It's a question of resources as well. Adding checklists means more time and audit needed. Let's say something initially took 30 secs (due to the muscle memory prowess of the health workers) but by using a checklist it gets down to 45 secs - a 50% increase in latency. If this process is done 10000 times a day (a respectable number if you consider high-volume processes like administering a drug):

* you might have just increased manpower requirements across the board by about 50%

* you might have just caused patients to wait over the phone 50% longer, or queue to get their medicine 50% longer, or wait for the discharge process to finish 50% longer...

The trick is to apply this cost only in places where preventing mistakes that are far more expensive. ;)

To be sure is not an impossible thing to deal with - but the 'cost of sale' is so high as to make it easier to just let patients suffer and die.

That seems.... unlikely. I'm sure the saving of forms filled out when patients die and malpractice trials results in a fairly large benefit in efficiency. Just pick the highly useful situations first, and don't do the stupid ones.

Will in one sense, herding cats in another ;).