Wednesday, May 18, 2011

What I've Been Reading

Checklist Manifesto by Atul Gawande. Having developed an almost unhealthy obsession for my own fallibility, I had indefinitely postponed reading this book. Let's just say the turn of events in the past few months made me pickup this book.


When I started my career in IT, I was more than delighted to work with computers - the rational creatures unlike us. Over the years, I had come to realize that people not only build software but their egos are implanted it as well. Checklists are one the most efficient tools to subdue our fallibilities and keep that ego on check. Ironically, checklists are the hardest to implement since it forces people to check their egos and accept their fallibility. It takes patience, discipline and persistent nudging to implement it. Good luck!!


On Discipline:
"The closest our professional codes comes to articulating the goal is an occasional plea for "collegiality". What is needed, however isn't just that people working together be nice to each other. It is discipline. Discipline is harder - harder than trustworthiness and skill and perphaps even than selflessness. We are by nature flawed and inconstant creatures. We can't even keep from snacking between meals. We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at."


On Failure:
"The first is ignorance - we may err because science has given us only a partial understanding of the world and how it works. There are skyscrapers we do not yet know how to build, snowstroms we cannot predict, heart attacks we still haven't learned how to stop. The second type of failure the philosphers call ineptitude - because in these instances the knowledge exists, yet we fail to apply it correctly. This is the skyscrapper that is built wrong and collapeses, the snowstrom whose signs the meteorologist just plain missed, the stab wound from a weapon the doctors forgot to ask about."

On Fallibility:
"In a complex environment, experts are up against two main difficulties. The first is the fallibility of human memory and attention, especially when it comes to mundane, routine matters that are easily overlooked under the strain of pressing events. (When you've got a patient throwing up and an upset family member asking you what's going on, it can be eay to forgot that you have not checked her pluse.) Faulty memory and distraction are a particular danger in what engineers call all-or-none processes: whether running to the store to buy ingredients for a cake, preparing an airplane for takeoff, or evaluating a sick person in the hosipital, if you miss just one key thing, you might as well not have made the effort at all."

Hilarious but a most important checklist for the pilots:
 “Fly the airplane,” amazingly, is the first item on a checklist for engine failure on a single-engine Cessna airplane. “Because pilots sometimes become so desperate trying to restart their engine, so crushed by the cognitive overload of thinking through what could have gone wrong, they forget this most basic task. FLY THE AIRPLANE.”


No question, we all believe we would be better off going to surgeon using a checklist. The question we should ask ourselves is, are we open minded enough to use checklists in our own profession?









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