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Doctor Urges 'Pause Points' Before Surgery

The surgeon Atul Gawande's book The Checklist Manifesto shows how doctors can use checklists to save lives and reduce mistakes, especially during surgery. Gawande's surgery checklist includes the following three "pause points": before anesthesia, before incision, and before leaving the operating room. Each pause point is designed to last no more than a minute—just long enough for members of the team to make basic checks (confirm the patient's identity at the beginning; check for all the needles and sponges at the end).

It might not seem like pausing for a few minutes would make a difference. But the results are striking. Even short pause points before the incision helps to slow down the tempo of a surgical procedure, and that slower tempo leads to better outcomes. For example, starting in the spring of 2008, eight hospitals began using Gawande's checklist. Within months, the rate of major complications for surgical patients had fallen by 36 percent. Deaths fell 47 percent. Now checklists are found at many hospitals.

Checklists work because they impose delay. They add a "speed bump" before an important task so people stop and think about what they are about to do. No wonder, then, that Gawande also urges other professions—airline pilots and financial professionals, for instance—to use pause points for their jobs.

That's also a good idea for every follower of Christ. Developing pause points throughout the day—before an important task or a crucial conversation, for instance—doesn't just add a "speed bump." It can also be a simple spiritual discipline that trains us seek God's perspective and ask for his help in every situation.

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