Reducing the Risks of Complexity

With the checklist in hand, the pilots went on to fly the Model 299 a total of 1.8 million miles without one accident. The Army ultimately ordered almost thirteen thousand of the aircraft, which it dubbed the B-17. And, because flying the behemoth was now possible, the Army gained a decisive air advantage in the Second World War which enabled its devastating bombing campaign across Nazi Germany.


That’s a story from 1935 and the birth of checklists as a way to reduce the risks of complexity. The heart of the original article is about applying a lesson from 1935 to Intensive Care Units today. I read the article as an endorsement for the wider use of checklists as a tool to deal with the complexities of information technology, but that’s my bias. I also read it as an amazingly simple way to reduce the risks and costs of modern medicine.
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In December, 2006, the results were published in The New England Journal of Medicine. Within the first three months of the project, the infection rate in Michigan’s ICUs decreased by sixty-six per cent. The typical ICU cut its quarterly infection rate to zero. Michigan’s infection rates fell so low that its average ICU outperformed ninety per cent of ICUs nationwide. In the first eighteen months, the hospitals saved an estimated hundred and seventy-five million dollars in costs and more than fifteen hundred lives. The successes have been sustained for almost four years-all because of a stupid little checklist.

Original article
posted December 2007

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One Response to Reducing the Risks of Complexity

  1. Pingback: More than half of all health spending wasted «

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