Making a list, checking it twice, gonna find out.

A study of preventable hospital deaths in the U.S. offers an estimate of just over 22,000 per year, much lower than previous estimates (General Internal Medicine, 2020). Drill down and you will find many reasons for these deaths, e.g. medication administration errors, surgical errors, and equipment and device failures. Hospitals do track certain issues and associated factors, which is how medication errors were identified, considered significant, and have been drastically reduced – the FDA mandated barcoding that matches medications with patients.

After the Boeing 737 MAX crashes, it was found that the evidence for a catastrophic event was always present, but Boeing executives did not want to accept the evidence, plus the history for that aircraft was exceptionally good. However, past history was then and is now a poor indicator of future potential: the odds caught up with Boeing when untrained pilots tried to manage a technology failure (angle-of-attack indicator), causing catastrophic results. Medication errors and aircraft design speak to how problems – confirmed and potential – should be tracked, and how they should be made to rise to the attention of the right people.

Not identifying critical evidence is the problem, but what’s the cure? In deciding which issue needs attention soon and which can wait, the cure is to ignore the past and focus instead on what the current factors are (A tip of the hat to Paul Steinberg 3/17/22 Gazette letter). Weighting (not waiting) is the other cure: you need to prioritize what you scrutinize according to a reasoned criteria.

The problem of avoidance is not unique to Croton – nor to Boeing – but Croton should develop a method of weighting to help determine, first, which of many issues need attention soon, and second, to identify critical elements of that issue so the greatest of them can be addressed. Do this, instead of relying on a system based on the loudest public uproar, or the whim or blindness of officials (think Boeing).

Issues and problems are often known: what is needed is policy that mandates making a list of the issues (e.g. pedestrian safety issues, electric or gas powered vehicles, public land or low income housing, marijuana dispensary or none), identifying those factors that can have the greatest impact (e.g. vehicle speed, cost of electric vs petroleum, tax revenue, health and safety), and through discussion, prioritize and determine which issue deserves attention, and then how to address those critical factors.

In other words, make a list, weight the issues and then the factors, discuss, and take action. It’s probably what you would want to do anyway, you just haven’t codified it.