As an unrepentant checklist fanatic and junkie, http://johncrossan.com/my-blog/1-maintenance-blogs/7-why-wont-we-use-checklists.html I recently found me picking myself up off the floor in an airport newsstand (not a bookstore, it was there too, but a newsstand). There with all the romance novels, the Dan Brown books, and the latest silver bullet management books, was The Checklist Manifesto by Dr Atul Gawande. A best selling book about checklists. Checklists! Can you believe it? The world wants to read about checklists?
The beginnings of hope for the world. A great book that I obviously recommend reading, and giving copies to everyone you work with. (The price of the book is nothing vs the value it delivers). The writer is becoming somewhat a rock star, I heard him interviewed by Terry Gross on NPR Fresh Air and even saw him on the Daily Show with Jon Stewart talking about using checklists.http://www.thedailyshow.com/watch/wed-february-3-2010/atul-gawande . A practicing surgeon, he goes over the pretty incredible reductions in hospital deaths and infections achieved with the use of checklists. In an eight hospital study the was a 36% drop in major surgical complications, and a 47% drop in deaths. 47%!!
Highly skilled, busy people forget basic, key things and don’t even realize it.
Just think of the productivity improvement potential. What expensive capital projects can deliver this type of improvement?
The point of book is that with the growing complexity of everything these days, no one, not even the best trained most capable people, can possibly remember everything. So let’s make sure we don’t miss any of the basic routine, essential items. The ones we’re most likely to forget. Use checklists. . There was a negative review of the book in the Wall Street Journal, but the reviewer evidently missed the fact that one of the fairly important parts of writing a book review is that you actually have to read the book.(A witty blog comment was that if he had had a book reviewers checklist he wouldn't have missed that item.) The reviewer made the standard argument that real experts just don’t need checklists because they are just that good, and just that smart, and they sure don’t need checklists holding them back.
Wrong! Wrong! Wrong! Wrong! Wrong!
The reviewer tries to make the point that checklists would only have gotten in the way of a great pilot like Chesley Sullenberger successfully ditching in the Hudson River. The book talks in detail about this, and how Sully was free to focus on gliding the plane because he and his copilot had taken care of the emergency basics with checklists, and he didn’t have to think about them. In Sullenberger's book Highest Duty he describes how within 8 seconds of hitting the birds, control of the plane had switched to Sully as he had more experience flying the A320, and the copilot was looking through the QRH (Quick Reference Handbook) for the checklist on Double Engine Failure for the restarting procedure.
Even successfully ditching could still have been a disaster if the cabin crew had not followed their emergency ditching checklists, and done all the things necessary to get all the people smoothly and quickly out of the cabin. Sullenberger himself refuses to consider himself a hero, and insists that this was a disciplined team effort with each member following their defined process responsibility. Successful even despite individuals never having worked together before. But that’s pretty boring stuff and we all seem to like the story much better with heroes.
It doesn’t hurt either that the guy can write. The book is a pretty quick enjoyable read. (But needs to be reread a bunch, so it all really sinks in and get used.)
A few other great items in here are:
Checklists need to include communication items, not just tasks.
How checklists help effective teamwork, to where the more limited, knee jerk, command and control approach just can't compete.
How to build an actual useable checklist, How Boeing does it, and how they build checklists for alarm conditions. Focus on the key basic routine items that get missed.
Training by itself won't succeed. Even the best trained people forget basic things.
Another related item I heard on NPR Fresh Air was an interview with the author Jonah Lehrer talking about his new book How We Decide and how easy it is to overload the prefrontal cortex of the brain. This is the relatively puny part of the brain responsible for organizing the conflicting signals coming from all the other parts of the brain into making the best decision.. A Stanford University study compared the resolve of some diet conscious folks on whether to eat chocolate cake or fruit salad. They were split into two groups. One group worked on memorizing two digit numbers and the other worked on memorizing seven digit numbers. The groups then had to make the diet choice and the seven digit group was more than twice as likely to choose the chocolate cake than the two digit group. The added mental effort affecting their decision to make the responsible choice. . Another argument for using checklists, to just plain reduce the workload on the brain so it can work better.
So I’m writing this before the Superbowl and I plan to watch Peyton Manning and Drew Brees really closely, because you just know that somehow these teams, with the complexity of what football has become, have to be using checklists, and I want to see if I can see how they’re doing it.