A Checklist Saves Lives

Safety and the sharing culture, coordinated action and team cohesion. These principles are valid for a corporate team and are borrowed from particular experiences ranging from submarines during wartime, to hospital emergency wards, and to racing car pit-stops. These experiences are also useful for coping with stress during the current economic crisis.


Perfect example of team cohesion during a Ferrari pit-stop

To check the identity of a patient who is about to be operated can be to most people a ‘no-brainer’. The same can be said of pre-emptively marking that part to be operated on with a felt-tip pen, or counting staff members in the surgical theatre at the beginning of the operation. Yet, precautions like these make a big difference to the success rates of surgical operations. Dr. Atul Gawande, a surgeon at Brigham Hospital in Boston, recently co-wrote an article about check lists, published in the New England Journal of Medicine. Quoting the outcomes of a World Health Organization project which started a year ago. The adoption of a 19-item surgical safety checklist designed to improve team communication and consistency of care would, the study concluded, reduce complications and deaths. More specifically, this initiative would half the death rates of patients in the operating room from 1.5% in hospitals that did not use it to 0.8 % in the hospitals that did.
The aviation industry has, likewise, verified that 70 percent of plane crashes involve human mistakes and for this reason has developed training and communication techniques that allows people from different professional backgrounds to work in a coordinated way. Also starting from this assumption, the European Institute of Oncology (Ieo), three years ago, started to compare patient’s safety with other complex systems, beginning with the aeronautics sector. As Ieo Managing Director Leonardo La Pietra explains, “These meetings have highlighted the importance of creating a shared safety and teamwork culture. This is where control check-lists are used and where operational sequences are fully understood.” “The more systematic the investigation and recommendations, the less likely will accidents occur” adds La Pietra.
An element that must be defeated is the so-called ‘normalization of deviance’, which leads to acceptance of non-compliance with some policies or procedures, be
cause of habit, time optimization and (fortuitous) lack of previous accidents. The same goal of reducing risks and improving staff work, lead Dr Martin Elliott and Dr Allan Goldman of the Great Ormond Street Hospital for Children (London), to get in contact with Ferrari. They had seen a pit-stop crew work on a racing car in less than 7 seconds. Their problem was how to face that critical moment for the patient right after the operation. In another medical example, Mirabelle’s technicians were struck by the fact that surgeons operated on fixed tables with the patient tied to complex tools. Nurses then moved the patients on a stretcher before they reached the intensive care unit. The solution they suggested was simple but effective – creating an operating table with wheels and portable instrumentation.

[W  brighamandwomens.org ferrari.com who.int]

Published in the hard-copy of Work Style Magazine, Spring 2009