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The Checklist Manifesto

I just finished reading the second book of 12 non fiction books I intend to read this year. To be honest I haven’t finished the first one yet. This one was recommended by a friend. Intrigued by the premise, I opted to put the first aside for a time.


The book? The Checklist Manifesto: How to Get Things Right by Atul Gawande. Gawande is a surgeon who “discovered” that following a simple checklist in the operating room dramatically reduced infection, mistakes, and deaths. He took his revolutionary idea around the world. Many hospitals were reluctant to adopt the checklist idea. Most people felt like it was too childish, that they were too intelligent to need a checklist to improve their outcomes.


Gawande says that our universe is so vast and complex that there is much of our universe that we don’t yet understand. However, there are substantial realms in which control is within our grasp. But even with what we do understand, there are two reasons we still fail. Ignorance and ineptitude. We err because we just don’t know or we err because we know, but fail to apply the knowledge correctly.


Atul identifies three primary kinds of problems in the world: simple, complicated and complex. Simple problems are like baking a cake. There is a recipe to follow and, with a few basic techniques, one needs only follow the recipe to produce a high likelihood of success. Complicated problems are more like sending a rocket to the moon. The task is huge, but can be broken into a series of simpler problems. There is no straight forward recipe. Success requires multiple people or teams and specialization. Once you learn how to send a rocket into space you can replicate the process and perfect it. Complex problems are like raising a child. Every child is unique. No one recipe will raise every child. Expertise is valuable, but it is not sufficient and does not guarantee success. In addition, the outcomes remain highly uncertain.


He explains how checklists can help manage these problems and improve the likelihood of success. Surgeons use them, pilots use them, investors use them. Checklists must be concise and clear. Our human nature does not like checklists. They are painstaking. It somehow feels beneath us to use them, almost embarrassing. yet Atul Gawande has proven that they reduce mistakes and save lives.


When we look closely, we recognize the same balls being dropped over and over, even by those of great ability and determination. We know the patterns. We see the costs. it’s time to try something else. Try a checklist.


I am a believer. A checklist can help us to be more consistent in repeating excellence. Join me as I help Atul Gawande spread the word about the value of checklists.


  1. 10 March 2012 at 2:01 am

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