The Checklist Manifesto: A Book Review

[tweetmeme source=”leanisgood” service=”” only_single=false]The Checklist Manifesto | Atul Gawande | Metropolitan Books

What are your thoughts on checklists? I know I have used them in the past with limited success. The new book by Atul Gawande titled “The Checklist Manifesto” may change your beliefs about checklists and what their limits and uses are.

The author uses airline pilots, construction sites, restaurants, and hospitals as well as brief discussions of other areas that checklists have been fundamental in improving performance.

What the aviation industry found was that there were a couple of reasons why there were accidents and failures. One was that people were so well trained and so focused on what they were doing, they did not focus on some of the more mundane and ancillary processes that could be just as important. Another point was that there had historically been a reliance on the individual to know everything and thus create success single handedly. I think everyone reading this blog understands that teams are what drive innovation and execution in the manufacturing floor. But what about Surgeons? Do they listen to nurses or even ask for their input?

Through several examples, Atul shows how a checklist can help eliminate stupid mistakes, create a team environment and actually help with creativity and improvisation. By using pause points to get everyone on the same page, a checklist develops a level playing field for all the team members to discuss, reflect and brainstorm if need be.

Checklists do not eliminate the need for training and experience. They help the experienced operator to ensure that they are not missing any of the basics and letting them focus on the parts of the process that take more concentration and skill.

Checklists do not eliminate Standard Work. Checklists should be set-up more like memory joggers instead of detailed step by step instructions. One of the references in the book is related to problems that occur on plane flights. The checklist states fly the plane so that the pilot does not get lost in the problem and forget that the plane still has to fly.

Checklists are not specifications. Checklists should be used for the mundane, routine tasks that so many take for granted that we may skip a few steps.

A couple of positive experiences I had in the past was related to PSM processes. These are processes that, if done incorrectly, either create environmental issues or fires or worse. When a couple of processes looked shaky, we made a team up to review what could be done. What we found was that a 2 person team that reviewed the checklist together was better than most if not all the engineering controls and mistake proofing mechanisms and it could be implemented quickly without any capital expenditure.

The book really changed my thinking about checklists, their usage and their impact on overall performance.

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