An Ode to Atul Gawande's Checklist Manifesto

I am a GINORMOUS fan of Atul Gawande’s The Checklist Manifesto.  With irrefutable data drawn from medicine and from commercial construction, he demonstrates how a “stupid little checklist” can raise the baseline standard of performance, ensure consistent excellence in service delivery and reduce risk in particular for complex problems.

There are 3 Problem Types: Simple (recipe for success), Complicated (sending rocket to moon - replicable), and Complex (raising a child – expertise is valuable  but not sufficient).  For complex matters, experts are up against 2 main difficulties:

    • Fallibility of human memory and attention. esp. when it comes to mundane matters that are easily overlooked under the strain of more pressing events.
    • A tendency to lull oneself into skipping steps that don’t always matter even when they remember them. 

He shares the story of Joe Salvia, who tells him that the #1 major advance oil the science of construction over the last few decades has been the perfection of tracking and communication.  Because a building involves many specialists, if not carefully orchestrated a cacophony of incompatible decisions and overlooked errors can be produced. The answer is a submittal schedule; a checklist specifying communication tasks and deadlines. For skyscrapers following this protocol the annual avoidable fail rate is less than 0.00002 percent and buildings take one-third less time to build than they did decades ago.  Checklists work.

Gawande laments that unlike construction, medicine has been slow to adapt.  Not surprisingly many doctors were initially offended by the idea that they would benefit form a checklist. Nurses helped with piloting, recording data and building the use case. Reduction in preventable complications, deaths avoided and costs saved have been remarkable.

“Much of our work today has entered its own B-17 phase. Substantial parts of what software designers, financial managers, fire-fighters, police officers, lawyers, and most certainly clinicians are too complex for them to carry out reliably from memory alone. Multiple fields, in other words, have become too much airplane for one person to fly.”– Atul Gawande

Ops in a Box, Legal Edition contains 30 templates, many of them checklists, step-by-step guides and forms addressing: Strategic Planning, Human Resources, Vendor Management, Technology Management, Project and Change Management, and Magic. All are items built, tested and refined while launching legal operations at 3 different fortune 500 companies.   They will help you set up and ensure consistently high performance on the covered tasks, freeing time for you to apply your craft and judgment to the original complex issues that arise in your day.