The Checklist Manifesto

"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

Best of, top ten, and to-dos. We are fascinated with lists – using them to organize our lives and organize information. But according to Atul Gawande, it’s the checklist we should pay closer attention to. In his latest book, The Checklist Manifesto, Gawande shows just how powerful well-designed and properly implemented checklists can be in reducing mistakes in fields such as medicine, aviation, construction, and finance. And he says we can all benefit from them, no matter what type of work we do.

Yet many of us resist the often mundane task of ticking a box or following a preset protocol. We see ourselves as intelligent, competent beings capable of relying on our own judgment, memory, or perceived thoroughness, especially when it comes to routine tasks.

But Gawande shows through several examples that even the most skilled among us miss critical steps that can lead to unintended and sometimes fatal consequences.

The Big Idea

The Big Idea: The biggest takeaway from the book

How Much Are You Leaving To Chance?

"Under conditions of complexity, not only are checklists a help, they are required for success. There must always be room for judgment, but judgment aided - and even enhanced - by procedure."
- The Checklist Manifesto, page 79

Gawande suggests that people tend to fail for two main reasons. The first is ignorance – having only a partial understanding of the task in front of us. The second is ineptitude – instances where we have the knowledge but we fail to apply it correctly.

But it’s not ignorance that leads to mistakes in today’s world. We have access to more and more information and our knowledge base is growing every day in every field. It’s the complexity of our world that is increasing, making it more difficult to deploy our knowledge predictably and routinely. Medicine is becoming more sophisticated – same with raising skyscrapers and responding to natural disasters.

As the complexity of the challenges, problems, and tasks we face increases, we can’t just rely on memory or our “routine” to help us perform at the highest level. Gawande points out that, “[checklists] remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification but also instill a kind of discipline of higher performance.”

Insight #1

An actionable way to implement the Big Idea into your life

If You Build It

"The fear people have about the idea of adherence to a protocol is rigidity. They imagine mindless automatons, heads down in a checklist, incapable of looking out their windshield and coping with the real world in front of them. But what you find, when a checklist is well made, is exactly the opposite. The checklist gets the dumb stuff out of the way."
- The Checklist Manifesto, page 177

Intelligent, educated, and experienced people resist having tasks or procedures that seem routine reduced to a checklist. Want to avoid this in your organization?  Build good checklists. Bad checklists are long, impractical, and vague. Often they are designed by people with no real hands-on experience of the situation or the nature of the task. And they are often tossed aside.

Gawande offers some tips for building good checklists:

  • Make them precise.
  • They should be efficient, to the point, and easy to use even in the most difficult situations.
  • Do not try to spell out everything.
  • Provide reminders of only the most critical and important steps – the ones that even highly skilled professionals using them could miss.
  • Above all, make sure they are practical.

But no matter how good they are, remember, “By themselves, checklists cannot make anyone follow them.”

Insight #2

An actionable way to implement the Big Idea into your life

What's Your Opportunity?

"We have an opportunity before us, not just in medicine, but in virtually any endeavor. Even the most expert among us can gain from searching out the patterns of mistakes and failures and putting a few checks in place. But will we do it? Are we ready to grab onto the idea?"
- The Checklist Manifesto, page 159

Whether in medicine, customer service, or auto repair – predictable, repeatable results are the cornerstone of the most successful businesses. One of the simplest ways of achieving high performance is eliminating unnecessary mistakes, especially when pride is the largest obstacle.

Part of the beauty of checklists is their versatility. You can use them as a way to ensure proper execution or as a tool when things don’t go as planned. The airline industry is a perfect example. Pilots go through a number of pre-flight checklists to make sure everything is in order and no steps were overlooked. And for an issues mid-flight, they again refer to a checklist to take corrective action.

Here are three suggestions on how you can implement checklists more effectively:

1. Identify areas of opportunity: What areas of your business could benefit from a checklist? How could you begin to reduce the number of mindless mistakes that lead to unhappy customers, failed execution, or even something far worse?

2. Check your ego: Throughout the entire book, ego more than anything seems to be the largest obstacle to implementing checklists. Remember, they are not intended to undermine your intelligence or ability. They are a tool to combat the increasingly complex nature of our lives.

3. Curate: Not everything requires a checklist, nor are they effective for every situation. The key is using them only in the most essential places and to be diligent about making them practical and precise.

The Checklist Manifesto is a short, fast read. But don’t be fooled, its implications are great. As we continue to have greater access to information and the ability to acquire knowledge in various fields and industries, it will be those who can deploy it the most reliably who will succeed.

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Joe McGonigal

ABOUT Joe McGonigal

WHO ARE YOU? My name is Joe McGonigal. In October 2012, after 12 years as a sales executive with a large healthcare distributor, I left to start my own venture...
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