The Checklist Manifesto

If there is one topic that I have no natural affinity for, it is checklists. I don’t use checklists. I’m not interested in checklists.

Yet, against all odds, I read Atul Gawande‘s new book about checklists, The Checklist Manifesto in one sitting yesterday, which is an amazing tribute to the book that Gawande has crafted. Not only is the book loaded with fascinating stories, but it honestly changed the way I think about the world. It is the best book I’ve read in ages.

The book’s main point is simple: no matter how expert you may be, well-designed check lists can improve outcomes (even for Gawande’s own surgical team). The best-known use of checklists is by airplane pilots. Among the many interesting stories in the book is how this dedication to checklists arose among pilots.

Even more interesting are the stories about Walmart’s response to Hurricane Katrina, and the real reason why David Lee Roth used to demand that there be a bowl of M&M’s with all the brown ones removed in his dressing room backstage.

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  1. Philippe says:

    Re: why David Lee Roth used to demand that there be a bowl of M&M’s with all the brown ones removed in his dressing room backstage.

    It was to be able to test to see if his contracts were actually read.

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  2. zoltan says:

    I’m a professional magician – my list of equipment for any given show contains a list of all sorts of fiddly small items and a range of liquids, specific clothing, etc. Combustible liquids are stored safely in a metal box, some items must be stored in a freezer, or in their charging stand (for electronic gizmos)…I’d be lost without my pre-show checklist to ensure I have all the gear I need before a show.

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  3. Michael Scriven says:

    Checklists have long been regarded as beneath the level of serious consideration by methodologists and others interested in the logic of the disciplines. But they are more sophisticated than they appear–and are perhaps the key methodology of those disciplines that really treat theory and practice as equals, e.g., surgery, engineering, neural and public economics, program and product evaluation. Recently some effort has been made to set this out: for more details about what may be the key methodology of the 21st century, see “The Logic of Checklists” first posted in 2000, at:
    http://www.wmich.edu/evalctr/checklists/papers/index.html

    Michael Scriven

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    • Walter P. Komarnicki says:

      checklists are a form of decision tree, and eliminate indecisiveness and confusion. they clarify and focus on what needs attending to at this very moment, and help us get to where we’re meant to be in the shortest, most cost-effective time. and avoid forgetting to remove sponges and scissors from the insides of the patient after the operation – and incurring the consequent costs.

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  4. James says:

    I’m an academic, and frankly checklists don’t seem that important to me, aside from the five-things-I-have-to-do-before-I-fly-to-Ohio variety. I can’t even imagine how they could possibly improve my performance. I bet this is true of most academics — if you forget something, you can always add it in later.

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  5. nick Grosvenor says:

    This is why I read this blog. To get book suggestions from some of the smartest people around. Great!! I just went out and bought the book today.

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  6. Joe Smith says:

    ISO quality control suggestions for business processes is all about checklists.

    So called “expert” systems are computerized checklists in disguise.

    Call it a checklist or a protocol, it reflects the accumulated experience of the discipline. Personally, I would like to see Judges use a explicit checklist in determining whether evidence is credible rather than just flying by the seat of their pants all the time.

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  7. David says:

    To James:

    I guess as an academic you can do tomorrow what you forget to do today, but for those who can not afford to miss something the checklist is important. I was never one for the checklist until I started to learn to fly. Then I became all about the checklist because the consequences of forgetting even the smallest item can be the difference between a good flight and a not so good flight; okay life and death. I guess to checklist or not checklist comes down to the penalty exacted for missing something.

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  8. Christopher Strom says:

    “I can’t even imagine how [checklists] could possibly improve my performance.”

    While I raise an eyebrow at the pride in limited imagination, I suppose the utility of a checklist is far more clear in fields where success and failure (and the work in general) is more clearly defined and therefore measured, such as surgery, engineering, or piloting aircraft.

    I don’t mean to single out academia – business management suffers this general problem as well.

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