The Checklist Manifesto: How to Get Things Right Unknown Binding – 2010

I had to read this book for work, and I wasn't looking forward to it. To my surprise it has a very good narrative is quite readable. The examples used are compelling and keep the pages turning. By the end it had me thinking of our processes and I have my team scouring them looking for places where a checklist would be appropriate. If you're concerned about quality, you should give this book a try.

Meh. The book is WAY over-hyped!! It spends MOST of its long never-ending pages explaining medical scenarios. It's unbelievable....I felt as if I was studying my Paramedic book again! All that nonsense to get to "Checklists are good...you should develop one for everything you do". That's it folks...I just gave you the cliff Notes for the ENTIRE book! Even the sample checklists (all two of them) they illustrate are a joke.

Pay ME whatever this book costs, and I'll actually MAKE a checklist for you! Tell ya what...contact me if you want the book. I'll give it to you if you just pay shipping. Very disappointing!

The book is great! I wish he dealt more with the pros and cons of checklists in various situations, and how to write a good checklist for different situations. For example - is there a case for a checklist for 1 person use? What about IT systems checklists? Everything he presents is anecdotal, but I think could be summarized in about 3 pages. Still, it's a great story and compelling read. I just would have preferred some more "meat" and less "carbs" so to speak. The stories are great and teach good lessons. But it needs to be explored across more industries and situations, and with better summaries at the end to tie up the lessons learned and the key points.

Very interesting exploration of the benefits of using checklists in various industries (but mainly in operating theaters in hospital) to facilitate consistency which leads to improvements in many areas : productivity, safety, profitability to name but a few. The author is a highly experienced surgeon who saw the advantages of introducing checklists to radically improve patient safety during operations and in recovery. What I found shocking from reading this book was the sheer number of mistakes that are routinely made in operating theaters around the world which lead to poor recovery rates and even death in some cases. The benefit of introducing checklists into theater was enforcement of policy that all staff during an op were now "singing off the same hymn sheet". The book alludes to this idea repeatedly.

The book was very readable my only gripe was I'd have liked to have seen an example of the checklists that the author referred to.

I suppose you could order the abbreviated summary version of the book to get the main idea and you might already suspect that the main idea is that checklists are the way to get things right. I must say, however, that the main idea is just the destination and understanding how Atul arrived at this simple and perhaps obvious result is just as important in driving the point home. I am only three chapters in and the point has been made but the supporting evidence around how and why checklists are the way has been profoundly moving.

Atul Gawande is a physician interested in improving surgical practice. He reviews surgical cases with disastrous outcomes that could have been prevented and cites research claiming that nearly half of deaths that occur in surgery are in fact preventable. We read a detailed analysis of a drowning accident in which the young victim's life was saved against all odds. Why? Because the hospital staff had discussed and practiced the procedures to treat cold-water drowning ahead of time. They used no new knowledge; they just coordinated and communicated more effectively.

Gawande examines how human beings do things. There are two reasons we fail at complex tasks. The first is ignorance. We correct it by conducting research and building schools to increase our knowledge. The second and more common reason for failure is ineptitude--the right knowledge is available, but we do not apply it correctly. People continually forget, are distracted, or skip steps because they seem unimportant. This problem lurks below the radar; we don't recognize it, let alone try to solve it. Instead we send people off for more training to increase their knowledge.

What is needed instead is a simple way to remind people of what they know at the right time to make a difference. We have an answer, we just aren't using it. "Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification, but also instill a kind of discipline of higher performance."

The author examines checklists used by airline pilots, building contractors, investors and other physicians. In these professions work has become too complex for even a talented individual to perform alone. Teams of skilled experts must manage both communication and complexity to succeed. They do both with checklists. These checklists make people stop and think at "pause points" to ensure that the right things have been done. They get coworkers to bond as a team by requiring them to talk to each other. As a result, people become comfortable enough to speak up when they see a potential problem.

Chapter Six, The Checklist Factory is the instructional meat of the book, with recommendations that help us develop good checklists. There are direct guidelines about brevity and clarity. There are also process guidelines about identifying common mistakes and fine-tuning a checklist with field testing. He distinguishes between READ-DO checklists, which march novices through the tightly specified steps of rote tasks, and DO-CONFIRM checklists, which provide checkpoints for experienced professionals solving complex problems in coordinated groups. Both have their place, but DO-CONFIRM checklists have the most potential to make a difference.

There are barriers to checklist use. They have a serious user acceptance problem. Many accomplished professionals consider themselves virtuosos who don't need help from other people at all, let alone somebody else's checklist. To many others checklists seem too mundane to make a difference. The author works hard to persuade us. His own research on checklists in operating rooms finds significant drops in death rates, post-operative infections, and other outcome measures. He highlights successes at prominent hospitals to encourage wider acceptance, asks administrators to impose requirements, and calls on nurses to help change the culture of the operating room. The idea is slowly catching on.

Gawande wishes we would move more quickly. "In the money business everyone looks for an edge. If someone is doing well, people pounce like starved hyenas to find out how. Almost every idea for making even slightly more money ... gets sucked up by the giant maw almost instantly. Every idea, that is except one: checklists."

I learned some things from this book and highly recommend it. Give it at least a quick look, starting with Chapter 6. It has the potential to make you even better at what you do best.