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The Checklist Manifesto: How to Get Things…

The Checklist Manifesto: How to Get Things Right

by Atul Gawande

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An excellent discussion for a proposed resolution to a major problem. Gawande's style is very Gladwellian. He posits the lowly checklist to the reader as a solution and sells and sells the point with numberous quick digestible examples. Fascinating though, is what he and Gladwell attribute flight heroism to. Gladwell says it's training and decision making. Gawande says its procedure. Calls to mind another Gladwell "argument" with Steven Levitt about the crime drop in the 90s. Gladwell says it's the "broken windows" phenomenon, Levitt says Roe vs. Wade averted the birth of criminals. These debates, and this book, are absolutely fantastic.
  MartinBodek | Jun 11, 2015 |
This compelling book written by a successful surgeon argues the case of using a humble checklist in major medical surgery as Airline Pilots do in flying. Checklists, suggests (and proves) Dr. Gawande can save lives. It's as as simple as that. The writer shows us in detail how a simple checklist can minimize mistakes that lead to horrendous problems and even fatalities.

This manifesto is electrifying and I for one loved it. ( )
  Writermala | Apr 19, 2015 |
recommended by Christie Johnson RN, 2014
  Mikenielson | Feb 24, 2015 |
Really fascinating read. Gawande describes how checklists can improve outcomes in processes that involve teams of people. The book argues that a checklist's effectiveness comes not from replacing human reasoning, but ensuring that communication and consideration of mission critical steps has occurred. There's a subtle theme that checklists distribute power to the less dominant members of a team.

Surprisingly (or not), good checklists are difficult to create and must balance comprehensiveness with brevity. Gawande's own checklist design went through many iterations before it was culled to 3 groups of 16 steps, each administered at separate pause points e.g. before incision.

There are a number of fascinating anecdotes. Most involve surgery, as Gawande is a surgeon by trade, but there are also good examples from construction and aviation. I think this would be a good to read with Kahneman's "Thinking Fast and Slow", as it seems to me that the checklist forces its user into a deliberate mode of thought, or System 2 thinking as Kahneman describes it. ( )
  rywang | Nov 23, 2014 |
Shows the power of process. Why it makes sense to take wisdom and put it into something as mundane as a checklist.

It saves lives for pilots and should be used more by doctors.

Two Kinds of Checklists
When you know what steps to take (like a pilot) then you list the actions.

When you don't, (like building a new kind of sky scraper) you list all the people who need to be in the room at various points in the process. ( )
  BizCoach | Aug 4, 2014 |
Showing 1-5 of 74 (next | show all)
I already know that "The Checklist Manifesto" will be on my list of best books this year. Gawande writes with gusto, humor and clarity. He features his mistakes -- always a good sign in a reporter -- including the one that ends the book.
Read this book and you might find yourself making checklists for the most mundane tasks—and be better off for it.
But that narrative gift doesn't transfer automatically to accounts of in-flight safety checks and structural engineering near-misses. Gawande's style is always clear, with the crispy lilt that is a trademark of the New Yorker, where he is also a staff writer. But there's no escaping the fact that this is a book about, well, checklists. Hemingway would struggle to make it gripping. Gawande does well to pull off engaging.
added by stephmo | editThe Observer, Rafael Behr (Jan 24, 2010)
Gawande, a professor of surgery at Harvard Medical School and a staff writer at The New Yorker, makes the case that checklists can help us manage the extreme complexity of the modern world. In medicine, he writes, the problem is “making sure we apply the knowledge we have consistently and correctly.” Failure, he argues, results not so much from ignorance (not knowing enough about what works) as from ineptitude (not properly applying what we know works).
Dr. Gawande is right to note that checklists are indispensable in situations where a small mistake can lead to tragic consequences, as in surgery. But his call for a broad checklist regime would be counterproductive—fraught with all the dangers of bureaucracy and excessive law.

» Add other authors (4 possible)

Author nameRoleType of authorWork?Status
Atul Gawandeprimary authorall editionsconfirmed
Fyfe, LisaCover designersecondary authorsome editionsconfirmed
Levavi, Meryl SussmanDesignersecondary authorsome editionsconfirmed
Lloyd, John BedfordReadersecondary authorsome editionsconfirmed
Schloss, RoslynCopy editorsecondary authorsome editionsconfirmed
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I was chatting with a medical school friend of mine who is now a general surgeon in San Francisco. (Introduction)
Some time ago I read a case report in the Annals of Thoracic Surgery.
Faulty memory and distraction are a particular danger in what engineers call all-or-none processes: whether running to the store to buy ingredients for a cake, preparing an airplane for takeoff, or evaluating a sick person in the hospital, if you miss just one key thing, you might as well not have made the effort at all.
...the real lesson is that under conditions of true complexity--where knowledge required exceeds that of any individual and unpredictably reigns--efforts to dictate every step from the center will fail. People need room to act and adapt. Yet they cannot succeed as isolated individuals, either--that is anarchy. Instead, they require a seemingly contradictory mix of freedom and expectation--expectation to coordinate, for example, and also to measure progress toward common goals.
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The modern world has given us stupendous know-how. Yet avoidable failures continue to plague us in health care, government, the law, the financial industry--in almost every realm of organized activity. And the reason is simple: the volume and complexity of knowledge today has exceeded our ability as individuals to properly deliver it to people--consistently, correctly, safely. We train longer, specialize more, use ever advancing technologies, and still we fail.
Now, acclaimed writer and surgeon Atul Gawande makes a compelling arguement that we can do better and finds a solution in the most humble of places: the lowly checklist. He explains how checklists have made possible some of the most difficult things people do--from flying airplanes to building skyscrapers of mind-boggling sophistication. And drawing on his own experience, he shows how applying this idea to the immensely various and complex world of surgery produced a ninety-second checklist that reduced deaths and complications by more than one-third in eight hospitals around the world--at virtually no cost and for almost any kind of operation.
In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection, and to the flight deck of a crashing plane. Along the way, he reveals what checklists can do, what they can't, and how they could bring about striking improvements in fields well beyond medicine, from homeland security to investment banking to professions and businesses of all kinds.
The Checklist Manifesto is a gripping exploration of the nature of complexity in our lives and essential reading for anyone working to get things right.
-flap copy
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Reveals the surprising power of the ordinary checklist now being used in medicine, aviation, the armed services, homeland security, investment banking, skyscraper construction, and businesses of all kinds.

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