Book Review: The Checklist Manifesto

Title/ Author/ ISBN;

The Checklist Manifesto
Atu Gawande,
ISBN-978-0-8050-9174-8
Pages=211

Introduction:

Atu Gawande is a medical doctor first and a journalist/writer second. His specialty in the medical field is General and Gastrointestinal Surgery. He is known for as an expert on reducing error, improving safety and increasing efficiency in surgery. He wrote The Checklist Manifesto to make an impact to the world in terms of preventing unnecessary loss of lives due to human error and carelessness of procedures in the operating room, hospital and or any workplace. He explained in clear examples how a simple checklist saved lives in his own operating room and later observed others do the same

What is the book about?

If I have to summarize the book into one sentence, it will be like this-“Make a Checklist of Everything You Do”. Of course the contents of the book are more than that.

The Table of Contents:
1. The Problem of Extreme Complexity
2. The Checklist
3. The End of the Master Builder
4. The Idea
5. The First Try
6. The Checklist Factory
7. The Test
8. The Hero in the age of checklist
9. The Save

The Structure of a Good Checklist
1. Simple
2. Brief
3. To the Point
4. One Page
5. Step by Step
6. One already knows

Complex Environment Difficulties:
1. Fallibility of Human Memory and Attention
-mundane, routine matters, faulty memory , distractions
2. People skip steps even when they remember them
-thinks that a step in not important and can be skipped.

Three Different Kinds of Problems:
1. Simple-baking a cake from a mix; a recipe can be followed
2. Complicated- sending a rocket to the moon, no straightforward recipe
3. Complex-raising a child, expertise is valuable but cannot guarantee if the next child will be a success also; outcome is uncertain; not impossible to raise a child, just complex.

US Airways Flight 1549 Miracle at Hudson River, 2009
-no loss of lives
-at first, investigators thought it was the pilot who really did a good job but then later in the investigation, it was learned that the checklist and procedures, the crews and it’s effort saved the 155
-key items of the miracle were-teamwork of the crew, adherence to procedures and individual skills of the crew

Personal Code of Conduct
1. Expectation of Selflessness-accept responsibility for others; place needs and concerns of those who depend on us above our own
2. Expectation of Skill-aim for excellence in our knowledge and expertise
3. Expectation of Trustworthiness-we are responsible in our personal behavior toward our charges.
4. Expectation of Discipline-discipline in following prudent procedures and in functioning with others; make discipline a NORM.

What do you think about the book?

We’ve seen “checklist in action” in so many scenarios in our career and personal life. Anywhere we go there is a checklist present. Examples such as going to the doctor’s office, bringing our car to the dealer for a regular maintenance, doing grocery shopping, planning a trip or a vacation, doing big projects at work, performing a failure analysis, performing a complex repair of a complex system, going to college, joining the military. We’ve seen them all but how often do we study our checklist and revise them so as to yield an efficient flow of execution and how often do we question someone else’s checklist or procedure. At the basic concept of human behavior, we normally just accept what is given to us. No questions ask. “Ok, I’ll fill it up” or “I’ll do it without complaining”. Reasons for that is because most of the time, we do not have control of the checklist or the procedures. I recently finished reading another book about “Managing Chaos and Complexity” and I’ve learned that chaos will always be there because life is a complex system. Humans will always face chaos no matter what. After reading “The Checklist Manifesto” I had another answer on how to manage “chaos” – use a checklist. Simplify every complex task into a one page checklist.

Conclusion:

I did not realize that I had been using a checklist all my life. I have journals, small notebook for personal stuff, small notebook for work related materials, I have action items [actionable items] even the moment I wake up I did not even know it that I am following a checklist. When I write, the tone of my writing is in a checklist form. In some ways, most of us are using a checklist and we don’t even know it. Even for those that don’t even write it on paper- those items on our head when we make a decision, those are mental checklist. Reading The Checklist Manifesto reiterates the importance of a checklist. As mentioned in the book, there are key ingredients of a good checklist and it has to be followed. Silly, but the author made a checklist on “how to make a checklist” because like any other activities, when we function robotically, we miss things. Checklist has to be analyzed several times because there are times we miss a step or the step is confusing. .

Recommendations:
Read the book, it will change the way you look at procedures.
Apply it, it will change the way you create a checklist and procedures.
Live it, it will make your life/work less chaotic.