Atul Gawande's Surgeon Checklist

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Atul Gawande's Surgeon Checklist

A patient bleeds out during surgery because the blood type was never checked.

Three floors down, another operation stalls when no one ordered antibiotics.

In 2007, surgeon Atul Gawande faced an impossible mandate from the World Health Organization: reduce preventable surgical deaths worldwide.

Gawande, oddly, looked to aviation for answers.

He visited Boeing and Daniel Boorman, a veteran pilot, who had spent twenty years perfecting checklists. Aviation's failure rate was 0.00002%.

Boorman's impressed upon Gawande that checklists created in offices failed in cockpits.

Good checklists were "precise, efficient, easy to use even in difficult situations." They reminded teams of "only the most critical steps."

Gawande learned two checklist types:

1. "DO-CONFIRM" (perform, then verify)

2. "READ-DO" (check off steps as you go)

Gawande assembled his team and targeted surgery's main killers: infection, bleeding, unsafe anesthesia.

The final checklist contained just 19 items across those 3 key moments.

• Before anesthesia: confirm patient identity, site, blood availability

• Before incision: verify antibiotics, team intros, critical procedural steps

• Before leaving: count instruments, discuss complications, plan recovery

Your team faces different complexities. Here's how to build checklists that work:

1. Start with failures. What goes wrong most often?

2. Stay ruthlessly short. Five to nine items maximum.

3. Test relentlessly. Design checklists where work happens.

4. Choose your type. Fast-paced work needs DO-CONFIRM. Step-by-step needs READ-DO.

Excellence isn't left to memory. It's built into the system.

Athena’s XPert Zones

“After completing the Marathon des Sables near Merzouga in Morocco, I’d like a private transfer arranged to Ouarzazate.”

Wait, where?

At Athena, your assistant is trained to handle almost any request, ordinary or extraordinary.

But did you know that behind your assistant stands an entire network of specialists ready to solve problems you didn't even know could be solved?

Meet Athena’s XPert Zones.

These specialized support teams assist with:

• Travel Desk - travel arrangements, itineraries, packing lists, event logistics

• Office Ops Team - AI tools, software advice, technical solutions

• Source Squad - sourcing trusted vendors and specialty services

• Care Crew - US healthcare, doctor recommendations, insurance navigation and claims

Two examples of recent requests we've handled:

With Athena, you're never limited by one person's expertise. Instead, you have an entire system designed to deliver exactly what you need, precisely when you need it.