How checklist improves productivity in Delhi hospital

In his book, “Checklist Manifesto”, Atul Gawande of Harvard Medical School explains how a simple tool such as a ‘checklist’ can eliminate errors and prevent accidents and deaths. Gawande had helped WHO in developing a ‘safe surgery’ check list,  which was later implemented in different pilot sites all over the world.

While visiting the pilot sites, Gawande came across surgeries being performed in so many different kinds of settings. This is how he describes a charity hospital in Delhi:

The volume of patients they were asked to care for in this city of thirteen million people was beyond comprehension. The hospital had seven fully trained anesthetists, for instance, but they had to perform twenty thousand operations a year. To provide a sense of how ludicrous this is, our New Zealand pilot hospital employed ninety-two anesthetists to manage a similar magnitude of surgery. Yet for all the equipment shortages, power outages, waiting lists, fourteen hour days, I heard less unhappiness and complaining from the surgical staff in Delhi than in many American hospitals I’ve been to"

Twenty thousand operations per year handled by seven anesthetics means an average of eight operations per anesthetist for every single day of the year. That’s amazing. I wonder what their technique is. Do they use hammers? The check list for the anesthetist will simply read:

1) Sterilise hammer.

2) Put on surgical gloves.

3) Lift hammer from the table

4) Give a solid whack on the patient’s head.

5) Move to next operating table.