains, Pronovost -one of the early adopters of checklists in medicine- had to work hard to convince his colleagues on how important it is to have checklists in medicine.  However he was able to present very relevant numbers of the effectiveness of such procedures and convince more relevant people.

The chapters ends returning to the example in the introduction of the 3 year old  girl saved after drowning in icy water. This was another brilliant and very emotional example of the possibilities of the checklist.

 

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One thought on “The Checklist Manifesto. Chapter 2 The Checklist

  1. Well, the hero of the book finally appears: the checklist.

    The story of the B17 crash and how it spawned the use of checklist in aviation is amazing. In fact, we have been used to the typical “front door checked” “ready for take-off” messages in the planes. I had always wondered why they did so. I know now.

    The story of the crusade of Peter Pronovost is also fascinating and moving. A kind of the silent heroes that never make into the headlines but make our world much better.

    Very interesting also the idea of the need of empowering the lower levels of the hierarchy, in this case the nurses.

    Unlike you, before reading the book, I had never assumed that checklist had been in use in medicine. I was a victim of the myth of the expert and thought that the human expertise was enough to do a good job done. I was so wrong.

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