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The Checklist Manifesto: How to Get Things Right Paperback – January 4, 2011

by Atul Gawande (Author)

1,124 customer reviews

in Health Care Administration

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In his latest bestseller, Atul Gawande shows what the simple idea of the checklist reveals about the complexity of our lives and how we can deal with it.

The modern world has given us stupendous know-how. Yet avoidable failures continue to plague us in health care, government, the law, the financial industry—in almost every realm of organized activity. And the reason is simple: the volume and complexity of knowledge today has exceeded our ability as individuals to properly deliver it to people—consistently, correctly, safely. We train longer, specialize more, use ever-advancing technologies, and still we fail. Atul Gawande makes a compelling argument that we can do better, using the simplest of methods: the checklist. In riveting stories, he reveals what checklists can do, what they can’t, and how they could bring about striking improvements in a variety of fields, from medicine and disaster recovery to professions and businesses of all kinds. And the insights are making a difference. Already, a simple surgical checklist from the World Health Organization designed by following the ideas described here has been adopted in more than twenty countries as a standard for care and has been heralded as “the biggest clinical invention in thirty years” (The Independent).

The Checklist Manifesto: How to Get Things Right

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Editorial Reviews

Amazon.com Review

Amazon Best Books of the Month, December 2009: With a title like The Checklist Manifesto, it would be natural to expect that Atul Gawande is bent on revolutionizing that most loved-hated activity of workers the world over: the to-do list. But it's not the list itself he wants to change; there are no programmatic steps or tables here to help you reshuffle daily tasks. What you'll find instead is a remarkably liberating and persuasive inquiry into what it takes to work successfully and with a personal sense of satisfaction. The first thing you'll realize is that it takes more than just one person to do a job well. This is a toppling revelation made all the more powerful by Gawande's skillful blend of anecdote and practical wisdom as he profiles his own experience as a surgeon and seeks out a wide range of other professions to show that a team is only as strong as its checklist--by his definition, a way of organizing that empowers people at all levels to put their best knowledge to use, communicate at crucial points, and get things done. Like no other book before it, The Checklist Manifesto is at once a restorative call to action and a welcome voice of reason. --Anne Bartholomew

Amazon Exclusive: Malcolm Gladwell Reviews The Checklist Manifesto

Malcolm Gladwell was named one of TIME magazine's 100 Most Influential People of 2005. He is most recently the author of What the Dog Saw (a collection of his writing from The New Yorker) as well as the New York Times bestsellers Outliers, The Tipping Point, and Blink. Read his exclusive Amazon guest review of The Checklist Manifesto:

Over the past decade, through his writing in The New Yorker magazine and his books Complications and Better, Atul Gawande has made a name for himself as a writer of exquisitely crafted meditations on the problems and challenges of modern medicine. His latest book, The Checklist Manifesto, begins on familiar ground, with his experiences as a surgeon. But before long it becomes clear that he is really interested in a problem that afflicts virtually every aspect of the modern world--and that is how professionals deal with the increasing complexity of their responsibilities. It has been years since I read a book so powerful and so thought-provoking.

Gawande begins by making a distinction between errors of ignorance (mistakes we make because we don't know enough), and errors of ineptitude (mistakes we made because we don’t make proper use of what we know). Failure in the modern world, he writes, is really about the second of these errors, and he walks us through a series of examples from medicine showing how the routine tasks of surgeons have now become so incredibly complicated that mistakes of one kind or another are virtually inevitable: it's just too easy for an otherwise competent doctor to miss a step, or forget to ask a key question or, in the stress and pressure of the moment, to fail to plan properly for every eventuality. Gawande then visits with pilots and the people who build skyscrapers and comes back with a solution. Experts need checklists--literally--written guides that walk them through the key steps in any complex procedure. In the last section of the book, Gawande shows how his research team has taken this idea, developed a safe surgery checklist, and applied it around the world, with staggering success.

The danger, in a review as short as this, is that it makes Gawande’s book seem narrow in focus or prosaic in its conclusions. It is neither. Gawande is a gorgeous writer and storyteller, and the aims of this book are ambitious. Gawande thinks that the modern world requires us to revisit what we mean by expertise: that experts need help, and that progress depends on experts having the humility to concede that they need help. --Malcolm Gladwell

From Publishers Weekly

That humblest of quality-control devices, the checklist, is the key to taming a high-tech economy, argues this stimulating manifesto. Harvard Medical School prof and New Yorker scribe Gawande (Complications) notes that the high-pressure complexities of modern professional occupations overwhelm even their best-trained practitioners; he argues that a disciplined adherence to essential procedures—by ticking them off a list—can prevent potentially fatal mistakes and corner cutting. He examines checklists in aviation, construction, and investing, but focuses on medicine, where checklists mandating simple measures like hand washing have dramatically reduced hospital-caused infections and other complications. Gawande gets slightly intoxicated over checklists, celebrating their most banal manifestations as promethean breakthroughs (First there was the recipe, the most basic checklist of all, he intones in a restaurant kitchen). He's at his best delivering his usual rich, insightful reportage on medical practice, where checklists have the subversive effect of puncturing the cult of physician infallibility and fostering communication and teamwork. (After writing a checklist for his specialty, surgery, he is chagrined when it catches his own disastrous lapses.) Gawande gives a vivid, punchy exposition of an intriguing idea: that by-the-book routine trumps individual prowess. (Jan.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

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Product Details

Paperback: 240 pages
Publisher: Picador; Reprint edition (January 4, 2011)
Language: English
ISBN-10: 0312430000
ISBN-13: 978-0312430009
Product Dimensions: 5.5 x 0.7 x 8.2 inches
Shipping Weight: 5.6 ounces (View shipping rates and policies)
Average Customer Review: 4.5 out of 5 stars See all reviews (1,124 customer reviews)
Amazon Best Sellers Rank: #1,253 in Books (See Top 100 in Books)
- #1 in Books > Medical Books > Medicine > Internal Medicine > Pathology > Clinical Chemistry
- #1 in Books > Medical Books > Administration & Medicine Economics > Health Care Administration
- #1 in Books > Medical Books > Administration & Medicine Economics > Hospital Administration

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Top Customer Reviews

Game Changing...

ByD. KaniganVINE VOICEon December 23, 2009

Format: HardcoverVerified Purchase

Amazon's December Book of the Month summary describes the author's mission of revolutionizing the "to-do list...without programmatic steps or tables to help reshuffle daily tasks." One may infer from this recap that this is a how-to-self-improvement book for making one more productive, more efficient and less stressed - this couldn't be farther from the core message of this book.

The author's key message is that the volume and complexity of knowledge today has exceeded any single individual's ability to manage it consistently without error despite material advances in technology, boatloads of more training and super-specialization of functions and responsibilities. Yet, despite demonstrating that checklists produce results, there is resistance to their use because of the (1) Master of Universe mentality (Rock Star; Fighter Pilot; Hero), (2) our jobs are too complex to reduce to a checklist, (3) checklists are too rigid and don't force us to look up and see and think ahead of what's in front of us. Yet, in a complex environment, he states that experts are up against 2 difficulties - the fallibility of human memory when it comes to mundane, routine matters that are easily overlooked under the strain of more pressing events and secondly, people can lull themselves into skipping steps even when they remember them - after all certain steps don't always matter...until one day they do. Gawande makes a persuasive case in his book as to why you should develop and implement a process checklist for critical processes/decisions.

* Whether you are from the medical field or not, you will benefit from the inspiring thinking and insights.

* This book is game changing - a call-to-action for generating better results despite the pull to run with intuition or gut instinct. If you are implementing via intuition rather than a systematic process, this book's message will force you to pause in your tracks to seek a more disciplined approach.

* The author uses a wide range of industries to make his case using an engaging blend of anecdotes, storytelling and research - from healthcare to aviation (US Airways 1549 landing in Hudson River) - - to high-end award winning restaurants - - to building massive office skyscrapers and shopping centers - -to setting up a Van Halen rock concert - - to FEMA's response to Hurricane Katrina in New Orleans - - to money managers making investment selections.

* Can be read in 1-2 sittings. Page Turner. Fully engaging and riveting until the last page is turned.

* Author's determination, authenticity, inspired thinking, modesty and willingness to disclose personal mistakes makes this an inspirational book. Both brilliantly written and a pleasure to read.

My favorite excerpts:

"Despite showing (hospital) staff members of the benefits of using the checklist, 20% resisted stating that it was not easy to use, it took too long and felt it had not improved the safety of care. Yet, when asked an additional question - would you want the checklist to be used if you were having an operation - a full 93% said yes."

"In a world in which success now requires large enterprises, teams of clinicians, high-risk technologies, and knowledge that outstrips any one person's abilities, individual autonomy hardly seems the ideal we should aim for. ..what is needed, however is discipline...discipline is hard - harder than trustworthiness and skill and perhaps even than selflessness. We are by nature flawed and inconstant creatures. We can't even keep from snacking between meals. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at."

"We don't study routine failures...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."

"We're obsessed in medicine with having great components, the best drugs, the best devices, the best specialists - but pay little attention to how to make them fit together well""

"It somehow feels beneath us to use a checklist, an embarrassment. It runs counter to deeply held beliefs about how the truly great among us - those we aspire to be - handle situations of high stakes and complexity. The truly great are daring. They improvise. They do not have protocols and checklists. Maybe our idea of heroism needs updating."

1212 comments 562 people found this helpful. Was this review helpful to you?YesNo

10 Highlights of This Book

ByAdamSmytheon January 24, 2010

Format: HardcoverVerified Purchase

I looked over the other reviews of this interesting book, and there are many of them that you will find very useful--so I'll just try to list some highlights. As Dr. Gawande points out, a checklist can't be too long (people won't use it), yet it must succinctly cover the most essential considerations of the situation at hand. Although what follows isn't a checklist, I'll try to focus on the most essential characteristics of Dr. Gawande's book:

First, this is an easy-to-read, engaging book. I'll bet that you will find it hard to put down. It is interesting enough to make you want to read the book and serious enough to deliver important messages.

Second, the value of using checklists springs directly from the complexity of modern life, whether we're talking about surgery (the author is a surgeon), flying an airplane or building a skyscraper. By the way, in reading this book I have developed a newfound appreciation of how complex the construction business can be.

Third, checklists are not just for simple, straightforward tasks. Checklists help people communicate and work together better, especially when the unexpected occurs.

Fourth, checklists are important regardless of the time available. Indeed, when the cockpit crew of US Airways flight 1549 lost both engines over New York City, they had only three minutes of airtime remaining. The first thing they did was to get out their checklists. (You can read Captain Sully Sullenberger's excellent book for more details.)

Fifth, checklist usage has saved numerous lives, including one of Dr. Gawande's patients. His candor in discussing that episode is laudable.

Sixth, humans being human, mistakes will inevitably occur. Checklist usage is important when the potential cost of human mistakes is great.

Seventh, the mere act of creating a checklist focuses the mind on the most important characteristics of our tasks.

Eighth, like anything else, it takes practice to produce and use checklists effectively.

Ninth, practice comes from commitment and personal discipline. Indeed, one of the most important things Sully Sullenberger did was to maintain his composure and discipline, even while the gravity of his situation must have been racing through his mind.

Tenth, as I read this book, my mind frequently reflected on how a checklist approach could be applied in some of the business and academic practices that I am familiar with. That's the real beauty of this book--it gets the reader thinking about ways to improve life.

0Comment 171 people found this helpful. Was this review helpful to you?YesNo

Why read the book when the article will do?!

Byavdrdron February 6, 2010

Format: Hardcover

Dr. Gawande acknowledges that this book grew out of his December 10, 2007 New Yorker article, "The Checklist". I suspect that, for many readers, it would be a better use of their time and money to read the article (which is available online) rather than the book. Although the book, like Dr. Gawande's previous books, is well-written, the author's essential conclusions could easily be summarized in one page (and have been in several reviews).

1313 comments 492 people found this helpful. Was this review helpful to you?YesNo

OK, but no methods

ByE. Millson January 18, 2010

Format: HardcoverVerified Purchase

The Checklist Manifesto is a good book if you require convincing that checklists are a good thing. Or if you like to read a quasi-novel on how checklists can be useful. If you already believe in checklists then you may be bored with 193 pages espousing their virtue. You will not find anything at all on how to construct a checklist, or methods to keep them current amid ever-changing procedures and technological advances. Well written, but not particularly practical.

2828 comments 240 people found this helpful. Was this review helpful to you?YesNo

The simple checklist

ByLaura Sequeiraon December 23, 2009

Format: HardcoverVerified Purchase

I work in a hospital as an intensive care nurse. We have been working on a multitude of projects to improve patient safety and outcomes. And in the midst of all the technology and knowledge and training, it is the simple thing--a checklist. Having a husband who is a private pilot and works for the FAA, I have heard about checklists for years. This book shows how pilots use checklists to avert disaster and save lives. It explains how the people who build complex buildings use checklists to plan the construction but also communicate and correct the changes and errors. And it gives a multitude of examples in medicine to show how checklists work and what happens when they aren't used. It is a fascinating, quick and easy read. And it will have you thinking very differently about checklists and safety, whether in the air, a building or a hospital.

0Comment 155 people found this helpful. Was this review helpful to you?YesNo

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Most Recent Customer Reviews

Long on Why, Short on How

Atul Gawande makes a valiant effort in The Checklist Manifesto to highlight checklists as a repeatable means of driving discipline to prevent negative consequences of human...Read more

Published 1 year ago by Walter H Ward Jr

Invaluable Reminder

As in all of his work, Dr. Gawande latest book brilliantly reminds us all of the huge value of getting the human interaction side right to accompany the advancements in science...Read more

Published on December 23, 2009 by Drew Kugler

Two Points - Checklists and Team Communications - Make Us Better

I'm a huge fan of Dr. Atul Gawande ever since meeting him at a patient safety conference in 2005, and then subsequently reading his books and following his New Yorker articles.Read more

Published on January 15, 2010 by Davis Liu

Nice stories, not much process

This book is full of fascinating stories of how checklists improved the quality and safety standards in various industries, including medicine, engineering and airlines.Read more

Published on December 27, 2013 by Tony M.

Checked Out

Checklist Manifesto reads like a very good long form blog post that got stretched into a book. I bought the book having sparked to Atul's premise that "Checklists" might be an...Read more

Published on December 28, 2014 by Doug

... very much substance other than repeating that lists are good. Don't get the Forbes review where businesses are ...

Not very much substance other than repeating that lists are good. Don't get the Forbes review where businesses are giving this book away. There is no content in the book.Read more

Published on January 5, 2015 by B. F. Lyons

A simple solution to a complicated world

One hundred years ago, flying an airplane was slightly more difficult than mastering the many handles and levers on a Model T Ford.Read more

Published on January 11, 2010 by Charles A. Lukey

Too narrow in its focus to be of use

Obviously I'm not a part of the hit parade for this title. I had very high hopes when I ordered it from Amazon.Read more

Published on January 31, 2010 by Chuck

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