(You just pay attention, right?) But it is neither. Diligence seems an easy and minor virtue. The first is diligence, the necessity of giving sufficient attention to detail to avoid error and prevail against obstacles. The failure is one of reliability and diligence – skills for which Atul Gawande has a deep appreciation. Medical professionals know how to perform all 178 of those tasks they’ve probably done them hundreds if not thousands of times. Patients are subjected to many interventions, most of which are complex and carry some risk the average ICU patient requires roughly 178 daily care tasks (having worked as an ICU nurse myself, I believe it!), so even getting it perfect 99% of the time leaves an average of about two medical errors per day. The hospital environment itself is chaotic, time-pressured and filled with interruptions and distractions: far from ideal for human workers making high-stakes decisions. A hospitalized patient’s treatment involves coordination between dozens of different specialized professionals and departments. Even when the right answer is known by someone – and often by everyone involved – patients slip through the cracks.įundamentally, medicine knows too much even decades of medical training are insufficient for a doctor to know everything. And yet, mistakes are still made diagnoses are missed, critical tests aren’t run, standard treatments aren’t given. The 20th century saw vast increases in medical knowledge, both through a richer understanding of the body, and from swathes of new drugs, tests, and surgical procedures. For decades, though, it was anything but obvious.Ītul Gawande walks readers through his experience of how the modern medical system fails. It’s easy to look at the core concept and think of it as trivial. ![]() ![]() ![]() By the time I read it a few years ago, the hard-earned lessons explained in this book had already trickled into hospitals across North America. Atul Gawande’s The Checklist Manifesto was originally published in 2009.
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