Review: The Checklist Manifesto: How to Get Things Right by Atul Gawande

My Interest

Sometimes you need to do professional reading to solve a problem. It may always be helpful, and at some level interesting, but enjoyable? Fascinating? Well, pull up a chair my friends, this book is both. One of the helpful things about mixed-age work teams is that younger colleagues are interested, not jaded, and get fired up over what they are learning. This results in the old folks getting rejuvenated, shedding some of their ennui, and learning something as well. When my young colleague recommended this book I jumped at it. After all, she and I had had amazing conversations over the book Invisible Women: Exposing Data Bias in a World Designed for Men and had used what we learned to re-tool how we presented our work team.

The Story

Imagine World War II without the B-17 “Flying Fortress.” It nearly happened. The plane was nearly “unflyable” due to the complexity of its systems–too many details to be remembered. Think of those stories of people having the wrong limb amputated or having the wrong surgical procedure performed on them. Scary, right?

Now think about renting a car–it is tedious. You must fill out a form. Inspect the car carefully noting any dings or scratches. Or, at the doctor’s office think of the questions the nurse or aide goes through with you before the doctor or nurse practitioner comes in.

What’s the difference between unflyable planes, wrong amputations, being off the hook for damage to a car, or waiting an overscheduled doctor’s time to talk about what matters with a patient? Checklists.  The B-17 was too complicated for one person to remember all the necessary details, but a checklist, and in time for pilots a how notebook of checklists, made it into the “Flying Fortress” that helped win the war. Doctors reduce problems in surgery with checklists. Even investors can have checklists to make sure they’ve covered all their research bases.

Now, do we like using them? Not always. They can threaten our autonomy. They can seem tedious and unnecessary. But, when done right–when boiled down to just the absolute most necessary things–like those a pilot uses, they can improve so many things. The surgeon who wrote this book set out to improve the survival and safety rates of surgery regardless of the setting. A few simple checklists, implemented at various points in surgery, taking a minute or so in total time, saved lives, reduced accidents and mistakes, and from the richest hospitals with the best of everything down to a rural hospital in Tanzania, the improvement rates were astonishing.

My Thoughts

This was honestly one of the most interesting nonfiction books I’ve read ever. Yes, ever.. When you see how and why these checklists came about, and the results, you could easily go checklist happy. That isn’t necessary though. Checklists make the extremely complex understandable. They sort the significant from the merely urgent or important. They let us cope.

I highly recommend this book. It is engaging, short, and useful. Enough said? Just read it.

My Verdict


3 thoughts on “Review: The Checklist Manifesto: How to Get Things Right by Atul Gawande

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