Checklists – the latest fad to hit health care?

I have a copy of Atul Gawande’s book “The Checklist Manifesto: How to Get Things Right“. It’s next on my reading list once I’m finished with Clayton Christensen’s book “The Innovator’s Prescription: A Disruptive Solution for Health Care“. Since I haven’t yet read Gawande’s book, I am not going to talk about the comment. However, I think it is safe to say that “checklists” will be the next big thing in health care for the next little while. Why do I think so?

The main reason is because the mainstream media seems to be picking-up on this idea that checklists will improve care and outcomes and have started writing about it.

• ModernMedicine has an article titled “Medical checklists needed to improve care and outcomes“.
• Harvard Business Review has a podcast with Dr. Atul Gawande titled “Using checklists to prevent failure” and another blogger arguing that checklists will be a “transformative innovation” (How innovation can tame chaotic care).
• There’s also the New Yorker article by Gawande which had several of my colleagues talking about checklists in 2008 (The Checklist) in addition to the New York Times opinion piece “A lifesaving checklist“.
• In 2009, MSNBC reported “Simple checklist cuts surgical deaths in half“
• Dr. Gawande also appeared on the Daily Show
• CNN’s Dr. Sanjay Gupta did an interview with Dr. Peter Pronovost, author of Safe Patients Smart Hospitals
• Salan published a review of the Checklist manifesto
• It’s even been on Oprah (The power of a checklist)

Again, without having read the book, I can see how use of a checklist can help bring order to a complex environment. That’s always been the reason for use within the airplane cockpit. Some evidence on the impact of checklists is available from the AMA (Infection rates drop as Michigan hospitals turn to checklists) and the original NEJM article titled “An intervention to decrease catheter-related bloodstream infections in the ICU“

I’m hoping that checklists, even if they are a fad, do make a difference and improve care. If some of the needless complexity can be simplified with the knowledge codified (and thus more accessible), then this will be a great thing. Perhaps checklists will be a first step in making health care more open to disruption. Christensen’s theory points to the notion that codification of “expert knowledge” is a first step in making a process open to innovation and disruption. I’m just hoping that checklists can improve care.