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Tracy Gustilo's avatar

One of the most interesting books I’ve read is built around an incredibly simple premise. I’m thinking about the Checklist Manifesto written by surgeon Atul Gawande. He was looking for a way to improve patient outcomes after surgery, a complex and potentially high risk activity. He got the idea for using a checklist from airline pilots and went through a series of adaptations to get it right. A key component was more democratic control by nurses, who are given room to speak up to against autocratic surgeons.

I wonder if the relevant trade off isn’t one of more process and reporting vs increased authority and control.

Of course you mention the important of low level contributions, but even they have to be held to strict performance standards and alignment with safety goals.

Another analogy strikes me, that of waterfall vs agile software development. Top down rigid specifications create rigidity and inability to adapt. Agile is named that for a reason. Then again a motto of “Move fast and break things” doesn’t sound very safety conscious!

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