Atul Gawande’s The Checklist Manifesto

Essentially reading like an ode to the checklist, this easy read by one of my favourite authors is interesting in that it takes a simple concept and shows how it can optimally work. I use to-do lists for everything – I have them on my phone, on post-its scattered around my perpetually messy desk, in Google docs and in my calendar – but I don’t necessarily use them as effectively as I could.

What fascinated me was the resistance people have to using a checklist. Gawande delved into medicine, surgery in particular, examining how, with so many procedures to remember, even the most successful surgeons periodically bypass easy but essential steps. When Gawande partnered with the UN to introduce a surgery checklist he met with significant resistance from operating rooms around the world. Many perceived it as a waste of time and an insult to experienced doctors’ expertise and intelligence – but upon adoption almost everyone was converted after experiencing positive results.

In Gawande’s own operating room, he claims going through a simple 7 step checklist before surgery, after the initial incision and just after surgery prevented a problem almost every time he operated. Other hospitals around the world reported the same, and it’s well known that pilots rely on checklists before and during flight, landing and take-off. In fact, one of Gawande’s anecdotes is how Captain Chesley B. Sullenberger and First Officer Jeffrey Siles used a checklist to successfully perform an unpowered emergency landing on the Hudson River.

For me, the takeaway from this book was to embrace the humble to-do list and use it in the work place. At the moment, my team has a very long checklist they have to adhere to, which it’s now clear I need to simplify. Part of the work of the checklist is to prompt important steps, but to also leave some things up to the individual to be accountable for. It wasn’t the most revolutionary read, but I do enjoy Gawande’s stories from the operating room – he really is an extraordinary man and surgeon.


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