The Checklist Manifesto: How to Get Things Right

Useless book

Atual Gawande is an American-raised indian Born surgeon practicing in Boston and he is also a writer for the New Yorker he has written 3 books, all three of them excellent. Complications his first is a revelation, better his middle one I enjoyed less, and this third one, the Checklist, is spellbindingly good Gawande is no mere doctor he was also a Rhodes Scholar (i.e seriously bright) earning a PPE in Oxford England in the late 90s. To me, it seems that this is the secret to his appeal, he is a seriously intelligent and gifted academic, who later turned to the practical art of surgery. So he is very well rounded. The central feature of his writing is to convey to the layperson that there are no easy choices, no bravura macho surgeons who can reliably fix everything. He is searingly honest about the shortcomings of medecine and his own shortcomings in particular, relaying again and again over all three books where he has screwed up, often very badly. These accounts read very well as fair accounts of how difficult it is to actually do any significant surgery on anyone without killing them, or making them iller. He is neither too harsh nor seeking to exculpate himself. He starts with the premise that (nearly) all doctors want to help, but that medecine can be horribly complicated and difficult, that they make mistakes and they are sometimes out of their depth, and that they are all learning on the job. What is magnificent about checklists is that, you'd think there wouldn't be much to say about them, that could hold your interest for very long. In this you'd be seriously wrong. it turns out that our prejudicial views on checklists (we don't like them and find them patronising) is in inverse proportion to how useful they are regardless of your levels of commitment to excellence, ingenuity or sheer brilliance. In the heat of an emergency many of the things that go wrong are EXACTLY the kinds of things that simple checklists can help you spot when your mind skips steps to focus on what you think is essential. in this book, Gawande focusses on the usefulness of checklists in medecine, commercial flying, architecture/engineering and finance and he does a masterful writerly job of keeping you engaged and enlgightened as he slowly builds a very compelling case for dropping the prejudice and adopting the checklist in more and more areas of life. One fascinating aside to me, is that the going through a checklist with other people (say before operating) was no mere mechanical procedure, but that it had a 'activating effect' of equalising the status and hierarchy of all concerned, suddenly you were no longer just some nurse or mere technician in awe of the surgeon. In fact, taking responsibility for your own part of the checklist made you a vital member of a team, and it was this team building spirit that made people work better together, think better and most importantly handle disasters with far greater focus as they knew each other and didn't waste time on blame or evasion. Much more commonly checklists even prevented disasters because since everyone felt part of a team, the junior members were not so intimidated into not pointing out errors which could later develop into disasters. It's a list on a piece of paper, but adhering to it in this public and collegiate way, had a profound impact on the psychology of the practitioners solidifying their sense of being part of a team and therefore being steadfast in calling things as they saw them, rather than simply deferring to authority and keeping quiet (a frequent cause of all types of disasters). Gawande is a good friend of Malcolm Gladwell, but he is no mere wannabe, Gawande has his own unique authorial voice and he comes across as a genuinely likeable, clever decent and highly sophisticated but down to earth human being. He is such a good writer that not least of his skills is how funny he sometimes is when he points out the absurdities of human foibles (especially his own) and of taking on any ambitious human endeavour. He is no pious preacher.

Greta book that help me with getting the things right!

Good one, covering practices across industries. If followed properly, life changing book.

I measure a great book by how often I'm reading sections to my long-suffering wife/listener. Another indicator: I read the book slowly, tasty morsel by tasty morsel. Lastly, there's serious emotion when I turn the last page--somehow hoping it could go on and on. This book scores 10s on all counts. Really? A book about checklists is that good? Yes. If you enjoyed Malcolm Gladwell's Outliers: The Story of Success , you'll love this one. [x] 1. Atul Gawande, a surgeon and staff writer for The New Yorker, leads the World Health Organization's Safe Surgery Saves Lives program. If you didn't believe in checklists before, you'll be a born-again checklist-maker after Chapter 1. [x] 2. He quotes a 1970s study on "necessary fallibility." It cites two reasons we fail at stuff: a) ignorance and b) ineptitude. In the latter, "...the knowledge exists, yet we fail to apply it correctly." [x] 3. Caution! If you're having surgery soon, or have friends or family facing the knife, you may want to skip this book--or ask your surgeon's views on operating room checklists. (In a recent global experiment, a two-minute pre-surgery team review of a standard checklist has dropped infection rates, death rates and complication rates by a staggering amount.) [x] 4. Pilots have long been the checklist gurus--but the art and science of well-crafted checklists have not found favor in other professions or industries...yet. The Captain Sully story, though expected, still caused my heart to beat fast. You'll appreciate how checklists saved the day for the "Miracle on the Hudson." [x] 5. The chapter, "The End of the Master Builder," takes you into the elite world of checklists created under the hardhats of McNamara/Salvia, a Boston high rise construction firm. The dingy construction trailer is long gone. In its place, "...on the walls around a big white oval table, hung sheets of butcher-block-size printouts of what were, to my surprise, checklists." [x] 6. Checklists are "ridiculously simple." What seems obvious, isn't. Checklists enhance teamwork--even among virtuoso surgeons. "There's a reason much of the world uses the phrase, operating theater." [x] 7. Boeing's checklist expert uses "pause points" when building checklists for pilots in crisis. Within each pause point, he limits the checklist to between five and nine items. I had no idea that there were checklist connoisseurs. [x] 8. For crisis lists, decide whether you want a DO-CONFIRM checklist (do what your gut tells you, then go back and confirm you did it) or a READ-DO checklist (more like a recipe). [x] 9. Gawande interviewed the managing partner of a California investment firm who is a checklist zealot. He cited the "cocaine brain" that researchers often experience when investigating company financial reports. Without a thorough checklist (honed over years of experience), a greed mode kicks in and wipes out thoughtful discernment. They use a "Day Three Checklist" to avoid disasters. "Forty-nine times out of fifty, he said, there's nothing to be found. `But then there is.'" [x] 10. "Fly the airplane," amazingly, is the first item on a checklist for engine failure on a single-engine Cessna airplane. "Because pilots sometimes become so desperate trying to restart their engine, so crushed by the cognitive overload of thinking through what could have gone wrong, they forget this most basic task. FLY THE AIRPLANE." In one study of 250 staff members (surgeons, anesthesiologists, nurses and others), 80 percent reported that the new checklist had improved the safety of care and 78 percent "actually observed the checklist to have prevented an error in the operating room." Yet, 20 percent gave it a thumbs down. Then Gawande asked one more question, "If you were having an operation, would you want the checklist to be used?" A full 93 percent said yes!

This is a wonderful book! Descriptions of how checklists can help are provided for surgeries, airlines and building skyscrapers in this easy to read book. As an investor I can see how checklists can help in that field as well as many others. A checklist can help make a very difficult job a little easier by ensuring that more critical items are not missed. As I age and the inevitable surgeries appear on the horizon I am pleased that checklists in surgery theaters have taken root and are being widely used. A very simple tool that can help eliminate or reduce catastrophic errors. The book will leave you thinking about applications in your own field of expertise. I believe that can only lead to improvements in a wide range of activities. This is a book that will help in any endeavor where complications can occur and should be eliminated early on in the process. A very worthwhile read.