A great weekly as usual, Azeem, but I hope no one misinterprets your contrast of contractual checklists with a culture of safety. Checklists are critical to safety. But, they only work when there also is a commitment to safety. I avoid unsafe situations, e.g., in medicine, but I also avoid situations where a checklist is appropriate but is not followed universally. Both are essential. Atul Gawande has written well on this topic.
Absolutely. A checklist is very important, but some of the most bureaucracy and checklist-heavy industries have had disasters (NASA with Challenger, etc.) because of a problematic safety culture surrounding these kinds of protocols.
Agreed. It's interesting to note that in some hospital settings, it is the lowest status person in the operating room who calls the timeout and goes through the checklist. This automatically sends a message that everyone, regardless of status, has the right and obligation to intervene if there is a potential safety issue. The details of going through that safety check end up in the electronic patient record, at least in the university hospitals where I have been treated, which means that the patient can see them, so there is accountability.
A great weekly as usual, Azeem, but I hope no one misinterprets your contrast of contractual checklists with a culture of safety. Checklists are critical to safety. But, they only work when there also is a commitment to safety. I avoid unsafe situations, e.g., in medicine, but I also avoid situations where a checklist is appropriate but is not followed universally. Both are essential. Atul Gawande has written well on this topic.
Absolutely. A checklist is very important, but some of the most bureaucracy and checklist-heavy industries have had disasters (NASA with Challenger, etc.) because of a problematic safety culture surrounding these kinds of protocols.
Agreed. It's interesting to note that in some hospital settings, it is the lowest status person in the operating room who calls the timeout and goes through the checklist. This automatically sends a message that everyone, regardless of status, has the right and obligation to intervene if there is a potential safety issue. The details of going through that safety check end up in the electronic patient record, at least in the university hospitals where I have been treated, which means that the patient can see them, so there is accountability.