(Our weekly reading according to our reading calendar)
The benefits of using checklists of simple task are obvious. However, the author ask himself it they can be also beneficial when tackling complex tasks, that is, tasks with lots of different actions to be taken and with unexpected and unforeseeable complications. The kind of environment that he has previously shown us that is the norm in modern medicine.
To look for answers he turns to the building construction industry. Building big skyscrapers is an extremely complex task that involves the coordination of hundreds of workers and specialists. It seems, like the intensive care units of hospitals, the perfect kind of environment for mistakes to easily appear. And however they don’t. Building collapse is an extremely rare event. The building industry manages quite well the complexity.
Until the twentieth century, the construction of a building was organized and managed by the Master Builder, and experienced expert who took responsibility of all the critical decisions and steps of the building process.
During the last 100 years this figure has disappeared. The job is nowadays organized in a mechanical way around two kinds of procedures. On one side, there is a checklist-like amount of documentation that describes the planning of the building process and which is constantly checked by all parts for consistency and accomplishment. On the other side, there is also a clearly defined documentation that defines the steps of communication between different participants that have to be performed when unexpected events happen.
In the author’s opinion, medicine has still to make the step out of the master builder stage like the construction industry did almost a century ago.