The building industry delegates power to resolve complex situations. This is important when there are problems that are difficult to plan for. Gawande says, “In response to risk, most authorities tend to centralize power and decision making.” This typical response was disatrous for New Orleans when Katrina hit. State and Federal officials refused to cede […]

Complicated problems can be broken down into simple ones, with simple steps to follow but there are always unexpected issues that can arise. How are buildings constructed? There are many specialized individuals performing discrete tasks, yet you rarely hear of a building falling down. Gawande visits Joe Salvia, part of the construction firm McNamara/Salvia. Salvia […]

The B-17 was the most sophisticated, but complicated, airplane of its time. Boeing lost a government contract to Douglas due to its complexity. To make it flyable, they created a pilot’s checklist. Pilots had never needed them before, but they helped to fly increasingly complex machines. In every hospital, four vital signs are checked constantly: […]

A Swiss rural hospital in Klagenfurt manages to save a girl who drowned in icy water via a complex series of coordinated actions involving the dispatchers, EMTs, nurses, and doctors. Medicine has been getting increasingly complicated with many different specialties, and specialties within specialties. In addition, doctors see patients having many different maladies, prescribing many […]