The Checklist Manifesto

The Checklist Manifesto by Atul GawandeHow to Get Things Right
by Atul Gawande
ISBN: 9780312430009

This book is far more interesting than one might think, given the title. (Unless productivity porn is your thing, in which case it is that interesting but not what you’d expect.) I believe it started off life as an article in The New Yorker (“The Checklist”), and in an all too rare turn of events deserved to grow to full book length.

Gawande’s insight is as simple as it is radical: checklists, when well-designed, can make experts dramatically better at what they do. In operating rooms, using checklists can save lives. In building enormously complex structures, they can prevent serious problems and correct issues before they are more expensive to fix. Checklists made is possible to fly the B-17 bomber, and help make commercial air travel safe. The power of checklists isn’t limited to risk reduction, either: checklists can be used to successfully promote communication and working as a team. If this sounds in the least bit dry, it’s because I’m not doing Gawande’s writing justice — he has a knack for telling stories.

The real mystery is: why aren’t aren’t checklists more widely deployed? Experts resist them, because they fall into the trap of thinking they know better — rather then seeing the checklist as a tool to let them act more effectively to leverage their skills and insight. And checklists aren’t revenue-generating the way a blockbuster medication or medical device can be — though they can be responsible for enormous cost savings. Creating checklists and refining them can be a thought- and labor-intensive process, and it requires behavior change, something most of us are not as good at or willing to do as we might believe ourselves to be.

After reading this book, 1) I was grateful for aviation checklists, as I am a nervous flyer, 2) determined to ask about the use of checklists in the operating room if anyone in my family needs surgery, and 3) curious to see if I can implement checklists in my work environment.

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