Many of the loftier things in life rest on surprisingly mundane details. Think of democracy: it’s a very big idea, but can be undone by very small administrative errors. A few years ago in Maryland, a local election official forgot to put the cards needed for voting machines into the supply boxes for some polling places. Those polling places became fully functional hours late. In effect, this means that people were disenfranchised. What that election official needed was a checklist.<\/p>\n
In The Checklist Manifesto<\/em>, Atul Gawande makes the case that most complex situations are helped by checklists. A well-designed checklist, as he envisions it (and as the brilliant checklist writers of Boeing envision it) is not exhaustive, but covers the most important and easily forgotten details of a procedure. Equally importantly, it fosters teamwork among the people performing the procedure, whether they are medical staff in an operating room, or an airline crew flying an airplane. It does so in part by mandating that all participants introduce themselves to each other, which not only creates a sense that they are part of a team, but can also embolden the less-powerful members to speak up when it is important to do so.<\/p>\n Gawande repeats the story of an Austrian girl saved from drowning that he rivetingly told in the New Yorker, and reveals that the hospital which saved her (in an extremely long and difficult series of medical procedures) had attempted to save drowning victims before, but had never succeeded: until they implemented a checklist, a detailed and well thought-out set of protocols for what should happen from the first moment when a drowning is reported.<\/p>\n The building trade is another example. Gawande describes how it has moulded itself in a world grown too complex to accommodate the traditional master builder system (in which one architect had control of all details of the building process). As he points out, it is rather miraculous that so many large buildings manage to go up with so little incident. Builders achieve this, you will not be surprised to learn, through an elaborate system of checklists. Gawande discussed this at the 2009 New Yorker festival.<\/a><\/p>\n Gawande also weighs in on heroism in an increasingly complex world. The Miracle on the Hudson, as he describes it, was due not to the sole work of the captain, but instead to the teamwork of the entire crew — which was guided by a set of checklists. Heroism, Gawande suggests, though occasionally the work of a single, inspired individual, derives more often from the disciplined teamwork of a group of people.<\/p>\n The Checklist Manifesto<\/em>, though less focused on medicine than Gawande’s previous books, continues his work of bridging the knowledge gap between medical workers and everyone else. He is also, as in his past books, quite ready to admit to his own failings. He confesses that he only grudgingly adopted a checklist in his own operating room (he didn’t want to be a hypocrite), but now says that he has “yet to get through a week in surgery without the checklist’s leading [them] to catch something [they] would have missed.”<\/p>\n Sadly, no matter how much evidence accrues for the value of checklists, Gawande describes an uphill battle in persuading organizations to use them. It is to be hoped that this work will help change that.<\/p>\n This is an important book. It shows us how to do things, sometimes extremely important things, better, and that doing things better is not about what we think it is about. In fact, it is often vastly less glamorous and more mundane than we expect. In The Checklist Manifesto<\/em>, Gawande shows us a kind of perfection. The kind of perfection achievable by flawed, disorganized, easily distracted human beings. It’s a beautiful idea.<\/p>\n","protected":false},"excerpt":{"rendered":" Many of the loftier things in life rest on surprisingly mundane details. Think of democracy: it’s a very big idea, but can be undone by very small administrative errors. A few years ago in Maryland, a local election official forgot to put the cards needed for voting machines into the supply boxes for some polling […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[5,4],"class_list":["post-7","post","type-post","status-publish","format-standard","hentry","category-book-review","tag-medicine","tag-nonfiction"],"_links":{"self":[{"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/posts\/7","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7"}],"version-history":[{"count":23,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/posts\/7\/revisions"}],"predecessor-version":[{"id":30,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=\/wp\/v2\/posts\/7\/revisions\/30"}],"wp:attachment":[{"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lorinkleinman.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}