The Checklist Manifesto: How to Get Things Right by Atul Gawande

The book can be summed up into two main points: we need checklists and nurses are heroes.


The New York Times bestselling author of Better and Complications reveals the surprising power of the ordinary checklist

We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.

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. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.

An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right. from Goodreads


This book stressed me out. Between the tragedies that befell airline passengers to the routine dangers of medicine, this quick read convinced me that this is not a book to read if you have surgery scheduled. I knew that things could and did go wrong but, holy moly, Dr. Gawande did not need to detail quite so much for me. I suppose though, the level of importance only highlights how powerful a simple checklist can become.

This is, however, a great book to give to a nurse in your life. Dr. Gawande points out numerous times the plethora of ways nurses save lives and the historic and cultural reasons that they do not have more power. From hinting that gloves need to be changed to reminding doctors of medication interactions, every step of the way there is a nurse there to advocate for a patient. If only the system allowed them the privilege of speaking up more….

I picked this book up, initially, to see how I could take my natural inclination to write down tasks and create a master list that would be a useful combination of habits and to-do lists. I was convinced, before reading a word, that this would be a good idea. Unfortunately, the book spends 90% of the time convincing me that all I need is a checklist. And, zero time on the actual how-to of making a checklist.

It did, however, clear up for me the difference between a check-list and a to-do list. What I am doing is a to-do list. I sit down, each day, and dump all the things I am worrying about into my to-do list. What this book is trying to establish is that everything we do in life can be summed up in a checklist that, if used properly, would stop us from making simple mistakes.

Dr. Gawande focuses on two fields, medicine and aviation. This is a common comparison since anesthesiologists took to studying flight checklists and applying them to anesthesia to prevent death. Both are high risks fields with both a repetitive aspect and an unpredictability that requires on-demand decision making. Both fields have found that the mundane and the improbable can be predicted, and dealt with, by making checklists. Not just mental ones. Checklists that are written down and agreed upon in a field, used consistently, and edited when necessary.

I can certainly see the benefit of this. Many daily tasks have accepted the checklist without our knowledge through automated use. Even this blog has checklists embedded in them that ask me to look and make sure I have tagged everything, linked it to social media, verified when the blog would be published etc.

I find myself fascinated by this idea. Is there a way to write down my own more complicated tasks to avoid mistakes? And, while I am disappointed to not have learned quite what I set out to discover when I started the book, it was a quick read by a leading expert in checklists in surgery that has kept me wondering since I finished the book. If you are curious about whether a checklist could change your career, this is a great place to start. Just don’t, seriously don’t, read it if you expect to be under anesthesia anytime soon.

Tell me, please! Do you use any checklists in your life or work?


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