Book Review: The Checklist Manifesto: How to Get Things Right

Professionals spend years developing expertise. We expect it as one of at least three characteristics that define a profession.

• Selflessness -- put the needs of the person you serve above yourself
• Skill -- expertise in a body of knowledge
• Trustworthyness -- following a code of ethical conduct

Unlike most professions, airline pilots have a fourth; discipline -- developing and applying a consistent set of behaviors when things go wrong. As a surgeon, Atul Gawande led a team to develop a surgical checklist for the World Health Organization as a means of improving outcomes in hospitals around the world. This book is both the story behind that project and a collection of stories showihng the value of checklists in any complex profession.

Checklists are useful in two kinds of situations. The most common is in routine circumstances to make sure everything that should happen does hapen. They are also useful in high risk situations for a team to consider the problems which might arise and outline a contingency plan.

Although the book offers guideliens for deveoping checklists (simple, clear, focused on vital items only, etc.) it does so in the context of stories which illustrate their value. The book males a strong case for the use of checklists. I would have liked to see something more explicit in implementation guidelines.

The author strongly makes the case that checklists can save time, money, and lives. Even so, professionals resist using them. High priced, high tech solutions with similar success get aggressively marketed and enthusiastically implemented. It seems to me that developing and implementing checklists is appropriate technology which makes extreme common sense everywhere.