process.st https://process.st/2015/06/the-checklist-manifesto-review/

Benjamin Brandall

The Checklist Manifesto Review

A book about disasters, human error and a simple tool that could well be the answer.

Surely we don’t need any more bureaucracy, do we? Writer and surgeon Atul Gawande says yes, in fact we do. Box-checking and form-filling are often seen as the direct opposites of efficiency, but how many skyscrapers just tumbledown out of the blue? Not very many, and The Checklist Manifesto explains why. It all comes down to recognizingthat checklists are a powerful weapon in the fight against human error. In a series of anecdotes/case studiesspanning from Gawande’s familiar operating theater to the secretive world of venture capitalism, the author makesrock-solid arguments in quick succession about why we all need more checklists in our lives. But not just any oldchecklists…

What Makes a Bad Checklist?

Perhaps the most enlightening passage in the book comes from Daniel Boorman, a man who has spent the past 20years developing flight checklists for pilots using Boeing airplanes.

“There are good checklists and bad, Boorman explained. Bad checklists are vague and imprecise.They are too long; they are hard to use; they are impractical. They are made by desk jockeys with noawareness of the situations in which they are to be deployed. They treat the people using the tools asdumb and try to spell out every single step. They turn people’s brains off rather than turn them on.

Good checklists, on the other hand, are precise. They are efficient, to the point, and easy to use evenin the most difficult situations. They do not try to spell out everything—a checklist cannot fly a plane.

Instead, they provide reminders of only the most critical and important steps—the ones that even thehighly skilled professionals using them could miss. Good checklists are, above all, practical.

The power of checklists is limited, Boorman emphasized. They can help experts remember how tomanage a complex process or configure a complex machine. They can make priorities clearer andprompt people to function better as a team. By themselves, however, checklists cannot make anyonefollow them.”

Much of the book revolves around the checklists used on the planes that are said to have been a huge driving factorin the World War II victory, the 299 variant of the Boeing B-17. Despite being deemed in 1935 ‘too much airplane forone pilot to fly’ by the newspapers, the beast was tamed with the power of one simple checklist.

The Checklist as a Collaborative Tool

As Boorman said, however, checklists don’t do the job by themselves. In another notable chapter Gawande visits abuilding site in Boston and speaks to Joe Salvia. Joe is the Vice President of Maloney Properties, a Wellesey,Massachusetts-based property development firm, a big part of which involves construction. After wondering abouthow buildings as complex as skyscrapers can be built without error, Gawande seeks out Salvia to discuss how hepersonally avoids the perennial problem of human fallibility. A mix of team communication and collaborativechecklists, Salvia explains, is enough to avoid 99% of errors.

When multiple minds collaborate, both on creating a checklist and executing each task, there is a higher chance thata silly, avoidable error will be caught before it happens. In some cases this means avoiding a skyscraper tumblingdown in the middle of Manhattan and in some cases avoiding surgical mistakes. In the operating theater,miscommunication can be fatal. The first story in the Checklist Manifesto details a shocking error in communicationbetween doctors and surgeons that almost led to fatal blood loss:

A patient is rushed to an L.A emergency room on Halloween night with a stab wound in his stomach. What weaponwould you assume he was stabbed with? He was treated as if he had been stabbed with a knife but it was laterrevealed the weapon that had almost killed him was a bayonet – it happens plenty. A bayonet in Los Angeles is notthe first thing that springs to mind. If there was a checklist for gathering information in the ambulance or emergency

room, the nurses would have found he was stabbed at a costume party with a blade far longer than your everydayknife. If that was the case, the patient wouldn’t have almost died.

The Ultimate Tool for Efficiency

While most people aren’t involved in the kinds of industries that hold them responsible for structural integrity orhuman lives, most are involved in making money. When it comes to business, behind-the-scenes efficiency isincredibly important. It powers sales, customer relations, communication and every pillar of the ancient businessmodels that are still used today.

The popularity of productivity tools in the modern age shows just how easy it is for humans to fail, to forget and tomake a mess of things. Tools like Process Street, as proven by The Checklist Manifesto, are invaluable in an agewhere things only ever get more complicated.

The Checklist Manifesto wasn’t what I expected. As I was reading it, most of the time I was wondering what dramaticmedical stories had to do with checklists. At some point it all clicked into place and I realized that the anecdotal styleof the text was logical, systematic and comprehensive, with all the stories interlocking, building to the author’s finaltale of success. Incredibly persuasive, it gets into your head and argues a point through storytelling so subtle youdon’t realize it’s an argument at all – unlike some manifestos I’ve read. Rather than a manifesto, I feel read the storyof how one surgeon influenced thousands worldwide with a tool that is just mundane enough to be brilliant. If youenjoyed The Checklist Manifesto, you should take a look at our checklist software built on the principals of the book.You can sign up for a free account here.

Have you read the Checklist Manifesto? We’d love to hear your thoughts about the book, so leave a comment below.Thanks!