Whenever I need to wake up early in order to catch a bus or train, I make sure to lay everything out in a clear and sequential manner. That is the most effective way of not forgetting critical items, while also not wasting too much time checking and re-checking things. While, in my case, it is early-morning brain woolliness that makes such clear sequencing valuable, there is evidence that simple lists and straightforward procedures can also serve a useful purpose in situations where complex and demanding tasks are undertaken, sometimes making it too easy to forget a seemingly small but crucial step. Flying airplanes and performing surgery are examples. Indeed, it seems that the pilots might be able to teach some useful techniques to the men and women with the scalpels.
Some recently published research has shown that a simple World Health Organization (WHO) checklist (PDF) is highly valuable for preventing surgical mishaps. The British National Patient Safety Agency found that the use of the checklist (which includes simple items like having the surgical staff confirm the patient, site, and procedure to be performed) can cut deaths by over 40% and complications by over a third. The finding is especially impressive due to the sample size examined: 7,688 patients, 3,733 before the checklist was implemented, and 3,955 afterwards. The patients were located in a diverse collection of countries, including the United States, Canada, the United Kingdom, New Zealand, Jordan, India, the Philippines, and Tanzania. Clearly, surgeons worldwide tend to overlook the same things.
It’s a curious quirk of human nature that someone can be both capable of performing advanced cardiac surgery and capable of forgetting a sponge inside the patient’s body while sewing them up. Hopefully, simple tools like the WHO checklist will help the former to occur more successfully without the danger of the latter. In a less specific context, it is worth remembering the value of simple tools that produce welfare improvements quite disproportional to their cost or difficulty of use.