The Checklist Manifesto by Atul Gawande

The Checklist Manifesto: How to get things right
By Atul Gawande
2009

To start off, this is a really excellent book and I recommend it to everyone. I’ve reviewed a few management books in the past, but this one is by far the best one, in part because it’s less about managing people in specific scenarios and more about managing complex situations in general, and in part because it’s focused on a single recommendation and discusses how and why that recommendation is important. As the title says, the book is about the importance of checklists.

As a manifesto, it set out to convince me of its premise: that checklists can be used to great effect. It succeeds. I am thoroughly convinced and now think you should be convinced, too.

A lot of jobs today are incredibly complex and only getting more so as time goes by. Checklists can go a long ways towards helping to compensate for this extreme complexity. The examples Gawande uses are surgery (Gawande himself is a surgeon), aviation, building construction, investment analysis, and cooking.

Historically, these jobs were all performed by individuals relying solely on personal experience and instinct. Now, these jobs are most often performed by teams of experts with access to vast quantities of research in addition to their own personal knowledge. This is an improvement, of course, but it also introduces problems of complexity in having to coordinate with multiple people and incorporate excessive amounts of information.

In performing these jobs, the professionals need to know and be able to instantly recall more detailed information than is really possible and they need to be able to trust that their teammates are performing equally super-human mental tasks as well. Such trust is often a mistake. When dealing with extremely complex tasks, professionals will sometimes focus so much on the difficult or tricky portions of their tasks that they forget to perform the basic preliminary steps. Even the best and most experienced experts in their fields are still just human. Checklists, however, can supplement memory to ensure that everyone remembers the basic steps, while at the same time running through a checklist as a group can ensure that everyone on a team is on the same page.

I would love to go through each of Gawande’s examples and explanations because the examples were all so interesting and the explanations were all so useful. For example, the discussion of how airplane pilots came to use checklists and why they go through some every single time they fly, no matter how experienced they are, is fascinating. Equally fascinating is the interview with Boeing’s master checklist writer regarding what defines a good or bad checklist. The whole book is both interesting and useful and I could burble on about each of the stories or arguments or lessons, but really, it’s probably better if you just go and read the book.

4 comments on “The Checklist Manifesto by Atul Gawande

  1. Anna says:

    It will definitely be preaching to the choir for me; I’m already a huge proponent of checklists in the design field when editing and preparing files for the printer.

    A few months ago, I read a really interesting and upsetting article on arson investigations, and in particular errors in the investigations that send people to jail without proper justification. One of the criticism is how the arson investigation field is still almost entirely reliant on simple experience of the investigator, and new scientific discoveries don’t get incorporated into the investigations easily. I would think this realm could be a possibility for a check list, too, like: look for smoke patterns along floor boards, look for burn patterns on carpets, etc.

    Also, clearly my pilot on Sunday was carefully running through his checklist, because a hot air leak light prevented us from flying on our current plane. As much as it was a bit of a irritant to have to get off and reboard a different plane, I’m still glad he went through his checklist!

    • Rebecca says:

      It was preaching to the choir for me, too, but it was still a good sermon. 🙂 I’m a believer in checklists, but this clarified why it was a good idea and some direction on how to go about it. I heard a mention on the radio about an old arson case being overturned, but not any of the details. The arson investigators should definitely be using a checklist. I think the professions that have already incorporated checklists into their process are the ones where failures involve large body counts (building construction and aviation) while the ones where failures just kill one person at a time are not as conscious of the need.

  2. Anna says:

    So, I just finished reading this while on a beach vacation, much to the scorn of my friends for my “summer reading.” As payback, I constantly gave them anecdotes about successful checklists, because, wow, this book will turn you into a checklist fanatic! I thought I was on-board before, but now, not only do I fully intend to use checklists myself, I want to quiz every professional I see, like my doctor and stock broker, about whether they use checklists.

    Also, I’d like to add as an aside that, because the author delves so deeply into pilots’ checklists as examples of simplifying really complicated tasks, I felt nervous flying for the first time in my adult life. Now I have a much better idea of how much can go wrong, and when our flight was delayed, I was probably the only one in the waiting area thinking, “I hope the pilot doesn’t try to shorten the delay by rushing through his checklist.”

    • Rebecca says:

      Hee! Yeah, I also have the urge to ask my doctors and bosses and random people on the street if they use checklists and if not, why not? (And there is no acceptable excuse.) I always kind of rolled my eyes at how, when going to the doctor, the nurse always took my weight, my blood pressure and my temperature, but I am now not only reconciled but supportive. Yes! They should be double checking all that information, each and every single time.

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