What I’m Reading: The Checklist Manifesto

In April of this year, after doing a podcast about cold calling on SalesTuners with Jim Brown, he thanked me with a one-year subscription to ReadItForMe, which delivers book summaries specifically designed for entrepreneurs, executives and business coaches. I was very pleased; book summaries are something I’ve always wanted to explore, yet I was concerned that I wouldn’t make the time to benefit from the service. Much to my delight – and astonishment – one book summary contained a year’s worth of value.

What did I discover in that book summary? How is it continuing to impact me?

In The Checklist Manifesto – How to Get Things Right, Atul Gawande introduces the premise that we can all do better. Despite the growing complexity of our lives, we can improve what we do with one simple method – the checklist.

When I read this, I was compelled to purchase the book immediately. I’ve run my life with checklists since high school but recently, with the arrival of new responsibilities, my life has gotten a bit … messy. Could this book help?

The quick answer is “yes” but not in the way I expected.

Atul Gawande is a beautiful writer and a master storyteller. A topic that could easily be dry and academic is transformed into an easy-to-read flow about real people meeting and overcoming incredible challenges … with the use of checklists. (In fact, the methods Gawande reveals were very likely part of the recent cave rescue in Thailand.)

Engineering, construction, medicine and airline travel are the main disciplines Gawande examines. All of these sectors, like our own lives, are continually impacted by new complexities and demands. In medicine for example: “By 2004, surgeons were performing some 230 million major operations annually – one for every 25 human beings on the planet – and the numbers have likely continued to increase since then. The volume of surgery has grown so swiftly that, without anyone quite realizing, it has come to exceed global rates from childbirth – only with a death rate of ten to one hundred times higher. Although most of the time a given procedure goes just fine, often it doesn’t; estimates of complication rates for hospital surgery range from 3 to 17 percent. While incisions have gotten smaller and recoveries have gotten quicker, the risks remain serious. Worldwide, at least seven million people a year are left disabled and at least one million dead – a level of harm that approaches that of malaria, tuberculosis, and other traditional public health concerns.”

Gawande was approached by the World Health Organization (WHO) in 2006 to “develop a global program to reduce avoidable deaths and harm from surgery”. The book reveals his journey and his discovery of the indisputable value of the simple checklist. What stood out most for me was that every successful checklist involved people talking to each other. Not emailing, not texting, but talking to each other in real time, whether by phone, video or face-to-face.

Examples include:

In construction, when an application called a Clash Detective reveals that the specs from different sectors (electrical, plumbing, structural engineering, etc) conflict with one another,  “… it’s not enough to show the clash on the screen … you have to resolve it, and to do that you have to make sure the critical people talk.”

When Captain Chesley B. “Sully” Sullenberger III famously crash-landed in the Hudson River, it was the first time that he and First Officer Jeffrey Skiles had ever flown together. What Gawande highlights is: “Before the pilots started the plane’s engines at the gate … they adhered to a strict discipline … They ran through their checklists. They made sure they’d introduced themselves to each other and the cabin crew. They did a short briefing, discussing the plan for the flight, potential concerns, and how they’d handle troubles if they ran into them. And by adhering to this discipline – by taking just those few short minutes – they not only made sure the plane was fit to travel but also transformed themselves from individuals into a team, one systematically prepared to handle whatever came their way.”

In terms of improving surgical outcomes, the experience of three hospitals revealed that “their insistence that people talk to one another about each case, at least just for a minute before starting was basically a strategy to foster teamwork” and this led to one of the key elements on the WHO checklist, that “surgical staff members were expected to stop and make sure that everyone knew one another’s names.”

Gawande’s work fuels my passion to not only continue to #InspireConversation but to refine my own checklists at work and at home. The 2009 preliminary data from the global WHO program Gawande helped create revealed that 78% of those who participated in using the checklist observed it preventing an error in the operating room. That’s phenomenal … and why this book deserves our time.

It’s worth noting that Gawande has quite the resume. He is a MacArthur Fellow, a general and endocrine surgeon at the Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and an associate professor at Harvard Medical School and the Harvard School of Public Health, and he also leads the WHO’s Safe Surgery Saves Lives program. In addition, Gawande was recently chosen to be CEO of a new and improved health insurance program for U.S. employees by none other than Warren Buffett, Jeff Bezos, and Jamie Dimon. I believe we will be learning a lot from his upcoming entrepreneurial insights.

#InspireConversation