Let’s make this short and sweet. In this week’s New Yorker, Atul Gawande describes Peter Pronovost’s crusade to improve the safety of intensive care through the use of checklists. If it sounds dull, it’s not. In fact, it is thrilling and inspiring.
Gawande glides effortlessly from microscopic detail to panoramic view and back again to help us understand the complexity of modern medicine, how standardization and decision support are essential to improving safety, and how one person – in this case Pronovost – can take a simple idea and change the world. A brief excerpt:
We have the means to make some of the most complex and dangerous work we do – in surgery, emergency care, and ICU medicine – more effective than we ever thought possible. But the prospect pushes against the traditional culture of medicine, with its central belief that in situations of high risk and complexity what you want is a kind of expert audacity – the right stuff, again. Checklists and standard operating procedures feel like exactly the opposite, and that’s what rankles many people.
It’s ludicrous, though, to suppose that checklists are going to do away with the need for courage, wits, and improvisation. The body is too intricate and individual for that: good medicine will not be able to dispense with expert audacity. Yet it should also be ready to accept the virtues of regimentation.
To those of us in the safety and quality fields, having Gawande profile Pronovost is the equivalent of Norman Mailer writing on Picasso, or David Remnick on Muhammad Ali – one virtuoso writing about another, each at the top of his game.
But enough Cliff Notes. Do your best to find 15 minutes to read the article. It is really terrific.