The Checklist Manifesto - Atul Gawande

Question 1

What did Gorovitz and MacIntyre (philosophers) say are the two main sources of our human fallibility?

Answer 1

1. Ignorance (lack of knowledge)

2. Ineptitude (failure to apply knowledge correctly)

Question 2

What is likely the main reason doctors still fail in cases where they have all the requisite knowledge to succeed?
(Why do cases of ineptitude occur?)

Answer 2

The sheer complexity of medicine and volume of available scientific knowledge is overwhelming

Question 3

What percentage of patients with the following conditions receive inadequate or incomplete care consistent with how current medical knowledge has stated they should be treated?

Stroke
Asthma
Heart attack
Pneumonia

Answer 3

30%
45%
50%
60%

Question 4

Approximately how many WHO-recognized diseases, syndromes, and injuries are there?

How many drugs do physicians have access to today?

Answer 4

13,000

6,000

Question 5

What are the four vital signs?

Answer 5

Blood pressure
Heart rate
Respiratory rate
Body temperature

Question 6

What are examples of simple, complicated, and complex problems?

Which of these best exemplifies the mistakes made in medicine?

Answer 6

Simple - baking a cake
Complicated - sending a rocket to the moon
Complex - raising a child

Medicine has elements of each level of complexity, but the mistakes made in medicine are often simple ones (e.g. forgetting to wash hands or consider a certain diagnosis in the differential)

Question 7

What are two simple measures that can greatly improve surgical outcomes and surgical teamwork with very little cost in time or resources?

Answer 7

Make sure everyone knows each other’s name;
pause for a minute or two before the surgery to discuss the case, potential complications, etc. (make sure every team member contributes)