On the advice of Judy Brown, I picked up The Checklist Manifesto, and I have to say it’s a must-read. This is a short, well-written, and mind-changing book. Frankly, it ranks up there with Don Norman‘s Design of Everyday Things, and that’s saying a lot.
Atul Gawande is a medical doctor who’s also an eloquent writer. In the course of his work he’s become interested in reducing errors, and has looked deeply into how to minimize them. And he’s had the opportunity to put into practice and test his ideas, refining them until they work. This book documents his explorations, developing a thesis that he recognizes has applicability far beyond medicine. And that’s important for us, if we care about improving outcomes both professional, personal, and societal.
He breaks up flaws in execution into those where we don’t have knowledge, and those where we make errors despite having the requisite knowledge. And he explores eloquently how likely the latter are in the real world. Demonstrably smart and knowledgeable people, acting in complex situations, regularly make mistakes. Those who have heard me speak about how our minds work know that there’s some randomness built into our system. Frankly, we’re not really good at doing rote tasks. He doesn’t go into the cognitive architecture, but rather documents it via stories and explanations of complexity. And he develops a particular approach that is striking in it’s simplicity and powerful in it’s effects.
Not surprisingly, given the title, the solution are checklists. He has two types, ones that help us execute those rote steps that are critical to success, and another that helps connect us at critical times. He categorizes, in a way I find reminiscent of Van MerriÃ«nboer’s elegant task analysis in terms of the knowledge you need and the complex problems you apply it to, the benefits of both remembering those crucial but empirically overlooked steps and of having people build a quick rapport and share the critical information at critical times. He illustrates with flight and large-scale architecture examples as well as medical,situations where performance literally is life-or-death. The clear implication is that if it saves lives there, it can save dollars or more anywhere.
And, refreshingly, he admits you’re not going to get it right the first time, and you need to trial, iterate, and refine again. He recognizes that it must be quick, easy to use, and tuned for the context of use. This is no quick fix, but it ends up providing small easy changes that actually save time as well as reduce error. It’s really about performance support, and it’s not complex, and it can work. It’s also a natural match to mobile delivery, which I’m sure is one of the reasons Judy pointed it out.
This short, eloquent book holds the power to make significant improvements in many fields. I strongly recommend it.