It is week 3 of our re-read of The Checklist Manifesto by Atul Gawande (use the link and buy a copy so you can read along). Chapter 2 continues building the case for checklists to deal with complex and complicated environments. This chapter firmly pins down the idea that checklists save time, money and lives.

Chapter 2 continues using examples where knowledge, process, and memory collide. The first example tells the story of how the B17 (World War II heavy bomber) failed its initial tests because the very experienced test pilot could not remember all of the steps needed to get the plane in the air and keep it there. The solution was a simple checklist rather than trying to increase the training of already very experienced test pilots or trying to focus on rote memorization. A simple, well-tuned checklist is more effective and empowering in complex situations rather than putting the onus on individuals knowledge and recall because checklists remind us of the minimum necessary steps in a visible and explicit fashion.

The medical examples in Chapter 2 tell similar stories and also highlight that checklists can empower participants in the process defined in the checklist. In the examples, the nurses were able to hold each and others (including doctors) accountable because the steps are visible and explicit. This accountability point is important because there are times when steps are not needed therefore skipped. Even when skipping steps for good reasons, it is easy to fall into the trap of making mistakes of omission.  Allowing participants to call each other out helps to errors of omission.

The final example goes back to the drowning victim in Chapter 1. Checklists have operationalized the process and involved the right people to ensure proper staging. All of the examples in the chapter show measurable improvement (it is a book on checklists). Checklists have a track record of saving money, delivering value and in many cases saving people.

Checklists are useful!

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Previous Installment:

Week 1 – Approach and Introduction

Week 2 – The Problem With Extreme Complexity