Book Review: The Checklist Manifesto

In an attempt to improve my writing, I have decided to review films and books here occasionally. This won't be my usual rant about about the state of Dexter or my offhanded comments about Fringe. These will be short reviews of around 300 words.


First up: The Checklist Manifesto: How to Get Things Right by Atul Gawande. Gawande is a surgeon who wanted to learn how people successfully handle complex tasks, such as surgeries, flying planes, or constructing a skyscraper. How can they keep track of all the variables? Gawande's two answers surprised me.

One: You can't. But you can keep track of the individuals keeping track of the pieces and schedule communication between them. Complex systems are best managed in pieces by super-specialists. A centralized, top-down approach doesn't work as tasks become increasingly complex and involve more people and equipment. Gawande cites the failure of FEMA during Hurricane Katrina to prove his theory. Wal-Mart did a far better job of providing food, medicines, and supplies to flood victims and first responders than the government because Wal-Mart allowed their employees on the scene to use their best judgment in the moment. Similarly, Dr John Snow did a better job of stemming a terrible cholera outbreak in Victorian London than the government and health officials, because he observed and then acted against accepted wisdom based on his careful observations. [1]

Two: checklists. Yes, checklists. Even the most skilled person can forget or choose to skip simple yet crucial steps in a process because those steps don't usually turn up problems. Until they do. The deadly 1977 Tenerife airport collision of two Boeing 747s (583 fatalities) happened because a pilot skipped a routine procedural step. Simple, crucial-step checklists, not pages and pages of detailed steps, are used with great result by the airline industry. Gawande helped developed a checklist for surgeons to reduce infection rates and human error. This checklist which takes 90 seconds to run through has saved thousands if not tens of thousands of lives and countless millions of dollars and has been adopted in many countries.

You can see how answer one incorporates answer two. Gawande is a great believer in the checklist, and you might be too after reading this book. In an age where our first response is to throw money at problems and add complicated software and technology to the mix, it's nice to read that someone is espousing an incredibly simple and more comprehensive alternative.

The Checklist Manifesto is an excellent read for anyone interested in project management or effective human interactions. I highly recommend it.

Note: [1] See Stephen Johnson's outstanding book, The Ghost Map: The Story of London's Most Terrifying Epidemic - and How it Changed Science, Cities and the Modern World.