Atul Gawande: Want to get great at something? Get a coach
Surgeon and public health professor by day, writer by night, Atul Gawande explores how doctors can dramatically improve their practice using approaches as simple as a checklist – or coaching. Full bio
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who has been really interested
how good you are now,
that really matters.
in the north of India.
an extreme form of this very struggle,
in the face of complexity --
has a one-in-20 death rate for the babies,
ten times higher than they do elsewhere.
in birth for decades,
that even in this place --
and put on clean gloves,
of dilute bleach,
on the gloves from the last delivery.
with difficulty breathing everywhere.
to stimulate them to breathe.
you give them breaths with the baby mask.
mostly from textbooks,
just how dire the situation is.
his temperature by the minute.
requires a successful team of people.
skilled and coordinated;
in a place like this,
for 22 critical drugs and supplies
of the whole facility.
part of thousands of deliveries.
that they face,
that really matters.
get better at what they do?
you learn, you graduate,
of managing their own improvement.
all professionals have learned by.
Juilliard violin instructor Dorothy DeLay.
of violin virtuosos:
habits of thinking and of learning
in the world without her
comes out of sports.
about this as a surgeon.
into my operating room,
as a very American idea.
first American-rules football games.
violinist of his generation.
getting to write for "The New Yorker"
and they return my phone calls.
an almost two-hour conversation
to where he got in his career.
"Why don't violinists have coaches?"
together from Juilliard,
as a concert violinist
a little bit mechanical.
he became, he said.
in making it on your own.
that are standing in your way
know how to fix them.
that somewhere along the way,
what had happened to me as a surgeon.
improvement in my learning curve.
from one year to the next.
any better anymore.
as good as I'm going to get?"
of mine who had retired,
anything much he'd have to say
dense with notes.
had swung out of the wound
from reflected surfaces."
every once in a while.
at their sides resting comfortably.
your elbow going in the air,
or just move your feet."
fundamentally profound about this.
your external eyes and ears,
picture of your reality.
build them back up again.
drop down even further.
to have to work on things.
I would get worse before I got better.
called Ariadne Labs,
in the delivery of health care,
the World Health Organization
a team needs to go through
are ready to go home.
wasn't going to change very much,
wasn't necessarily going to be enough
that you needed to bring it alive.
at a massive scale?"
in 120 birth centers.
in India's largest state.
basically we just observed,
got visits from coaches.
of doctors and nurses like this one
and also the managers
build on their strengths
they had to work on with people --
fundamentally important --
when the baby mask is broken
including the managers,
ended up coaching 400 nurses
across 160,000 births.
who did not get coaching --
of 18 basic practices
over the course of the years of study,
got four months of coaching
of the practices being delivered.
across a whole range of centers
could be a whole line of way
that could reach out in the world
at the beginning of it, though,
all of the checklist together
reductions in mortality.
that were getting there,
learn to execute on the fundamentals.
to the labor and delivery room,
how quickly all of this happens
that makes things.
measured her pulse
the heart rate of the baby.
and the fetal Doppler monitor,
and the nurse knew how to use them.
which is normal.
of the contractions picked up,
that her cervix was fully dilated.
to do her next set of checks.
she worked her way through
she needed at the bedside.
the sterile towel,
one push and that baby was out.
in that room had changed.
at the community health worker
did not seem to be alive.
with her checkpoints.
when that didn't stimulate that baby,
because you could count on electricity,
that little girl's airways.
of being able to do that
on her mother's chest,
to grab that nurse's hand,
because of coaching.
saved because of it.
a few months later.
ABOUT THE SPEAKERAtul Gawande - Surgeon, writer, public health innovator
Surgeon and public health professor by day, writer by night, Atul Gawande explores how doctors can dramatically improve their practice using approaches as simple as a checklist – or coaching.
Why you should listen
Atul Gawande is author of several best-selling books, including Complications: A Surgeon's Notes on an Imperfect Science, Better: A Surgeon's Notes on Performance, Being Mortal: Medicine and What Matters in the End and The Checklist Manifesto.
He is also a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker and a professor at Harvard Medical School and the Harvard School of Public Health. He has won the Lewis Thomas Prize for Writing about Science, a MacArthur Fellowship and two National Magazine Awards. In his work in public health, he is Executive Director of Ariadne Labs, a joint center for health systems innovation and chair of Lifebox, a nonprofit organization making surgery safer globally.
In June 2018, Gawande was chosen to lead the new healthcare company set up by Amazon, JPMorgan and Berkshire Hathaway.
Photo: Aubrey Calo
Atul Gawande | Speaker | TED.com