Makin’ a List, Checkin’ it Twice

Checklists, it seems, are not just for Santa.

I’d seen the book The Checklist Manifesto: How to Get Things Right by Atul Gawande back in 2009, propped up high as a must-read business book in airport bookstores and listed on the New York Times Bestseller List. The author is a surgeon, a professor at Harvard Medical School, a MacArthur Fellow and a staff writer for the New Yorker.  Hardly seems fair, but he’s also clever, charming and erudite on TV and the Internet (witness his TED Talk). And he’s written a mind-blowing book about the power and simplicity of checklists.

Dr. Gawande is a beguiling writer and storyteller, spinning tales about his own experiences in the operating room with humor and humility. Invited by the World Health Organization to create a “Safe Surgery Saves Lives” program, he traveled around the world building a team that researched how checklists synthesize what’s critical to safe and healthy outcomes before, during and after surgery. Dr. Gawande also visited Boeing to learn how checklists are a part of the culture of aeronautics, telling the now-famous story of the plane that landed in the Hudson River, piloted by Captain Chesley “Sully” Sullenberger, and everyone survived. Yep, there was a checklist.

Dr. Gawande also wondered, as I do when I look up at skyscrapers in Chicago, how on earth big buildings get built. So he turned to the construction team on the campus of Brigham and Women’s Hospital in Boston where he practices medicine to learn more. Turns out that checklists are a crucial part of that dance between architects, engineers and all the professionals and trades people who contribute to the process of building a structure.

TheChecklist-bookshot-432x550Before you accuse me of being a plot-spoiler, let me just share that the stories he tells, and the results of Dr. Gawande’s research, are staggering. In his study of operating rooms using a checklist, the reduction rates of infection, the increased survival rates of patients and the avoidance of near-miss catastrophes are all results of adhering to the discipline of using a checklist. Do we resist checklists? Absolutely. Do we need them? It appears so.

This isn’t a book just for public health officials, or for pilots, or for architects and engineers. This is for anyone who has a complex job and who can’t rely on a memory that is notoriously fickle. While reading The Checklist Manifesto I thought of all the checklists I’ve created and abandoned… checklists for packing light (an oxymoron in my case) for a business trip, for “on-boarding” new clients, or for ensuring I bring everything with me to my speaking engagements. Why do I ditch them? Because I’m a lot like the people Dr. Gawande interviewed, even like Dr. Gawande himself: checklists seem absurdly simple and, well, kind of stupid. Like we can’t remember this stuff ourselves! Turns out, we can’t.

So I’m going to track down those checklists, dust them off and refine them according to the Checklist Manifestoguidelines. I invite you to do the same for whatever ambitious goals you’re trying to achieve. The checklist must be simple and able to fit onto one page. The items must be critical to the outcome. Consider it a work-in-progress: refine it, hone it and revise until it works for you. Then–and here’s the kicker–use it. Consistently, over time. Then measure the results and let me know what you learn. I promise to do the same.

2 thoughts on “Makin’ a List, Checkin’ it Twice

  1. Vickie – Thanks for the writeup. I just read this book and tried making my first checklist. Two things I learned are
    1. The list doesn’t tell you “how” to do a task, it reminds you “to” do a task. Presumably you already know how.
    2. You need to define a time in your process when the checklist should be executed. This is different than just a “to do” list. It makes you stop and verify before proceeding.

    1. This is an important distinction–a checklist is NOT a to-do list! And yes, timing is everything. I asked my son’s surgeon if they use a checklist in his surgery suite and he said “Absolutely.” It’s a “before, during and after” process. Thanks for chiming in, Sue!

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