Atul Gawande: The Checklist Manifesto

Atul Gawande: How do we heal medicine? https://www.ted.com/talks/atul_gawande_how_do_we_heal_medicine

Surgeon and writer Atul Gawande suggests using checklists in medicine. Checklists are a cheap and effective QC tool that found numerous uses in other professional areas, such as aviation.

Our medical systems are broken. Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus: actually treating people. Doctor and writer Atul Gawande suggests we take a step back and look at new ways to do medicine -- with fewer cowboys and more pit crews.

"We created a 19-item two-minute checklist for surgical teams. We had the pause points immediately before anesthesia is given, immediately before the knife hits the skin, immediately before the patient leaves the room. And we had a mix of dumb stuff on there -- making sure an antibiotic is given in the right time frame because that cuts the infection rate by half -- and then interesting stuff, because you can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected. And we had items like making sure everyone in the room had introduced themselves by name at the start of the day, because you get half a dozen people or more who are sometimes coming together as a team for the very first time that day that you're coming in."

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The rate of death was 1.5% before the checklist was introduced and declined to 0.8% afterward (P=0.003). Inpatient complications occurred in 11.0% of patients at baseline and in 7.0% after introduction of the checklist (P<0.001).

Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009 Jan 29;360(5):491-9. doi: 10.1056/NEJMsa0810119. Epub 2009 Jan 14. PMID: 19144931: https://pubmed.ncbi.nlm.nih.gov/19144931/

Atul Gawande (2010) The Checklist Manifesto: How to Get Things Right: https://www.amazon.com/The-Checklist-Manifesto-Things-Right/dp/0312430000/

Study: When their party switched its policy position on major issues, citizens' policy opinions followed suite

Slothuus, R. and Bisgaard, M. (2020), How Political Parties Shape Public Opinion in the Real World. American Journal of Political Science. https://doi.org/10.1111/ajps.12550

How powerful are political parties in shaping citizens' opinions? Despite long‐standing interest in the flow of influence between partisan elites and citizens, few studies to date examine how citizens react when their party changes its position on a major issue in the real world. We present a rare quasi‐experimental panel study of how citizens responded when their political party suddenly reversed its position on two major and salient welfare issues in Denmark. With a five‐wave panel survey collected just around these two events, we show that citizens' policy opinions changed immediately and substantially when their party switched its policy position—even when the new position went against citizens' previously held views. These findings advance the current, largely experimental literature on partisan elite influence.

Via Rolf Degen.

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Esther Duflo: Social experiments to fight poverty