The Checklist Manifesto - Atul Gawande

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The Checklist Manifesto has a very solid underlying premise, but it is crammed full of anecdotes and ultimately boils down to "a really good article".

It's "good tweet" even: make checklists for all the "simple stuff" you have to do as an expert so it gets done every time and so you can focus on the things that actually require your expertise.

— Mike Sherov (he/him) (@mikesherov) September 23, 2019

I think that checklists can be an excellent tool and facilitate higher level thought. My favorite idea for a "checklist" is Amy Hoy's Pep. It's raw right now, but it makes processes that a fit for checklists flow very well.

Buy The Checklist Manifesto on Amazon.

Checklists can be a powerful lever to make complex processes more collaborative by giving a common understanding. They are a defense against failure.

We are besieged by simple problems that are very appropriate for checklists.

Checklists aren't static. They need to be revised over time. This is essential otherwise we are lulled into a false sense of lever pulling mediocrity.

Checklists can contain Communication prompts or be entirely oriented on communication.

Develop a communications checklist. Is this something that could be used after particular events/triggers in the workshop process?

You have to leave room for people to make decisions, but we also want to prevent simple mistakes.

In the face of the unknown-the always nagging uncertainty about whether, under complex circumstances, things will really be okay-the builders trusted in the power of communication. They didn't believe in the wisdom of the single individual, of even an experienced engineer. They believed in the wisdom of the group, the wisdom of making sure that multiple pairs of eyes were on a problem and then letting the watchers decide what to do. Man is fallible, but maybe men are less so

In the restaurants every dish is reviewed by the sous chef before being delivered to the guest.

Recognizing where the simple failures are, missed emails, calendar events not scheduled, etc is an area where checklists really shine.

the more familiar and widely dangerous issue is a kind of silent disengagement, the consequence of specialized technicians sticking narrowly to their domains. "That's not my problem" is possibly the worst thing people can think, whether they are starting an operation, taxiing an airplane full of passengers down a runway, or building a thousand-foot-tall skyscraper.

This is why checklists can suck. It's something that we have to be constantly aware of, with our without checklists.

we need them to see their job not just as performing their isolated set of tasks well but also as helping the group get the best possible results. This requires finding a way to ensure that the group lets nothing fall between the cracks and also adapts as a team to whatever problems might arise.

Transperancy, communication, filing notes in Notion, group chats versus 1 on 1, Zoom meetings that are progressively summarized...

Bad checklists are vague and imprecise. They are too long; they are hard to use; they are impractical. They are made by desk jockeys with no awareness of the situations in which they are to be deployed. They treat the people using the tools as dumb and try to spell out every single step. They turn people's brains off rather than turn them on.

We want to avoid bad checklists?

Good checklists, on the other hand, are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything-a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps-the ones that even the highly skilled professionals using them could miss. Good checklists are, above all, practical.

What are the most critical steps in the workshop production process? Where would a checklist help?

The power of checklists is limited, Boorman emphasized. They can help experts remember how to manage a complex process or configure a complex machine. They can make priorities clearer and prompt people to function better as a team. By themselves, however, checklists cannot make anyone follow them.

When you're making a checklist, Boorman explained, you have a number of key decisions. You must define a clear pause point at which the checklist is supposed to be used (unless the moment is obvious, like when a warning light goes on or an engine fails). You must decide whether you want a DOCONFIRM checklist or a READ-DO checklist. With a DO-CONFIRM checklist, he said, team members perform their jobs from memory and experience, often separately. But then they stop. They pause to run the checklist and confirm that everything that was supposed to be done was done. With a READ-DO checklist, on the other hand, people carry out the tasks as they check them off-it's more like a recipe. So for any new checklist created from scratch, you have to pick the type that makes the most sense for the situation. The checklist cannot be lengthy. A rule of thumb some use is to keep it to between five and nine items, which is the limit of working memory. Boorman didn't think one had to be religious on this point. "It all depends on the context," he said. "In some situations you have only twenty seconds. In others, you may have several minutes."

But after about sixty to ninety seconds at a given pause point, the checklist often becomes a distraction from other things. People start "shortcutting." Steps get missed. So you want to keep the list short by focusing on what he called "the killer items"-the steps that are most dangerous to skip and sometimes overlooked nonetheless. (Data establishing which steps are most critical and how frequently people miss them are highly coveted in aviation, though not always available.)

The wording should be simple and exact, Boorman went on, and use the familiar language of the profession. Even the look of the checklist matters. Ideally, it should fit on one page. It should be free of clutter and unnecessary colors. It should use both uppercase and lowercase text for ease of reading. (He went so far as to recommend using a sans serif type like Helvetica.)

Boorman is a pilot and aviation is an industry that has fully embraced checklists as it is "do or die". egghead workshops aren't that extreme, but the principles here and lessons learned from aviation are powerful.

This wasn't a record-keeping procedure. We were aiming for a team conversation to ensure that everyone had reviewed what was needed for the case to go as well as possible.

This is a powerful point. We aren't in the "checklist completion business" so that isn't the desired outcome. Checklists are a tool.

Just ticking boxes is not the ultimate goal here. Embracing a culture of teamwork and discipline is

👆 this.

The checklist doesn't tell him what to do, he explained. It is not a formula. But the checklist helps him be as smart as possible every step of the way, ensuring that he's got the critical information he needs when he needs it, that he's systematic about decision making, that he's talked to everyone he should. With a good checklist in hand, he was convinced he and his partners could make decisions as well as human beings are able

The fear people have about the idea of adherence to protocol is rigidity. They imagine mindless automatons, heads down in a checklist, incapable of looking out their windshield and coping with the real world in front of them. But what you find, when a checklist is well made, is exactly the opposite. The checklist gets the dumb stuff out of the way, the routines your brain shouldn't have to occupy itself with [...] and lets it rise above to focus on the hard stuff

This is the core idea here.

First is an expectation of selflessness: that we who accept responsibility for others Second is an expectation of skill: that we will aim for excellence in our knowledge and expertise. Third is an expectation of trustworthiness: that we will be responsible in our personal behavior toward our charges Fourth is discipline in following prudent procedure and in functioning with others. This is a concept almost entirely outside the lexicon of most professions

individual autonomy hardly seems the ideal we should aim for. It has the ring more of protectionism than of excellence.

What is needed, however, isn't just that people working together be nice to each other. It is discipline. Discipline is hard-harder than trustworthiness and skill and perhaps even than selflessness. We are by nature flawed and inconstant creatures. We can't even keep from snacking between meals. We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.

To be sure, checklists must not become ossified mandates that hinder rather than help. Even the simplest requires frequent revisitation and ongoing refinement. Airline manufacturers put a publication date on all their checklists, and there is a reason why-they are expected to change with time. In the end, a checklist is only an aid. If it doesn't aid, it's not right. But if it does, we must be ready to embrace the possibility.