Protocols are repetitive and in my view boring. Yet VITAL! You follow the same procedure each time. The trouble is you think you have a list embedded in your memory – but sometimes you forget.
My forgetting
I make bread every week in an electric bread-maker. All I need to do is put in the ingredients and let the machine do the work. It takes about three hours all told – the proving is what takes the time.
A few weeks back, however, I forgot the yeast! Probably because it is stored in the fridge whereas all the other ingredients are in a variety of cupboards: sugar, salt, butter and flour. At the end of the three hours in the bread-maker out came a very compressed loaf: tasty, but my goodness it was solid.
This is a trivial instance of forgetfulness. But what if it is a more serious, even life-threatening situation: such as this that I read about recently.
Operating on the Wrong Body Part
The story began: “A 70-year-old man from Alabama recently died at a hospital in Florida when a surgeon mistakenly removed his liver instead of his spleen.
This type of medical error is known as a ‘never event’ because it should never have happened. Unfortunately, they happen all too often.”*
This below is the Surgical safety checklist provided by the World Health Organisation. It was adopted by the UK’s National Health Service (NHS) in 2009. Doubtless since then the NHS has revised and re-designed it – at least I hope so, because the list is almost bound to elicit a yawn of boredom – it looks so uninspiring. There is a small note at the bottom which suggests additional and modifications ‘are encouraged’ to fit local practice.
If I were in charge of the NHS checklists I would have a series of bright and colourful designs so that surgeons would never know which one would be waiting for them when they enter an operating theatre. Such variety would help to keep them, and their surgical team, alert.
A bold attention-demanding kind of design might even encourage a surgical team to look forward to completing it: something warm and delightful in its appearance.
Or would it be such a Good Initiative?
Perhaps when you are about to embark on a medical operation you don’t want attention-demanding design? Boring might be exactly the right note, pre-op.
In my small experience of being under the knife for a cataract op during which I was fully conscious, the surgeon asked me what music would I like. Well, I hope he liked my choice – though perhaps I should have asked him to play whatever he liked, since he was the one who need to have his full attention on what he was doing.
For my op I chose anything by Mozart, in the hope that the classical sound would please everyone in the theatre. I cannot now recall what the music was because, while undergoing the op itself, my attention was completely involved in keeping myself calm.
Clearly this surgeon was up for variety, possibly hoping that one of his patients would choose music that is so out of the ordinary that his theatre resources couldn’t provide it… and so create the incentive to add a new disc for the future.
What is the kind of thinking are you doing with lists?
Research, done some time ago in Harvard, revealed that we can hold in our consciousness “plus or minus seven items”** Unless of course you have developed a list-learning structure: one way is to pair every new list of items with a fixed set of memorised images which you repeatedly use as your anchor.***
Our ‘listing’ capacities are named in Effective Intelligence (EI) as Specify and Categorise. These two Thinking-Intentions are in us all, but some of us are more proficient in our use of them than others.
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** The Magical Number Seven, Plus or Minus Two
*** Frances Yates – The Art of Memory 1966
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