职业与工作方法newyorker.com编辑精选
救命的清单（2007）
A Life-Saving Checklist (2007)
2016 — 2024，它一次次回到首页
黑点是上首页（≥ 50 分）的那次投稿，空心点是没冲上去的投稿，点越大分数越高。
导读
这是阿图·葛文德2007年发表在《纽约客》的文章《清单》。它通过重症监护、外科手术、航空和建筑等案例，说明简单清单如何帮助人们记住易漏步骤、改善团队沟通，从而减少高压力环境中的错误和伤亡。文章也写到专家对清单的抵触，以及清单为何能在复杂工作中发挥作用。
为什么经久不衰：它用一个极低成本、可复制的工具回应了复杂工作和人为失误这一永恒问题，所以今天在医疗、航空、工程和管理中仍值得重读。
HN 评论精选
医生不愿自己用清单，但绝大多数希望家人手术时医生用——说明清单价值被承认，但自尊和习惯造成抵触。
葛文德在《清单革命》一书中写道，世界卫生组织一个大型清单试点项目结束时，他们调查了参与的外科医生。其中一个问题大致是：使用清单会不会改善你的手术实践？大多数外科医生回答不会。这与葛文德遇到的抵触一致：我不需要什么破清单；我是个好外科医生！但更能说明问题的问题是：如果给你或你的家人做手术，你希望另一位外科医生使用清单吗？大约93%的受访外科医生回答……希望。
dctoedt查看英文原文
In his book, The Checklist Manifesto, Gawande reports that at the end of a big checklist pilot project for the World Health Organization (IIRC), participating surgeons were surveyed. • One of the survey questions was, in essence: Would the use of checklists improve your surgical practice? Most of the surgeons responded no. This was consistent with the resistance that Gawande encountered: I don't need no stinking checklist; I'm a good surgeon! • But the more-telling survey question was this: Would you want another surgeon to use a checklist if operating on you or one of your family members? Something like 93% of the surgeons surveyed responded ... yes.
清单的核心价值在团队协调、跨层级问责和流程追踪，尤其在高风险操作中。
我认为清单和清单纪律的一个关键要素是团队协作。清单能让你跨越经验、权威和专业差异建立问责，并跟踪流程随时间的变化。作为海军飞行员（提醒：我还是学员），我们在驾驶舱用清单协调发动机启动、起飞、着陆和紧急情况等。它们确保我们以同样方式启动发动机、确认做好着陆准备，并以批准的方式处理紧急程序。当驾驶舱里军衔和经验有差异时，清单有助于拉平差距，让经验较少或资历较浅的人也能问责资深成员。每次飞行前我们还有简报清单，包括疾病、用药、压力、酒精、疲劳、进食等可能相关的人为因素，确保团队总有一个地方说出该知道的事。我以前在海岸警卫队巡逻舰上工作，也用类似清单确保备航、进港或完成拖曳另一艘船等复杂操作。这些清单的主要价值是在团队人员多次轮换之间核实一切按时完成；清单也作为文档，证明前一个人已经收集了必要信息……
treetoppin查看英文原文
I think a key element of checklists, and checklist discipline, is coordination between members of a team. What checklists allow you to do is have accountability across differences in experience/authority/expertise and also track a process over time. In my work as a naval aviator (caveat, I'm still a student), we use checklists in the cockpit to coordinate all sorts of functions such as engine start, takeoff, landing and emergencies. These ensure that we start the engine the same way, verify we are ready for landing, and also handle emergency procedures in an approved way. When there are rank and experience differences in the cockpit these checklists help equalize the disparity, and let less experienced or junior members hold senior members accountable. Before each flight we also follow a briefing checklist, and that includes human factors such as any possible issues relating to illness/medication/stress/alcohol/fatigue/eating. Doing so ensures that there is always a place for people to vocalize anything that the team should know. Previously I worked on a Coast Guard cutter, and we used similar checklists to ensure we were prepared to get underway, enter port, or complete a complex evolution like tow another vessel. For these checklists the main value was in verifying between multiple changes of team personnel that everything was being completed to meet the timeline. The checklist served as documentation that the person before you had collected the necessary information, made proper notifications, and started/finished processes. It has baffled me when I hear that medical personnel dont use checklists for these exact reasons. They perform time critical, high stress procedures that have a fairly documented set of steps. They require a team of personnel that have different scopes of expertise, experience, and authority. There are frequently changes in the team's composition over the duration of the patients care, and it seems like the patient will be handed off between different teams that specialize in their own respective areas of patient care. For us in the military it is pretty easy for authority to mandate we use checklists, and the buy in come from accident investigations revealing that checklists were ignored or skipped. Is there an equivalent medical authority that can pass this information down, or does this have to emerge independently from each hospital system?
压力与疲劳下高层判断仍在，但日常小事容易漏，清单正好补这个缺口。
“普罗诺沃斯特观察到，清单带来两个主要好处。第一，它们有助于记忆回忆，尤其是那些在病人经历更剧烈事件时容易被忽视的日常事项……”确实，清单的好处可能很大。这让我想起前一段时间读到的一项美国陆军研究，考察睡眠剥夺和压力在苛刻环境中的影响。他们发现，一般来说，高层战略能力保持完好——人们仍然能分析复杂情况、制定和执行作战计划等。失去的是更小的日常功能，而这些可能累积成关键失败，比如忘记补充水罐或在出发前给车辆加油等。有趣的教训。
toss1查看英文原文
"The checklists provided two main benefits, Pronovost observed. First, they helped with memory recall, especially with mundane matters that are easily overlooked in patients undergoing more drastic events. . . ." Indeed, benefits of checklists can be huge. this reminds me of a US Army study I read about some time ago which examined the effects of sleep deprivation and stress in demanding environments. What they found was that, in general, the high-level strategic capabilities stayed intact -- the people could still analyze complex situations, make and execute battle plans, etc. What was lost was the smaller, mundane functions, which could add up to critical failures, such as forgetting to refill one's water can or refuel the vehicle before going out, etc. Interesting lesson
补充了文章被重新发上Hacker News的背景：与作者出任新医疗公司CEO的新闻有关。
（2007）这篇文章被发上来，很可能是因为有消息宣布作者阿图·葛文德将出任一家新医疗公司的CEO。
sp332查看英文原文
(2007) This probably got posted in reaction to the news that the author, Atul Gawande, was announced to be the CEO of a new healthcare company. https://news.ycombinator.com/item?id=17355346
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