The Checklist Manifesto

If there is one topic that I have no natural affinity for, it is checklists. I don’t use checklists. I’m not interested in checklists.

Yet, against all odds, I read Atul Gawande‘s new book about checklists, The Checklist Manifesto in one sitting yesterday, which is an amazing tribute to the book that Gawande has crafted. Not only is the book loaded with fascinating stories, but it honestly changed the way I think about the world. It is the best book I’ve read in ages.

The book’s main point is simple: no matter how expert you may be, well-designed check lists can improve outcomes (even for Gawande’s own surgical team). The best-known use of checklists is by airplane pilots. Among the many interesting stories in the book is how this dedication to checklists arose among pilots.

Even more interesting are the stories about Walmart’s response to Hurricane Katrina, and the real reason why David Lee Roth used to demand that there be a bowl of M&M’s with all the brown ones removed in his dressing room backstage.

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COMMENTS: 56

  1. Paul Harris says:

    I too appreciate the book recommendation! Co-workers used to laugh at me for having the messiest office around, yet the key to my organizational skills was maintaining a checklist. And if I didn’t finish something that checklist remained in my pants pocket to take home and to work on the next day. It truly works.

    As an aside I need to read what the author says about Walmart during Katrina. As a California tourist trapped in the Superdome during Katrina the only thing I saw when leaving was that the Walmarts had the only guards/police protection of any businesses I saw.

    Paul Harris
    Author, “Diary From the Dome, Reflections on Fear and Privilege During Katrina”

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  2. Kahomono says:

    I manage the financial reporting systems for an F100 company. We could absolutely never do a quarterly close if we did not follow a checklist to prepare for receiving and consolidating the numbers from all over the world.

    For hings that seem “Duh!” in the calm of a Monday morning conference room, never underestimate how easily they can get lost in the heat of a Friday afternoon battle!

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  3. Mr T. says:

    I am a fan of Dave Allen – Getting Things Done.

    His argument is that the brain can only do one thing at a time. A checklist takes the need away for the brain to think about what to do next, and concentrate on what it is doing now. (there are some rules on how to use checklists that make this effective)

    I have found this to help me tremendously.

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  4. AaronS says:

    Most people miss the greatest value of checklists. They think it’s all about performing with great efficiency, not failing to cross and t’s or dot any i’s. But the greatest value of checklists is that they serve as a stress reliever. Let me explain with a couple of scenarios….

    When your spouse sends you to the grocery store to buy, say, eight items, well, that’s easy enough…if you don’t get distracted, or can’t contact your spouse via cell phone and confirm the items.

    Or what if you are taking a test and need desperately to remember four very complex formulas? If you’re like me, as soon as the test starts, while the formulas are still fresh in your mind, you write them down on your scratch paper for future reference.

    The point is that your mind can juggle only so much information effectively. If you have too much going on, things get lost in the shuffle. And when you have that nagging suspicion that you are forgetting something…well, that causes stress, tension, and so forth.

    But a list serves as a sort of analog flash drive. It allows you to record information for later use, allowing your mind the freedom to wander as it will.

    Imagine going to the grocery store and repeating, over and over, the 8 items your spouse wants you to purchase, trying to come up with mnemonics, visual connections, or what have you to memorize the list. You dare not turn on the radio or take a phone call–you might “drop” something.

    Checklists take a great weight off of your shoulders. Anyone who claims they can’t see how a checklist would improve their performance…well, they must have a very non-demanding job indeed.

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  5. MITBeta @ Don't Feed the Alligators says:

    I used to be a Nuclear Plant Reactor Operator and I can tell you that not a single switch, valve, operator, etc. is ever touched, let alone manipulated by one hand without a checklist (procedure) in the other hand. Our job was to follow the checklist unless our training, intelligence, experience, etc. told us that the checklist was wrong, in which case we STOPPED and got clarification and permission from the checklist writer, supervisors, etc. before resuming the procedure.

    Much of our continuous training focused on how to properly use a checklist (circle and slash to keep your place…) and to drill this discipline into our heads to the point that it was second nature.

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  6. Chris says:

    “Check-Lists” are standard in the pharmaceutical industry, although they are usually call “Batch Records”. The batch record lists everything you must do and check (temperature, pH, drug concentration etc) as the drug is manufactured. Each step is typically done by one person and signed off by that person plus another. It just makes sense! And should be used in many other procedures/industries.

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  7. Jacib says:

    Also really interesting is the new use of protocols (not really a check list in sense of “make sure i do this and this and this” but more of “if this then that”) in the medical profession increasing doctors’ adherence to evidence based medicine.

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  8. Steve says:

    It is said that now more than 600 of Fortune 1000 companies use a Balanced Scorecard, a form of which has been adapted as part of the Malcolm Baldrige National
    Quality Award Program. A Balanced Scorecard is a great example of a checklist that achieves measurable results because it combines objectives in multiple perspectives, a financial perspective, customer perspective, internal processes perspective, and growth & learning perspective. A checklist may seem a simple thing, but if it is a good list, and most important, you actually implement it along with a prototyping mindset that confirms its effectiveness while trying to modify it as needed based on cumulative experience-then it can be a wonderful thing.

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