The other day, meaning last Tuesday, I read the book titled The Checklist Manifesto by Atul Gawande. No, it wasn’t a manifesto composed of a large checklist, but a book detailing how checklists can improve a variety of different industries and even save lives. The premise intrigued me, so that is why I chose to read it.

It mainly centered on the medical industry, as the author is a doctor. The medical industry is also where he tested his checklist theory and initially saw the need for something like it. He also referenced piloting, but I’ll get to that in a bit.

The book starts off by explaining that some professions are becomingly increasingly complex and one person cannot do everything. The amount of knowledge required to solve certain problems is very high, and people are increasingly specializing themselves; doctors exist for every little thing because that type of knowledge is required to be effective. But even with that splintering of responsibilities, there is still the problem with remembering and keeping track of everything under pressure and expecting the results to be consistent. This is where checklists come in.

The primary example Gawande looked at for where checklists can be helpful was for surgery. As he explained, there are many things that can go wrong before, during, and after surgery that can cause infection and death. So he began to try to minimize avoidable mistakes by introducing a pre-surgery checklist to make sure all the blood was in order, antibiotics were administered, and so on. He tested it with a few teams and then multiple hospitals. Performing the checklist actually cut the infection rate down by a significant factor. Simply making sure all the steps were done prevented the doctors or nurses skipping something that could prevent problems down the line. Mistakes were found and corrected because of the focus on ‘completing’ the checklist. Since these trials and test proved its effectiveness, the author has been trying to get the checklist implemented in as many hospitals around the world as he can.

Another industry the book referenced for where checklists have saved lives was with aircraft pilots. Apparently pilots have been using checklists for awhile now, because with the complexity of modern aircrafts, it was quickly realized there was no possible way for pilots to be able to actively access all the details and keep everything in check. The industry has become so good at perfecting the use of checklists that when a fluke problem involving temperature and fuel caused engine failure and a plane crash they added in a check for when the engines fail to perform a trick to solve the problem and restart the engine. And in the subsequent times where this niche problem happened again, the pilots successfully performed the trick as per the checklist and prevented a crash. He also brought up the much-publicized Hudson River landing, bringing up that the pilot who got all the attention repeatedly said he was only able to do the landing with the help of his crew and the checklists.

So, overall, The Checklist Manifesto was a fascinating read. I’m not sure how I’d use a checklist or make one up for a complex activity, but I think the lesson of things being too hard for us all to keep track of and not make little errors is an important one. We are not as good as we think we are.