The Checklist Manifesto: how to get things right

What do modern aircraft and most surgeries have in common? According to best selling author, Atul Gawande, in his short, fascinating book, The Checklist Manifesto: how to get things right (Metropolitan Press 2009), they are both systems which are designed to make our lives better, but are fraught with complexities which even a super-specialist cannot completely understand. What Gawande asserts is that the modern age has given us tremendous knowledge, but that knowledge doesn’t necessarily translate into bettering our lives: airliners do crash; surgeries do go awry; investments fail. What is the solution? The lowly checklist: the simplification of a complex situation into its most basic and necessary components.

Drawing graphic cases from surgical practices and from the annals of aviation (e.g., the test flights of the B-17) at the beginning of the book, Gawande shows how the vast volume of knowledge an individual acquires through long periods of training and specialized education often does not translate into higher success rates. The world has become too overwhelmingly complex for an individual to achieve consistent success. In contrast, Gawande also illustrates how simple checklists can lead to desired outcomes in emergency situations, such as in “the Miracle on the Hudson”.

Underlying Gawande’s theory, that carefully constructed checklists may be the key to higher success rates, is the idea of collaboration -- no longer can one person master everything in even the smallest specialty because of the torrent of new knowledge; teams of people must work together for the success of an enterprise, especially in emergency situations. They must communicate, question, take individual and collective responsibility. And the checklist is the basis for all these activities to take place.

But all checklists are not created equal. Gawande spends a few chapters examining what makes good checklists, and how they are created, and what hinders a checklist’s efficiency. He also spends some time discussing the limitations of checklists, and how their adoption requires a shift in cultural norms.

Given the examples Gawande provides, it hard not to be persuaded that checklists can be the solution to many of life’s vicissitudes. When all is said and done, Gawande would agree with Henry David Thoreau’s advice to “simplify, simplify, simplify.”

Post written by Ted Li

Note from Anne: what happens when you leave a book lying around the house and start another one and another one? People pick up "your" book and read it, but if you're lucky you can guilt trip them into writing a review for the library blog. Thanks, Ted. Now I really will finish The Checklist Manifesto, as soon as I finish Merry Hall and The Mapping of Love and Death.