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I am an anaesthetia doctor. There is, in fact, only mixed evidence of checklists actually helping in various health systems around the world. At a national level, Scotland began using checklists, but the whole health system and population is always in flux, so attribution of such a big change just to checklists is bold. It may also be that checklists do (temporarily?) improve broken or highly resource constrained peri-operative care: but this leaves open the question as to whether correcting underlying staff/morale/equipment/logistic problems would have, or should, play a role.

Checklists I have seen used during my career are often rushed through, with more time usually being spent appropriate to the complexity of a situation. Local culture will strongly impinge on effectiveness of (yet another?) checklist. The safety culture in medicine is improving dramatically, but there is tension between protocolizing everything into checklists, and individualizing care to each patient. AI will be part of the solution to this.

An important checklist commonality in medicine is the request that _anyone_ should speak up if they think something is wrong. In analyzing situations where patients were harmed, e.g. wrong side surgery, it is common to hear that someone, a nurse, a technician, did notice, but was not empowered to speak up. As a doctor, I am used to the power to speak up and act, but I value others' eyes in many situations. More complex and highly dynamic medical situations will always require the attention, knowledge and skill of those involved.




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