Checklists

One of my new favorite authors is Atul Gawande.  He is a surgeon who has written several very interesting books.   Last summer I read one of his earlier books called Better:  A Surgeon’s Notes on Performance and I wrote about it on my other blog.   This past week I discovered he had a new book out called The Checklist Manifesto:  How to Get Things Right and I’ve already downloaded it to Kindle and read it.  I actually stopped reading the giant new Stephen King novel 20% of the way in to read this one and now I’m back to the long Stephen King journey.

This new book is also excellent and highly recommended.   It is about the value of having checklists to cover important things in our operations.   It is about applying this kind of discipline to many of the things we do in the critical systems and operations around us.

There is a significant amount of time discussing the role of checklists in the cockpit of airplanes and how the airline industry has a culture of checklists to cover all kinds of boring and rare but critical events.   There are pre-flight checklists to cover the mundane that the crew needs to make sure to cover every single time and there are checklists when warning lights go off, engines fail and planes lose pressure.   When bad events happen with airplanes the industry quickly studies what happened, learns from the event, and then issues new directives and in many cases new checklists as appropriate.  The books talks about a door failure event on one flight that cost many lives that was studied, checklists were modified, and when the same event happened on a similar flight, the crew handled the problem differently and landed safely.

Other parts of the book talk about developing simplified checklists to use in the operating room before the procedure begins, before the first incision and after surgery completes.   One of the most interesting learnings was for everyone to introduce themselves to one another to make sure that the team that assembles in the operating room at least knows each others names and takes a simple step towards being a team.   One of the other steps is just asking if anyone has any concerns about what they are getting ready to do.   The author talks about many times where these kinds of discussions uncovered a piece of information that one person in the room knew but others didn’t.

Examples from the financial worlds are also discussed in one of the chapters.

This same thinking should apply in our data centers, our network security operations, and in our software production and quality control processes.  When we start a conference call, we should make sure everyone knows who is on the phone.  When we have complicated processes that we are managing and changing, we should develop checklists and use them.  When we have failures, we need to learn from them and modify instructions for the next time.  We need to have this kind of culture that is learning and adapting.

I very much recommend the book and will be looking for any future writings by the author.

I should add that this is highly related to the fast collaboration ideas and communication ideas that are being discussed all over the place.

5 thoughts on “Checklists”

  1. It seems too obvious and simplistic, but even highly skilled, highly experienced professionals benefit from standardised checklists, especially in a medical environment.

  2. It does seem obvious and simplistic and the author talks about that point too. I’ve had several people come up to me since I recommended this book who have since bought and read the book and they’ve all enjoyed it an thought it was most interesting.

  3. Hi – I also just finished reading Atul Gawande’s book and loved it. It is a simple low-tech idea and I agree — we should all implement to catch those things which we most commonly fail at in our daily operations, and during times of stress.

    The other thing I picked up from his book was the idea of “giving permission” for people who have less power on the team to question the authority figures (the surgeon, lead pilot, etc.) The protocols around the checklist allow for distribution of power. Thus the reason introductions are so important – it gives people a voice.

    I might go back and check out his other books based on your review!

    thanks, great post.

  4. Rani,
    Definitely check out his book called ‘Better’ which is about measuring things. Highly recommended.

    Thanks for stopping by,

    Mark

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