The New York Times bestselling author of Better and Complications reveals the surprising power of the ordinary checklist
We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. 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 avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.
In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.
An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.
Drawing from his rich experience and analogies from construction engineering and aircraft piloting domains, Gawande provides a deceptively simple (potential) approach to mitigate significant problems in healthcare delivery. In the early chapters, Gawande clearly explains the challenges associated with the exponential growth in the volume and complexity of information and the inability of deep expertise alone to manage that information successfully. Citing various examples ranging from Walmart's response to Katrina, Keystone initiative/Pronovost's research and WHO's efforts in characterizing patient safety issues in surgery, the author then hypothesizes about the key questions one need to be able to answer to develop solutions for complex problems (the discussion on the differences between what he considers a simple, complicated or complex problem, though short is quite informative). The remainder of the book essentially projects (quite successfully) the use of a checklist approach to identify ways to reduce errors in clinical processes. The author then discusses the two main types of checklists, characteristics of what constitutes a good checklist and some potential challenges of the approach. It is in the last component, one wishes Gawande had not only provoked an interesting discussion, but also prescribed a more definitive approach - while he acknowledges very unambiguously that the "codification of understanding" needed for developing checklist is not be feasible for all domains, it would have been immensely helpful if the author had devoted more space to discussing that observation and framed some potential research questions. (hence the half star deduction!).
Readers familiar with Better: A Surgeon's Notes on Performance and Complications: A Surgeon's Notes on an Imperfect Science are already exposed to a lucid, logical and entertaining narration style of the author and wont be disappointed with this book either. The well-referenced statistics used in the narration is an excellent starting point for more serious readers investigating healthcare delivery processes. Overall, a very informative, entertaining and thought-provoking book that can potential re-frame the way one thinks of process models for clinical settings. A must-read.
writes,
Unfortunately sporting one of the least promising covers ever, don't be deceived -- "The Checklist Manifesto" isn't a desktop publishing project by a high school student, it's real Atul Gawande being his normal, brilliant self. The book flows seamlessly and weaves medicine and other professions together in a story tapestry that will leave you shaking your head with blinding flashes of the obvious. A vital read for anyone managing complexity.
writes,
As in all of his work, Dr. Gawande latest book brilliantly reminds us all of the huge value of getting the human interaction side right to accompany the advancements in science and technology that his (and other's) field of work has witnessed. It highlights the inadequacy of technical expertise when not joined by an equal (maybe greater) emphasis on strengthening our relationships with those we work with and care about. Though the medical narrative is gripping, I challenge you to not be moved by so many of the other stories of people under complex pressure trying to get things right. The beautifully written examples of Wal-Mart and Katrina and of Mr. Hagerman are worth far more than the price of the book just on their own.
