The Checklist Manifesto – by Atul Gawande

The Checklist Manifesto by Atul Gawande is a great book. It is about the industry changing effects of checklists. Gawande studies aviation, engineering, restaurants, and finance and sees that well-designed checklists help top performers in each industry prevent very serious errors over and over again. The use of checklists improves the performances of people in these industries drastically.

Using a checklist in the medical field would be a very disruptive change. Currently, the medical profession uses the “captain of the ship” doctrine, which means that the Doctor is in charge. This is different from other industries. Other industries form checks and balances where the responsibility to avoid mistakes is spread out among all members of the team.

Gawande is a surgeon and is unsure of how much a checklist could help the field of medicine. He is also unsure that a checklist could be distilled down into something simple and time efficient considering how complicated medicine is. Ultimately, he develops 3 sets of checklists: a pre-anesthesia check, pre-incision check, and a post-surgery check, each one taking less than 1 minute.

The central line insertion checklist is a huge success. This is a common procedure that had a very high rate of infection. Gawande’s implementation of a checklist in conjunction with this procedure virtually eliminated the infection rate saving countless lives.

The stories of how checklists are used in aviation, engineering, finance, and restaurants are very interesting, and it obviously has some part in the success of these industries. Plane crashes and building collapses are almost nonexistent and millions of these tasks are done every year.

Overall, I recommend the book to anyone. It was a quick and easy read, very informative, and very interesting.