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  • Writer's pictureLars Christensen

The Checklist Manifesto by Atul Gawande~2 minute read

I finished this book in November 2021. I recommend this book 8/10.

When traveling, I often think how the pilots of a plane must be rolling their eyes when going over a takeoff checklist for the 1000th. Time—but I never want to be a passenger in an airplane where the pilots did not have that discipline. This is a classic book about how those types of checklists can solve complex situations in our lives.

I recently listened to a podcast where it was suggested that this book should be half the length—I disagree; I like the stories. I do wish that the book did spend a little more time on suggesting how you could approach creating your checklist, for that, Check out this site, my great friend Mary Anne shared

Get your copy of the book here.

My notes and thoughts:

  • "A lot of you are going to have to make decisions above your level. Make the best decision that you can with the information that's available to you at the time, and, above all, do the right thing."

  • This was the understanding people in the skyscraper-building industry had grasped. More remarkably, they had learned to codify that understanding into simple checklists. They had made the reliable management of complexity a routine. The routine requires balancing a number of virtues: freedom and discipline, craft and protocol, specialized ability, and group collaboration. And for checklists to help achieve that balance, they have to take two almost opposing forms. They supply a set of checks to ensure the stupid but critical stuff is not overlooked, and they supply another set of checks to ensure people talk and coordinate and accept responsibility while nonetheless being left the power to manage the nuances and unpredictabilities the best they know-how.

  • He designed a little metal tent stenciled with the phrase Cleared for takeoff and arranged for it to be placed in the surgical instrument kit. The metal tent was six inches long, just long enough to cover a scalpel, and the nurses were asked to set it over the scalpel when laying out the instruments before a case. This served as a reminder to run the checklist before making the incision. Just as important, it also made clear that the surgeon could not start the operation until the nurse gave the okay and removed the tent, a subtle cultural shift. Even a modest checklist had the effect of distributing power.

  • Checklist for the checklist:

    • Do you have clear, concise objectives for your checklist?

      • A critical safety step and in great danger of being missed?

      • Not adequately checked by other mechanisms?

      • Actionable, with a specific response required for each item?

      • Designed to be read aloud as a verbal check?

      • One that can be affected by the use of a checklist?

    • Have you considered:

      • Adding items that will improve communication among team members?

      • Involving all members of the team in the checklist creation process?

    • Does the checklist:

      • Utilize natural breaks in the workflow (pause points)?

      • Use simple sentence structure and basic language?

      • Have a title that reflects its objectives?

      • Have a simple, uncluttered and logical format?

      • Fit on one page?

      • Minimize the use of color?

    • Is the font:

      • Sans serif?

      • Upper and lower case text?

      • Large enough to be read easily?

      • Dark on a light background?

      • Are there fewer than 10 items per pause point?

      • Is the date of creation or revision clearly marked?

    • Have you:

      • Trialed the checklist with front-line users (either in a real or simulated situation)?

      • Modified the checklist in response to repeated trials?

    • Does the checklist

      • Fit the flow of work?

      • Detect errors at a time where they can still be corrected?

      • Can the checklist be completed in a reasonably brief period of time?

      • Have you made plans for future review and revision of the checklist?

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