Page 2 - Jim Stone Book Beginner

The Genesis of a Checklist for Volleyball

It was early in 2020, and I'm wearing one of those seductive hospital gowns, getting prepped for a
procedure to deal with a misbehaving heart. On a hierarchy of surgical procedures, mine would not
be at the top of the ticket relative to complexity and risk. However, when dealing with a heart,
especially when it's your own, there are no minor procedures.

The attending nurse is putting me through the paces of various questions and measurements,
including blood pressure, temperature, heart rate, possible reactions to multiple drugs, etc. Many
have experienced this pre-op procedure. I noticed the nurse was going down a specific list of
questions, to-do's, and making sure I was up to speed on what was in my immediate future. Upon
completing her list of duties, a supervisor joined us to sign off on the completed tasks. The
supervising nurses' review was not a token effort. There was a review of each item while offering a
few more questions to myself and the attending nurse before signing off.

At that point, the anesthesiologist entered to explain what lay ahead and his role in the operating
room. He detailed the timing of the drugs I was going to receive, the expected reaction, recovery
time, etc. Upon completing the consultation, we both signed off on the presented information and
noting that I had the opportunity to ask questions.

Then the fantastic Dr. Katz whirled into the room to review the exact procedure that I would undergo.
He just came out of a four-hour surgery and was getting energized with what I'm sure was not his
first cup of coffee on this day. He advised me of what lay ahead and was excited to get going. His
positive vibes were reassuring; however, I didn't quite share the enthusiasm. But I had confidence in
my doc.

We were still about 30 minutes out from going to the operating room, so I began to quiz the
attending nurse on the pre-op protocol that I had experienced. She proceeded to school me on how
everything is formatted in a checklist. There isn't an aspect of the procedure that doesn't have a box
to be checked by multiple staff. She then provided a "heads-up" of what would be taking place in the
operating room. I appreciated her taking the time to explain the operating room's meticulous
procedures. By the time I would enter the operating room, I would be in a drug-induced fog and
would miss this rehearsal. It sounded like a game-day practice detailing the scouting report on the
upcoming opponent. The lead surgeon would make sure everyone in the room would know each
other by their first name. He would review the upcoming procedure and what complications could
occur. Roles were reviewed and defined, with required medications and surgical equipment re-
checked. A checklist formatted this pre-op procedure.

A checklist dictated post-op procedures as well—medications, blood pressures, etc. Each time a
recovery room nurse checked in; the exact time is verified. Meticulous records are kept by all
involved.

In any medical procedure, there are a million decisions that are required. There are multiple medical
personnel involved in coordinating past, current, and future events. All of these medical