http://www.guardian.co.uk/lifeandstyle/2009/dec/19/change-your-life-checklists
http://www.spiegel.de/international/zeitgeist/0,1518,659577,00.html
“Umberto Eco: The list is the origin of culture. It’s part of the history of art and literature. What does culture want? To make infinity comprehensible. It also wants to create order — not always, but often. And how, as a human being, does one face infinity? How does one attempt to grasp the incomprehensible? Through lists, through catalogs, through collections in museums and through encyclopedias and dictionaries. There is an allure to enumerating how many women Don Giovanni slept with: It was 2,063, at least according to Mozart’s librettist, Lorenzo da Ponte. We also have completely practical lists — the shopping list, the will, the menu — that are also cultural achievements in their own right.
SPIEGEL: Should the cultured person be understood as a custodian looking to impose order on places where chaos prevails?
Eco: The list doesn’t destroy culture; it creates it. Wherever you look in cultural history, you will find lists. In fact, there is a dizzying array: lists of saints, armies and medicinal plants, or of treasures and book titles. Think of the nature collections of the 16th century. My novels, by the way, are full of lists.”
I have also just finished the Checklist Manifesto and wrote the following to the author.
From:
Clive Durdle
Designing hospitals and health services and the checklist manifesto
February 07, 2010
To:
GAWANDE@GAWANDE.COM
Superb book!
A few years ago I had a battery of tests for everything before they decided I had allergic asthma. The whole assessment process took over a year of out patients seeing heart nurses and various other species.
I know many many similar stories of people going from one specialist to another and no – one really working out what is going on – unfortunate drug interactions are common.
Is the problem that the hospitals and health services are not actually designed?
I have just done an accessibility course, and the key question is about flow – how easily can someone get to, in, around and out of a building?
I want to ask that question about how easily can someone meet a team of people and how easily can they work together to find the right solutions?
I have no evidence that anyone is designing hospitals and health services from that perspective.
This would mean a large comprehensive assessment area with teams working together to work it out quickly. It probably means abolishing wards – what you have as part of the assessment flow is that some
people require on site hotel facilities.
Once a treatment, probably series of interactions have been agreed, these are then delivered as required, probably from mobile units, so that the hospital facilities may be rejigged as required.
This would eventually be extended to the general environment and the person’s home.
Is not the idea of someone going to an unplanned hospital archaic? I know this is a bit production line, but actually, why did it take over a year to confirm asthma?
Your examples from the building industry and Boeing make me wonder how seriously person centred planning and a proper flow of interactions is happening. You have started excellently with surgery, what about the entire interactions with health and social services? Are the pathways actually possible with the way we currently design hospitals and their systems?
Clive Durdle
MSc BA (Econ) Dip Soc Studs FCIH
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clivedurdle@mac.com
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