Speaking of checklists and routine, Atul Gawande and colleagues put out an excellent example of a mindless execution of a surgical checklist on You Tube. As they say, a picture is worth a 1,000 words–in this case, a video of “how not to do it” eloquently makes the case for ‘how to do it’ correctly. Thanks Atul, for providing yet another example of true north to patient centered care.
And a more mindful, creative method of performing a surgical checklist follows. If you have a few minutes, it’s well worth it to watch this one–at least until the Remix portion:
In Gawande’s piece, The Velluvial Matrix, for the New Yorker in July of 2010, he writes:
…Doctors and scientists are now being asked to accept a new understanding of what great medicine requires. It is not just the focus of an individual artisan-specialist, however skilled and caring. And it is not just the discovery of a new drug or operation, however effective it may seem in an isolated trial. Great medicine requires the innovation of entire packages of care—with medicines and technologies and clinicians designed to fit together seamlessly, monitored carefully, adjusted perpetually, and shown to produce ever better service and results for people at the lowest possible cost for society…
Without mindfulness applied to daily practice, including routines that may seem to have little effect on outcomes, health systems will fail to reach the high reliability that will deliver the Triple Aim–better care, better population health at the lowest possible cost. It is imperative we start teaching these newer concepts of high reliability, mindfulness, teamwork, human factors and transparency to our students and residents. Our future caregivers should not have to struggle trying to provide care that is safe and low risk.