Thursday, January 15, 2009

Little Things Mean a Lot

If you want to make fewer mistakes, don’t sweat the big stuff. Instead, focus on the little things.

One example: checklists. You probably make one of these every time you go to the grocery store – and for good reason: they work. You write down “loaf of bread” and you don’t forget to buy a loaf of bread.

Now there’s startling new evidence that the same approach that works for you in the grocery store works for doctors in the operating room. An article in the New England Journal of Medicine shows that basic checklists cut the rate of surgical deaths in half. Half!

The checklist had 19 items, some so basic as asking the patient his name so you can make sure you have the right patient. It was tested in 2007-2008 in eight hospitals in eight cities around the world, from Seattle to London to Manila.

Before the checklist was introduced, 1.5% of patients in a comparison group died within 30 days of surgery at the eight hospitals; afterward, the rate dropped to 0.8% -- a 47% decrease.

That’s the power of little things.


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