The Mini-Gastric Bypass and the "Checklist"

The Mini-Gastric Bypass and the “Checklist”

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Amazon Exclusive: Malcolm Gladwell Reviews The Checklist Manifesto

Malcolm Gladwell was named one of TIME magazine’s 100 Most Influential People of 2005. He is most recently the author of What the Dog Saw (a collection of his writing from The New Yorker) as well as the New York Times bestsellers Outliers, The Tipping Point, and Blink. Read his exclusive Amazon guest review of The Checklist Manifesto:

Over the past decade, through his writing in The New Yorker magazine and his books Complications and Better, Atul Gawande has made a name for himself as a writer of exquisitely crafted meditations on the problems and challenges of modern medicine. His latest book, The Checklist Manifesto, begins on familiar ground, with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world–and that is how professionals deal with the increasing complexity of their responsibilities. It has been years since I read a book so powerful and so thought-provoking.

Gawande begins by making a distinction between errors of ignorance (mistakes we make because we don’t know enough), and errors of ineptitude (mistakes we made because we don’t make proper use of what we know). Failure in the modern world, he writes, is really about the second of these errors, and he walks us through a series of examples from medicine showing how the routine tasks of surgeons have now become so incredibly complicated that mistakes of one kind or another are virtually inevitable: it’s just too easy for an otherwise competent doctor to miss a step, or forget to ask a key question or, in the stress and pressure of the moment, to fail to plan properly for every eventuality. Gawande then visits with pilots and the people who build skyscrapers and comes back with a solution. Experts need checklists–literally–written guides that walk them through the key steps in any complex procedure. In the last section of the book, Gawande shows how his research team has taken this idea, developed a safe surgery checklist, and applied it around the world, with staggering success.

The danger, in a review as short as this, is that it makes Gawande’s book seem narrow in focus or prosaic in its conclusions. It is neither. Gawande is a gorgeous writer and storyteller, and the aims of this book are ambitious. Gawande thinks that the modern world requires us to revisit what we mean by expertise: that experts need help, and that progress depends on experts having the humility to concede that they need help. –Malcolm Gladwell

From Publishers Weekly

That humblest of quality-control devices, the checklist, is the key to taming a high-tech economy, argues this stimulating manifesto. Harvard Medical School prof and New Yorker scribe Gawande (Complications) notes that the high-pressure complexities of modern professional occupations overwhelm even their best-trained practitioners; he argues that a disciplined adherence to essential procedures—by ticking them off a list—can prevent potentially fatal mistakes and corner cutting. He examines checklists in aviation, construction, and investing, but focuses on medicine, where checklists mandating simple measures like hand washing have dramatically reduced hospital-caused infections and other complications. Gawande gets slightly intoxicated over checklists, celebrating their most banal manifestations as promethean breakthroughs (First there was the recipe, the most basic checklist of all, he intones in a restaurant kitchen). He’s at his best delivering his usual rich, insightful reportage on medical practice, where checklists have the subversive effect of puncturing the cult of physician infallibility and fostering communication and teamwork. (After writing a checklist for his specialty, surgery, he is chagrined when it catches his own disastrous lapses.) Gawande gives a vivid, punchy exposition of an intriguing idea: that by-the-book routine trumps individual prowess. (Jan.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
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223 of 234 people found the following review helpful:
5.0 out of 5 stars
Game Changing…, December 23, 2009
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This review is from: The Checklist Manifesto: How to Get Things Right (Hardcover)

Amazon’s December Book of the Month summary describes the author’s mission of revolutionizing the “to-do list…without programmatic steps or tables to help reshuffle daily tasks.” One may infer from this recap that this is a how-to-self-improvement book for making one more productive, more efficient and less stressed – this couldn’t be farther from the core message of this book.

The author’s key message is that the volume and complexity of knowledge today has exceeded any single individual’s ability to manage it consistently without error despite material advances in technology, boatloads of more training and super-specialization of functions and responsibilities. Yet, despite demonstrating that checklists produce results, there is resistance to their use because of the (1) Master of Universe mentality (Rock Star; Fighter Pilot; Hero), (2) our jobs are too complex to reduce to a checklist, (3) checklists are too rigid and don’t force us to look up and see and think ahead of what’s in front of us. Yet, in a complex environment, he states that experts are up against 2 difficulties – the fallibility of human memory when it comes to mundane, routine matters that are easily overlooked under the strain of more pressing events and secondly, people can lull themselves into skipping steps even when they remember them – after all certain steps don’t always matter…until one day they do. Gawande makes a persuasive case in his book as to why you should develop and implement a process checklist for critical processes/decisions.

* Whether you are from the medical field or not, you will benefit from the inspiring thinking and insights.

* This book is game changing – a call-to-action for generating better results despite the pull to run with intuition or gut instinct. If you are implementing via intuition rather than a systematic process, this book’s message will force you to pause in your tracks to seek a more disciplined approach.

* The author uses a wide range of industries to make his case using an engaging blend of anecdotes, storytelling and research – from healthcare to aviation (US Airways 1549 landing in Hudson River) – – to high-end award winning restaurants – – to building massive office skyscrapers and shopping centers – -to setting up a Van Halen rock concert – – to FEMA’s response to Hurricane Katrina in New Orleans – – to money managers making investment selections.

* Can be read in 1-2 sittings. Page Turner. Fully engaging and riveting until the last page is turned.

* Author’s determination, authenticity, inspired thinking, modesty and willingness to disclose personal mistakes makes this an inspirational book. Both brilliantly written and a pleasure to read.

My favorite excerpts:

“Despite showing (hospital) staff members of the benefits of using the checklist, 20% resisted stating that it was not easy to use, it took too long and felt it had not improved the safety of care. Yet, when asked an additional question – would you want the checklist to be used if you were having an operation – a full 93% said yes.”

“In a world in which success now requires large enterprises, teams of clinicians, high-risk technologies, and knowledge that outstrips any one person’s abilities, individual autonomy hardly seems the ideal we should aim for. ..what is needed, however is discipline…discipline is hard – harder than trustworthiness and skill and perhaps even than selflessness. We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.”

“We don’t study routine failures…when we look closely, we recognize the same balls being dropped over and over, even by those of great ability and determination. We know the patterns. We see the costs. It’s time to try something else. Try a checklist.”

“We’re obsessed in medicine with having great components, the best drugs, the best devices, the best specialists – but pay little attention to how to make them fit together well””

“It somehow feels beneath us to use a checklist, an embarrassment. It runs counter to deeply held beliefs about how the truly great among us – those we aspire to be – handle situations of high stakes and complexity. The truly great are daring. They improvise. They do not have protocols and checklists. Maybe our idea of heroism needs updating.”

Read more at www.amazon.com

 

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