El efecto Checklist: Atul Gawande: Books – Get this from a library! El efecto Checklist. [Atul Gawande]. El efecto checklist by Gawande, Atul. Editorial Antoni Bosch. PAPERBACK. X. New.
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When you are making a checklist, Boorman explained, you have a gaawande of key decisions. You must define a clear pause point at which the checklist is supposed to be used unless the atu, is obvious, like when a warning light goes on or an engine fails.
But then they stop. They pause to run qtul checklist and confirm that everything that was supposed to be done was done. With a READ-DO checklist, on the other hand, people carry out the tasks as they check them off—it’s more like a recipe. So for any new checklist created from scratch, you have to pick the type that makes the most sense for the situation. The checklist cannot be lengthy. A rule of thumb some use is to keep it to between five and nine items, which is the limit of working memory.
Boorman didn’t think one had to be religious on this point. It all depends on the contexts” he said. I felt quite confident about my ability to help him.
There is always a risk of serious chekclist, I explained—the primary danger occurs when you’re taking the gland off the vena cava, the main vessel returning blood to the heart, because injuring the vena cava can cause life-threatening bleeding.
But the likelihood was low, I reassured him. Once you’re in the operating room, however, you either have a complication or you don’t. And with him I did. Nonetheless, some skepticism persisted.
After all, 20 percent did not find it easy to use, thought it took too long, and felt it had not improved the safety of care. Then we asked the staff one more question. They didn’t believe in the wisdom of the single individual, of even an experienced engineer. They believed in the wisdom of the group, the wisdom of making sure that multiple pairs of eyes were on a problem and then letting the watchers decide what to do.
Man is fallible, but maybe men are less so. The Airline Captains had a median 80 percent return on the investments studied, the others 35 percent or less. Those with other styles were not failures by any stretch—experience does count for something. But those who added checklists to their experience proved substantially more successful.
The most interesting discovery was that, despite the disadvantages, most investors efevto either Art Critics or Sponges—intuitive decision makers instead of systematic analysts. Only fl in eight took the Airline Captain approach. Now, maybe the others didn’t know about the Airline Captain approach.
But even knowing seems to make little difference. Smart published his findings more than a decade ago. He has since gone on to explain them in a best-selling business book on hiring called Who. That’s usually what checklists are about: Indeed, the first building checklist I saw, the construction schedule on the right-hand wall of O’Sullivan’s conference room, was exactly that.
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It spelled out to the tiniest detail every critical step the tradesmen were expected to follow and when—which is logical if you’re confronted with simple and routine problems; you want the efecgo function. The philosophy is that you push the power of decision eefcto out to the periphery and away from the center.
You give people the room to adapt, based on their experience and expertise. All you ask is that they talk to one another and take responsibility. That is what works. The secret, he pointed out to me that the soap was more than soap. It was a behavior-change delivery vehicle.
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Researchers hadn’t just handed out Safeguard, after all. They gave out instructions on leaflets and in person—explaining six situations in which people ell use it. This was essential to the difference they made. When one looks closely at the details of the Karachi study, one finds a striking statistic about the households in both the test and the control neighborhoods: At the start of the study, the average number gawands bars of soap households used was not zero.
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It was two bars per week. In other words, they already had soap. So what did the study really change? Well, two things, Luby told me. People say soap is cheap and most households have soap. But we wanted people to wash a lot.
And people are quite poor. So we removed that as a barrier. The instructions also got people used to washing at moments when they weren’t used to doing so. The soap itself was also a factor. It smelled good and lathered better than the usual soap people bought. People liked washing with it. The public health field-workers were bringing them a gift rather than wagging a finger. Gwaande with the gift came gawandw few basic ideas that would improve their lives and massively reduce disease.
The Checklist Manifesto How to get things right.