Book Review - The Checklist Manifesto

Periodically you read books which change your habits and make you more effective. The Checklist Manifesto is one such book. Authors who can construct enjoyable prose from subjects as dry as this topic first appears should be treasured.

Although this book is primarily a story detailing the introduction of surgical checklist techniques learned from the aviation industry, Atul Gawande backs up his story with a broad range of examples. And as a surgeon himself, the author is a participant in the story too. I for one prefer to learn from experienced doers over of pure thinkers. 

The crux of the book is simply that by highlighting important steps within a process with defined pauses for team coordination you can eliminate many avoidable errors freeing the mind to work on high-level problems. 

But the problem is that we've come to venerate expertise to a point where we expect the expert to constantly be in control. We accept this situation unquestioned and the expert -whether in control or not - becomes an unapproachable authority. Aviation accidents of yesteryear abound with examples of decisions unchallenged which led to disaster and cost lives. 

How then to implement a simple checklist in teams comprised of subject matter experts? Gawande explains that ego must be left at the door in order that experts can be challenged by members of a hierarchically flattened team. 

Perhaps most difficult of all is consistency. We can all see the advantages provided by checklists which reduce simple errors. Indeed the author provides many statistical examples highlighting the transformative effects realised. But the self-control to step through a list for every repetitive process every time, sometimes through many repetitions in the same working day, requires discipline.

Discipline is hard – harder than trustworthiness and skill and perhaps even selflessness. We are by nature flawed and inconstant creatures. We can’t even keep from snacking in between meals. We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at. The Checklist Manifesto, page 183.

And with this insight we have the habit changing gem that will make you more effective. Expertise alone is not enough. It must be harnessed within a framework that allows experts time to devote to those higher level problems without commonplace distractions.

Buy it. Read it. Use it.