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Summary: The Checklist Manifesto Atul Gawande
This work offers a summary of the book "The Checklist manifesto" by Atul Gawante. When solving problems, it's easy to get caught up in the complexities whilst ignoring the obvious, simple solutions. Atul Gawande suggests that every business sector can take some tips from the commercial aviation industry's emphasis on checklists: "Avoidable failures are common and persistent, not to mention demoralizing and frustrating, across many fields… the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us. That means we need a different strategy for overcoming failure… And there is such a strategy – though it will seem almost ridiculous in its simplicity. It is a checklist."
Atul Gawande has case studies in both arenas to demonstrate its brilliant commonsense. We have developed such sophisticated, complex systems, that we cannot prevent error by memory alone. Despite the growth of superspecialisation, steps are sometimes missed, which demonstrates that problems often exist not because of a lack of knowledge, but just because routine can create complacency. One especially compelling case is the construction industry, which by using checklists has reduced building failures to 0.00002 percent: given such statistics, why would any business not follow suit?
- GenresProductivitySelf Help
27 pages, Kindle Edition
First published November 1, 2011
17 people are currently reading
248 people want to read
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Displaying 1 - 10 of 10 reviews
February 28, 2019
I think that The Checklist Manifesto is a book that every technical professional should read. It is simple to read, to the point and extremely useful. I first heard about it in a Scrum training and now, after reading it, I think it was the best thing that came out of it (and it was a pretty awesome training session). What is this book about, then? It is about a surgeon that researches the way a simple checklist can improve the daily routine in a multitude of domains, but mainly, of course, in surgery. And the results are astounding: a two fold reduction in operating room accidents and/or postoperatory infections and complications. Atul Gawande does not stop there, though, he uses examples from other fields to bring his point around, focusing a lot on the one that introduced the wide spread use of checklists: aviation.
There is a lot to learn from this book. I couldn't help always comparing what the author had to say about surgery with the job I am doing, software development, and with the Scrum system we are currently employing. I think that, given he would have heard of Scrum and the industrial management processes it evolved from, Gawande would have surely talked about it in the book. There is no technical field that could not benefit from this, including things like playing chess or one's daily routine. The main idea of the book is that checklists take care of the simple, dumb things that we have to do, in order to unclutter our brain for the complex and intuitive work. It enables self discipline and allows for unexpected increases in efficiency. I am certainly considering using in my own life some of the knowledge I gained, and not only at the workplace.
What I could skim from the book, things that I marked as worthy to remember:
- Do not punish mistakes, instead give more chances to experience and learning - this is paramount to any analytical process. The purpose is not to kill the host, but to help it adapt to the disease. Own your mistakes, analyse them, learn from them.
- Decentralize control - let professionals assume responsibility and handle their own jobs as they know best. Dictating every action from the top puts enormous pressure on few people that cannot possibly know everything and react with enough speed to the unpredictable
- Communication is paramount in managing complex and unexpected situations, while things like checklists can take care of simple and necessary things - this is the main idea of the book, enabling creativity and intuition by checking off the routine stuff
- A process can help by only changing behaviour - Gawande gives an example where soap was freely given to people, together with instructions on how and when to use it. It had significant beneficial effects on people, not because of the soap per sé, but because it changed behaviour. They were already buying and using soap, but the routine and discipline of soap use was the most important result
- Team huddles - like in some American sports, when a team is trying to achieve a result, they need to communicate well. One of the important checks for all the lists in the book was a discussion between all team members describing what they are about to do. Equally important is communicating during the task, but also at the end, where conclusions can be drawn and outcomes discussed
- Checklists can be bad - a good checklist is precise, to the point, easy to use. A long and verbose list can impede people from their task, rather than help them, while vague items in the lists cause more harm than good
- A very important part of using a checklist system is to clearly define pause points - they are the moments at which people take the list and check things from it. An undefined or vaguely defined pause point is just as bad as useless checklist items
- Checklists are of two flavours - READ-DO, like a food recipe, with clear actions that must be performed in order, and DO-CONFIRM, where people stop to see what was accomplished and what is left to do, like a shopping list
- A good checklist should optimally have between five and nine items - the number of items the human brain can easily remember. This is not a strong rule, but it does help
Investigate failures - there is no other way to adapt
- A checklist gotcha is the translation - people might make an effort to make a checklist do wonders in a certain context, only to find that translating it to other cultures is very difficult and prone to errors. A checklist is itself subject to failure investigation and adaptation
- Lobbying and greed are hurting us - a particularly emotional bit of the book is a small rant in which the author describes how people would have jumped on a pill or an expensive surgical device that would have brought the same great results as checklists, only to observe that people are less interested in something easy to copy, distribute and that doesn't bring benefits to anyone except the patients. That was a painful lesson
- The star test pilot is dead - there was a time when crazy brave test pilots would risk their lives to test airplanes. The checklist method has removed the need for unnecessary risks and slowly removed the danger and complexity in the test pilot work, thus destroying the mythos. That also reduced the number of useless deaths significantly.
- The financial investors that behave most like airline captains are the most successful - they balance their own greed or need for excitement with carefully crafted checklists, enabling their "guts" with the certainty that small details were not missed or ignored for reasons of wishful thinking
- The Hudson river hero(es) - an interesting point was made when describing the Hudson river airplane crash. Even if the crew worked perfectly with each other, keeping their calm in the face of both engines suddenly stopping, calming and preparing the passengers, carefully checking things off their lists and completing each other's tasks, the media pulled hard to make only the pilot a hero. Surely he denied it every time and said that it was a crew effort because he was modest. Clearly he had everything under control. That did not happen and it also explains why the checklist is so effective and yet so few people actually employ it. We dream of something else
- We are not built for discipline - that is why discipline is something that enables itself. It takes a little discipline to become more disciplined. A checklist ensures a kind of formal discipline in cases previously analysed by yourself. It assumes control over the emotional need for risk and excitement.
- Optimize the system, not the parts - it is always the best choice to look at something as a whole and improve it as a whole. The author mentions an experiment of building a car from the best parts, taken from different companies. The result was a junk car that was not very good. The way the parts interact with one another is often more important than individual performance
There is a lot to learn from this book. I couldn't help always comparing what the author had to say about surgery with the job I am doing, software development, and with the Scrum system we are currently employing. I think that, given he would have heard of Scrum and the industrial management processes it evolved from, Gawande would have surely talked about it in the book. There is no technical field that could not benefit from this, including things like playing chess or one's daily routine. The main idea of the book is that checklists take care of the simple, dumb things that we have to do, in order to unclutter our brain for the complex and intuitive work. It enables self discipline and allows for unexpected increases in efficiency. I am certainly considering using in my own life some of the knowledge I gained, and not only at the workplace.
What I could skim from the book, things that I marked as worthy to remember:
- Do not punish mistakes, instead give more chances to experience and learning - this is paramount to any analytical process. The purpose is not to kill the host, but to help it adapt to the disease. Own your mistakes, analyse them, learn from them.
- Decentralize control - let professionals assume responsibility and handle their own jobs as they know best. Dictating every action from the top puts enormous pressure on few people that cannot possibly know everything and react with enough speed to the unpredictable
- Communication is paramount in managing complex and unexpected situations, while things like checklists can take care of simple and necessary things - this is the main idea of the book, enabling creativity and intuition by checking off the routine stuff
- A process can help by only changing behaviour - Gawande gives an example where soap was freely given to people, together with instructions on how and when to use it. It had significant beneficial effects on people, not because of the soap per sé, but because it changed behaviour. They were already buying and using soap, but the routine and discipline of soap use was the most important result
- Team huddles - like in some American sports, when a team is trying to achieve a result, they need to communicate well. One of the important checks for all the lists in the book was a discussion between all team members describing what they are about to do. Equally important is communicating during the task, but also at the end, where conclusions can be drawn and outcomes discussed
- Checklists can be bad - a good checklist is precise, to the point, easy to use. A long and verbose list can impede people from their task, rather than help them, while vague items in the lists cause more harm than good
- A very important part of using a checklist system is to clearly define pause points - they are the moments at which people take the list and check things from it. An undefined or vaguely defined pause point is just as bad as useless checklist items
- Checklists are of two flavours - READ-DO, like a food recipe, with clear actions that must be performed in order, and DO-CONFIRM, where people stop to see what was accomplished and what is left to do, like a shopping list
- A good checklist should optimally have between five and nine items - the number of items the human brain can easily remember. This is not a strong rule, but it does help
Investigate failures - there is no other way to adapt
- A checklist gotcha is the translation - people might make an effort to make a checklist do wonders in a certain context, only to find that translating it to other cultures is very difficult and prone to errors. A checklist is itself subject to failure investigation and adaptation
- Lobbying and greed are hurting us - a particularly emotional bit of the book is a small rant in which the author describes how people would have jumped on a pill or an expensive surgical device that would have brought the same great results as checklists, only to observe that people are less interested in something easy to copy, distribute and that doesn't bring benefits to anyone except the patients. That was a painful lesson
- The star test pilot is dead - there was a time when crazy brave test pilots would risk their lives to test airplanes. The checklist method has removed the need for unnecessary risks and slowly removed the danger and complexity in the test pilot work, thus destroying the mythos. That also reduced the number of useless deaths significantly.
- The financial investors that behave most like airline captains are the most successful - they balance their own greed or need for excitement with carefully crafted checklists, enabling their "guts" with the certainty that small details were not missed or ignored for reasons of wishful thinking
- The Hudson river hero(es) - an interesting point was made when describing the Hudson river airplane crash. Even if the crew worked perfectly with each other, keeping their calm in the face of both engines suddenly stopping, calming and preparing the passengers, carefully checking things off their lists and completing each other's tasks, the media pulled hard to make only the pilot a hero. Surely he denied it every time and said that it was a crew effort because he was modest. Clearly he had everything under control. That did not happen and it also explains why the checklist is so effective and yet so few people actually employ it. We dream of something else
- We are not built for discipline - that is why discipline is something that enables itself. It takes a little discipline to become more disciplined. A checklist ensures a kind of formal discipline in cases previously analysed by yourself. It assumes control over the emotional need for risk and excitement.
- Optimize the system, not the parts - it is always the best choice to look at something as a whole and improve it as a whole. The author mentions an experiment of building a car from the best parts, taken from different companies. The result was a junk car that was not very good. The way the parts interact with one another is often more important than individual performance
November 25, 2013
I was fascinated by this idea but frankly, I wasn't brave enough to read an entire book on checklists. So instead I read this. The major takeaway from this, as is from GTD system is that the brain is not good at remembering things but is good at processing information. So instead of remembering a bunch of complex items, you would do well entrusting it to a piece of paper.
September 5, 2018
This is a great book. It has incredible relevance to the work of the foster care system in Washington and offers insights on how to think about complex systems. I've also read "Complex Adaptive Systems" by Nick Obolensky that helps one think about solving similar problems.
It's also short and beautifully written, which makes it nicer to read. Both things are not true about the Obolensky book.
I read the actual book, not this summary.
It's also short and beautifully written, which makes it nicer to read. Both things are not true about the Obolensky book.
I read the actual book, not this summary.
October 23, 2017
Was intending to get a full copy, but the summary version gave me more than could have asked for. I personally use checklist for overall lifestyle management purposes, experiencing great results & exactly what was shared with us in the Checklist Manifesto. In this information-overload environment, checklists are the way to go! Agree 100%
November 10, 2019
Insightful Read
I've always considered simple to-do lists an essential component for my daily activities as a physician. This is an amazing read that provides insightful data on how specific situations have benefited and even decreased morbidity or mortality by simply having a "stupid checklist".
I've always considered simple to-do lists an essential component for my daily activities as a physician. This is an amazing read that provides insightful data on how specific situations have benefited and even decreased morbidity or mortality by simply having a "stupid checklist".
June 14, 2020
The Book is pretty obvious. You basically can read the title and that is the book. However, reading it does help someone thick-headed like myself to understand the context of why checklists are so important. I instituted them at work, and they greatly reduced errors and improved efficiency.
March 1, 2020
This book, together with Triggers, prompted me to create more structure (checklist) into my day and life
May 8, 2020
Great book to read for anyone who doesn't have a manufacturing/process type of background.
If you like this book, also check out 'The Goal' by Goldradtt.
If you like this book, also check out 'The Goal' by Goldradtt.
January 7, 2016
Great book and great example
i like the idea of checklist its really powerful thing
i like the idea of checklist its really powerful thing
Read
September 21, 2018I didn’t finish this book as I felt like it could’ve been 90% shorter.
Displaying 1 - 10 of 10 reviews