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I'm not convinced about using a lot of checklists. I have no doubt when checklists first come in everyone follows them and there are some measurable improvements.

The problem I have twofold. A few years down the road will people still really follow the checklists religiously, or quickly just fill out the boxes.

The second part is people's jobs get dumbed down by this, I'm sure we've been in some situation where there is a structured system which you have no control, you just fill out forms, its disempowering so you learn not to think, just do your part of the system and hope it turns out OK. Its where bureaucracy and red tape starts. I've quit jobs like that because I found it demoralizing.

Will be interesting if there was a follow up 5 years later.

EDIT: Didn't you get the memo about your TPS reports? That is what I'm trying to avoid.

Its where bureaucracy and red tape starts.

What people call bureaucracy is process that they follow without knowing why it's there. Every single rule in a business is there because something went wrong, and someone didn't want it to happen again.

The answer to bureaucracy is transparency. If you explain why a rule has to be followed people don't mind that there's a rule.

(You also have to regularly review the rules and get rid of ones that don't make sense any more, but that's much less common that you'd think.)

It must become a culture. In Japan, there's a culture in the public transport business (trains etc) of 'point and say' where each responsible crew member points at a target e.g. safe door open zone marked on the pavement, and says out loud that its correct or not. Its a physical reenactment of a checklist? Anyway it becomes second nature if its a physical act, not a check-the-box-on-a-form thing. So that's how they manage it not getting skipped/becoming just paperwork.

The checklist was given elsewhere in the thread: https://apps.who.int/iris/bitstream/handle/10665/44186/97892... it really doesn't strike me as something that dumbs down the job...

"dumbs down" is such a loaded phrase, but I'd argue that it's accurate here and most other places it's used. Anything that makes something easier is dumbing it down.

However, I want it "dumbed down". I want it to be easier to prevent mistakes. I want smart people to use more of their brainpower on things that can't be solved by some words and boxes on paper. If the surgeon is thinking about the surgery instead of what he might have forgotten about the pre-op, that's good, IMO.

> If the surgeon is thinking about the surgery instead of what he might have forgotten about the pre-op, that's good, IMO.

Agreed. The only issue is that if the surgeon isn't thinking about the surgery because he's still doing all the routine paperwork.

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