What we see depends on what we look for. Using the ultimate checklists? Ever given them a try? There are lots of ways to use them. In addition, they are a great way to avoid bad mistakes. We like their use for simple reminders of ways to think and to work.
Check out our thoughts on team leverage.
After college, I spent almost 2 years training as a naval aviator. An important element of that training was the use of checklists in the learning and refresher process. Checklist utilization remains an important part of my business life. It is always a good idea to have a helpful checklist for daily reminders of improvements for your business or your personal life.
Before we continue, let me ask you a question.
What works best for your utilization of checklists in your business? We would love to hear what it was. Would you do us a favor and post it in the comments section below? Join the conversation. It would be greatly appreciated by us and our readers.
With the advent of the Internet, the number of marketing options available to both budding and experienced entrepreneurs has become staggering.
We read a great book on this subject recently. It was Atul Gawande’s book, The Checklist Manifesto. Gawande, who is several successful careers ahead of most of us (he is a surgeon, a Harvard professor, and a New Yorker staff writer) is accustomed to thinking about the error.
His first book, Complications, took a long, thoughtful look at the consequences of playing god while being human. His second, Better, tried to parse the subtle differences that enable some doctors to deliver outstanding care, while others — including many who seem just as dedicated — never rise above the average.
The Checklist Manifesto appears to be a logical follow-up to Gawande’s first two books. It, too, concerns the maddening difficulty and unquestionable urgency of making medicine fairer, kinder, and — especially — safer.
Avoid bad mistakes… book departure
In other ways, it represents a marked departure. Why do we conclude this? Take a review of the book covers. Complications are subtitled “A Surgeon’s Notes on an Imperfect Science.” Better is “A Surgeon’s Notes on Performance.” The subtitle of the new book? “How to Get Things Right.” Interesting, isn’t it?
First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to Ebola. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.
Essential reading
Checklists are essential reading for anyone working to avoid the serious impacts of mistakes.
Doctors often overlook or omit steps in the multitude of tasks we perform every day. As Atul Gawande argues in “The Checklist Manifesto,” these are situations where a simple to-do list could help. For example, a five-point checklist implemented in 2001 virtually eradicated central line infections in the intensive care unit at Johns Hopkins Hospital, preventing an estimated 43 infections and eight deaths over 27 months.
Gawande notes that when it was later tested in I.C.U.’s in Michigan, the checklist decreased infections by 66 percent within three months and probably saved more than 1,500 lives within a year and a half. Pretty conclusive stuff, isn’t it?
Mistake … managing complexity
Gawande, a professor of surgery at Harvard Medical School, makes the case that checklists can help us manage the extreme complexity of the modern world. In medicine, he writes, the problem is “making sure we apply the knowledge we have consistently and correctly.” Failure, he argues, results not so much from ignorance (not knowing enough about what works) as from not properly applying what we know works.
This is an essential insight. Taxed with great and increasing complexity, even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. The question is can the checklist be the process for improvement?
Other applications
Medicine is not the only complex profession where lives are on the line. In making his argument, Gawande deftly weaves in examples of checklist successes in diverse fields like aviation and skyscraper construction. He maintains that checklists not only help pilots and builders get the stupid stuff right but foster the communication required to deal with the unexpected.
Key checklist elements
Gawande describes the key things about a checklist, much of it learned from Boeing. It has to be short, and limited to critical steps only. Generally, the checking is not done by the top person. In the cockpit, the checklist is read by the copilot; in an operating room, Gawande discovered, it is done best by a nurse.
Highly intelligent and trained people are, occasionally, not as smart as they think they are. And the more complicated tasks become, the easier it is to crash and burn — because there are so many steps.
“Our great struggle in medicine these days is not just with ignorance and uncertainty,” Gawande says. “It’s also with complexity: how much you have to make sure you have in your head and think about. There are a thousand ways things can go wrong.”
At the heart of Gawande’s idea is the notion that doctors are human, and that their profession is like any other.
“We miss stuff. We are inconsistent and unreliable because of the complexity of care,” he says.
Interesting example?
Dr. Gawande closes “The Checklist Manifesto” with the story of the crash landing on the Hudson River, in January 2009, of a US Airways plane that had lost its power in both engines due to bird ingestion. It was undoubtedly a good thing that every member of the crew had been drilled in various procedures.
But the “miracle on the Hudson” happened because Capt. “Sully” Sullenberger focused on flying the plane, not a checklist on how to fly the plane. As William Langewiesche put it in his account of the incident, “Fly by Wire”: “There was no time for the ditching checklist. . . . Across a lifetime of flying, Sullenberger had developed an intimacy with these machines that is difficult to convey. He did not sit in airplanes so much as put them on. He flew them in a profoundly integrated way, as an expression of himself.”
Capt. Sullenberger himself described the final moments this way: “The earth and the river were rushing towards us. I was judging our descent rate and our altitude visually. At that instant, I judged it was the right time. I began the flare for landing. I pulled the side-stick back, farther back, finally full aft, and held it there as we touched the water.”
Takeaways
Certainly has convinced me of the value of great checklists. What about you?
Need some help in capturing more improvements for your staff’s teamwork, collaboration, and learning? Creative ideas in running or facilitating teamwork or continuous learning workshop?