Hospital checklists are meant to save lives, so why do they often fail?
I wonder. Does the Hawthorne Effect (<a href="https://en.wikipedia.org/wiki/Hawthorne_effect" rel="nofollow">https://en.wikipedia.org/wiki/Hawthorne_effect</a>) contribute to the success of these checklist regimes?<p>When surgical or emergency-department teams believe they're participating in an experiment to learn whether certain practices improve outcomes, do the outcomes improve?<p>Airplane pilots use checklists. It's illegal to start the engines unless the approved checklist book is within reach of the pilot in command. In training it's drilled into us that the response to panic is: get out the checklist and follow it.  It works. duh. It's all too easy under pressure to forget to lower the wheels or turn on the carburetor heat, or whatever. The drilling in training is what makes the difference.<p>(Aviation gasoline cools as it vaporizes in carburetors. Under certain conditions that can make the carburetor fill up with ice. If that happens the airplane will land soon. Not good. So carburetors have heaters. )<p>Checklists have far less success in medicine. Heck, almost two centuries ago Dr. Ignatz Semmelweis (<a href="https://en.wikipedia.org/wiki/Ignaz_Semmelweis" rel="nofollow">https://en.wikipedia.org/wiki/Ignaz_Semmelweis</a>) found that patients lived a lot longer when doctors and nurses washed their hands.<p>But, even in the 21st century, it's a struggle to get compliance with hand-washing rules in hospitals. Maybe something about medical training makes people resistant to fixed procedures. Maybe it's the age-old practice of eminence-based medicine rather than evidence-based medicine. It's a serious problem.