A crowd of more than 550 people filled Memorial Sloan-Kettering’s Rockefeller Research Laboratories Auditorium and three overflow rooms on January 5 to hear writer and surgeon Atul Gawande deliver the President’s Special Lecture. In his talk, Dr. Gawande, a staff member of Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, and a staff writer for The New Yorker magazine, described how the use of simple checklists can improve the increasingly complex practice of medicine by reducing errors.
Dr. Gawande’s lecture came several weeks after the publication of his book The Checklist Manifesto: How to Get Things Right. In his introductory remarks, Memorial Sloan-Kettering President Harold Varmus said, “Part of the charm of Atul is that he’s willing to acknowledge that the science we do is imperfect, and that there’s room for improvement.”
In his talk, Dr. Gawande pointed out that physicians now have at their disposal some 6,000 drugs and 4,000 medical and surgical procedures, each with different requirements and risks. “Medicine has become the art of managing extreme complexity,” he asserted. He explained that checklists have been used for decades to help with everything from the construction of skyscrapers to the flying of airplanes and are today being implemented by medical teams to reduce errors with dramatic results.
A study conducted by Dr. Gawande and colleagues in eight hospitals around the world, from Seattle and London to rural Tanzania, showed that the application of a surgical checklist reduced complications by an average of 36 percent and deaths by an average of 47 percent. Since the results were published in January 2009, more than 2,000 hospitals worldwide have adopted the checklist.
“As experts we think of a checklist as a sign of weakness,” said Dr. Gawande. “When we recognize that the complexities have overwhelmed our brains to the point that we are going to fail, we see that checklists fill in for our weaknesses. And we realize we can change more than just surgery, we can change medicine.”