The Checklist Manifesto

How to Get Things Right
by Atul Gawande | Metropolitan Books © 2009 · 240 pages

Atul Gawande is a surgeon, writer, and public health researcher. He’s also an extraordinary, best-selling author of a number of books. Short story: Want to get things right? Use a checklist. Sounds too silly to work but… It does. Period. Big Ideas we explore include two reasons we err (ignorance + ineptitude), what to do about it (checklists!), how to reduce your Masterpiece Day mortality rate by at least 47% (checklists!), why Van Halen doesn’t like brown M&M’s (checklists!), and your Big 3 Keystone Initiative (checklist!).

Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification but also instill a kind of discipline of higher performance.
Atul Gawande

“Here, then, is our situation at the start of the twenty-first century: We have accumulated stupendous know-how. We have put it in the hands of some of the most highly trained, highly skilled, and hardworking people in our society. And, with it, they have indeed accomplished extraordinary things. Nonetheless, that know-how is often unmanageable. Avoidable failures are common and persistent, not to mention demoralizing and frustrating, across many fields—from medicine to finance, business to government. And the reason is increasingly evident: the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.

That means we need a different strategy for overcoming failure, one that builds on experience and takes advantage of the knowledge people have but somehow also makes up for our inevitable human inadequacies. And there is such a strategy—though it will seem almost ridiculous in its simplicity, maybe even crazy to those of us who have spent years carefully developing ever more advanced skills and technologies.

It is a checklist.”

~ Atul Gawande from The Checklist Manifesto

Atul Gawande is a surgeon, writer, and public health researcher. He’s also an extraordinary, best-selling author of a number of books.

We ended our last Note on The Progress Principle by Teresa Amabile with a Big Idea featuring wisdom from this book. The basic idea of that idea and of this book?

Simple surgical checklists—of the most mundane, “stupid” things like confirming the side of the body on which the surgery will be performed and having the surgical team introduce themselves to one another—can reduce the mortality rates of surgeries by 47%.

After finishing that last Note, I immediately found this book on a bookshelf in my office (we’ve had a bunch of people request a Note on it) and started reading it.

It’s really good. Well written, very compelling. I highly recommend it. (Get a copy here.)

It is also, of course, packed with Big Ideas. Gawande walks us through the power of checklists on “How to Get Things Right.” His emphasis is on his field of medicine/surgery but he highlights the parallels between his world and that of aviation, building, finance and even running a world-class restaurant. The bottom line? Checklists improve performance everywhere they are applied. Yet, for some wacky reason, they are rarely applied.

Of course, I’m all about seeing how simple checklists can Optimize our lives—reducing the mortality rates of our Masterpiece Days. So, that’s where we’ll focus our energy. Let’s jump in!

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About the author


Atul Gawande

Surgeon, writer, and public health researcher.