When I was a child I had an operation on my shoulder. It was a scheduled operation, nothing urgent. And it left me with an ugly scar on my back. Today, it’s still very notable after all those years. Also still painful during season changes.

Roll the clock forward some 40 years, my youngest son had an operation right after birth. He was in a critical condition, and, in order to save his life, the main artery and vein in his neck were bypassed to connect him to an infant life support machine (ECMO). Despite the urgency and complexity, his scar is hardly noticeable. Despite his slim chances of survival, doctors treated him in both operations - connecting and disconnecting from ECMO - such that everything, cosmetic side effects included, will be as professional as they possibly can.

What makes the difference between a top notch surgical unit to a mediocre to a poor one?

What makes the difference between a top notch software team to a mediocre to a poor one?

The books "Better" and "The Checklist Manifesto" by Atul Gawande give us a peek into the characteristics that differentiate a mediocre surgeon practice from a better-and-always-improving one.

The resemblance between a medical team and a software team is so strikingly similar, that I collected ten practices from the Operation Room (OR) that software teams would be wise to adopt. 

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We have a bug in our industry: We over glorify bugs. We love them so much, that we use them as a primary metric for quality.

My take is that that is a bad idea. Bad, as in driving undesired behaviors that are misaligned with our desires to improve quality.

Let’s begin with an analogy, and then move to modeling this on software.

A tale of two restaurants

Joe was hungry. He was on a business trip, and it was lunchtime, and he just entered Bologna, an Italian restaurant.

It took almost 3 minutes before a host led him to a table, which was set up simply, yet invitingly. There were some loud voices from the kitchen, and Joe wondered what they are arguing about. When the waitress came back he ordered a pizza, which he noticed was recommended in reviews on TripAdvisor. While he was waiting for his order, he saw the staff going around customers - acting nice, but not overly nice, smiling from time to time, but not overly eager.

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