The Checklist Manifesto: How To Get Things Right (Every Time) by Atul Gawande: A Review
by Cynthia Lesky, Threshold Information Inc.
What do the following activities have in common?
Building a bridge… Flying a plane… Providing consistently high-quality business intelligence.
One thing they have in common is that they are all complex processes requiring a delicate balance between process on one hand and creativity grounded in expertise on the other hand. And because this is true, each activity can benefit by adherence checklists.
To learn some of the fine points of using checklists, turn to Atul Gawande. Dr. Gawande writes and speaks extensively about medical — especially surgical — safety, an area he staked out in two early books, Better (2008) and Complications (2003). The more recent, The Checklist Manifesto (2009), pulls the lens back to encompass any complex field of practice.
And in our modern world what field isn’t complex? In addition to medicine, consider aviation, skyscraper construction, automobile manufacturing, software design, maintaining safety in the food supply chain…the list of professions where know-how potentially outstrips the ability to manage complex processes goes on and on. With increasingly more diverse sources and higher expectations for added value, I would argue that business research, technical literature search, and many document-related operations also belong in this list, thus making The Checklist Manifesto recommended reading for information professionals.
Gawande’s foundational argument is that our knowledge has surpassed our ability to manage the execution of the knowledge. We have “accumulated stupendous know-how” and put it in the hands of highly-trained and hard-working people. But that know-how is often unmanageable. And thus we have failures that are demoralizing and frustrating in finance, aviation, the military, engineering, and medicine, just to name a few headline-generating examples. “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.” The strategy for overcoming this kind of complexity? A simple, well-designed, systematically utilized checklist.
Well, actually Gawande posits two kinds of checklists: one set of checklists to make sure that process steps are not skipped and another set of checklists to make sure that everyone involved in a project talks through and resolves unexpected problems. The two types of checklists are complementary. Top-down authoritarian task checklists capture the steps that always need to be taken and which by their nature take personal choice and discretion away from workers. Communication checklists, on the other hand, require team members to talk with each other at given pause points in the process. The communication may be as straightforward as members of a surgical team introducing themselves before beginning a procedure or as structured as engineers meeting to resolve unexpected problems in a complex process. The communications checklist restores the professional judgment and worker sense of control that the dictatorial task list takes away.
So, you might be thinking that the work of information specialists is not nearly so complex. Perhaps not. But it’s not getting any simpler either. And in my field, business and technical research and content curation, there is the tendency to work as lone rangers – or research heroes – rather than as a team. At Threshold we have checklists that we invoke to be sure that each client’s requirements for resource use, formatting, and delivery have been met and that the prescribed sources have been checked for our monitoring or content curation projects. The Checklist Manifesto gave me some ideas on how to more effectively design checklists and motivated me to require more structured team check-ins on larger projects.
Whether you manage all information center processes or focus on one or more specific functions like research or contract management, I guarantee you will get some ideas from the checklist stories from other complex industries. The Checklist Manifesto will indeed teach you “how to get things right.”
Now it’s your turn to share your experience:
- What kinds of activities do you use checklists for in your organization?
- Are checklists primarily training tools for you or operational tools? In other words, do you apply the discipline of running the checklist each time the operation or function is performed?
- Gawande notes that people who are comfortable in their jobs sometimes don’t like to surrender to the discipline of the checklist – but it will almost always ratchet up quality. Is compliance a problem with your staff?
- Have you found that checklists improve quality?
Research analysts at Threshold Information, the company Cynthia Lesky founded in 1993, help companies harness external information to enable smart decisions and accelerate innovation. Products and services include industry intelligence news digests, decision-support research and analysis, custom journalism and an infinite variation on these themes. Visit their website or contact Cynthia at cynthia.lesky@threshinfo.com.