The Checklist Manifesto: How to Get Things Right

“The modern world has given us stupendous know-how.  Yet avoidable failures continue to plague us….the reason is simple:  the volume and complexity of knowledge today has exceeded our ability as individuals to properly deliver it to people….”  Atul Gawnde, MD  The Checklist Manifesto: How to Get Things Right

Gawnde has a very simple premise.  He believes and preaches the gospel of the checklist.  If you’ve ever flown an aircraft, you know checklists.  Ask any experienced pilot what GUMPS means and you’ll get an earful.  If they’re old enough, they might even tell you about Charlie GUMPS!  Why do pilots and nuclear plant operators and many other safety critical professions rely so heavily on the checklist?  Because they employ humans.

Humans are amazing creations, capable of discovering the fundamental principles of the universe, crafting soaring works of art, and joining together to solve the problems of a planet.  We also forget things, particularly under stress.

Initially skeptical that something so complex as medicine could be aided by the humble checklist, Gawnde examined the data and ran some experiments.  By only implementing and enforcing a checklist for certain procedures, the infection rate and the associated death rate in intensive care units was not “reduced” or “halved”, it was nearly eliminated.  The results were akin to the discovery of penicillin.

Why?  Because even the best trained surgeon or nurse forgets things.  A tiny step left out of a central line insertion can lead to infection and death.  The checklist, properly used, nearly eliminates this.

OK, you’re not a surgeon and you don’t work in a hospital, so why is this important to you (other than you might one day be a patient)?  Because the lessons can be applied to almost any industry.  Did your best salesperson lose the big deal because she forgot to send a software key and they couldn’t try it out over the holidays?  Was that 1,000 gallon batch of micro-brew ruined due to a triple helping of hops?  Use your imagination.

I can hear the objections already.  “Our sales cycle is too complex for this.”  “My end users would never go along with it.”  Let me ask you, is your sales cycle more complex than open heart surgery or landing a jumbo jet in in the river after engine failure?  Are your end users higher maintenance than thoracic surgeons or fighter pilots?  I didn’t think so.

Look, you’re not going to be converted on the basis of one blog posting;  I wasn’t.  Get the book and read it.  It’s not a huge tome and the author’s style is conversational and his stories, riveting.  Read it and let me know what you think.  I’m off to work on my checklists for government sales….