The Checklist Manifesto: How to Get Things Right 1st Edition by Atul Gawande (PDF)

Description

The New York Times bestselling author of Being Mortal and Complications reveals the surprising power of the ordinary checklistWe live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third. In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds. An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.

User’s Reviews

Reviews from Amazon users which were colected at the time this book was published on the website:

⭐The author, Dr Atul Gawande is an American general and endocrine surgeon, and public health researcher. I have been meaning to read and review his book for many years. What a fitting introduction to ‘The Checklist Manifesto: How to Get Things Right.’Philosophers Samuel Gorovitz and Alasdair MacIntyre tackled the issue of why we fail at what we set out to do in the world. One reason, they explain is “necessary fallibility”, a consequence of some things in the world, and our lives, being beyond our understanding and control.But there is much that is not, and yet we fail at these too. Gorovitz and MacIntyre suggest that there are two reasons for this: ignorance and ineptitude (incompetence or clumsiness.)For most of human history, people’s lives have been lived largely in ignorance. However, over the last few decades, science has filled in enough knowledge to make our ‘ineptitude’ as much of a challenge as our ‘ignorance’ was in the past.Gawande’s context is the ineptitude in medicine. While our knowledge and sophistication has grown enormously, the struggle is still how to deliver on this know-how.The knowing-doing gap is found everywhere. From the frequent mistakes authorities make when disaster strikes, to the legal mistakes our lawyers make that are the result of little more than simple administrative errors.“Every day there is more and more to manage and get right and learn,” Gawande points out. With all we are required to manage, failure happens far more often – despite great effort rather than from a lack of it.Expertise has been seen as the solution to ineptitude in most areas of work – “they need more training!” and modern medicine has been no different. But capability clearly isn’t our primary difficulty; in most fields training is longer and more intense than ever. In the early twentieth century, you could practice medicine with only a high school diploma and a one-year medical degree. Today doctors have six years of university, and three to seven years of residency to practice paediatrics, surgery, neurology, or the like.Yet our failures remain frequent, but there is a solution – checklists.Though this seems almost ridiculous in its simplicity – especially to those of us who have spent years carefully developing ever more advanced skills – it has proven not to be.In 1935 the US Army was looking for the next generation long-range bomber. Boeing’s aluminium-alloy Model 299 was able to carry five times as many bombs as the army had requested, and could fly faster and farther than previous bombers. The army planned to order at least 65 planes until it stalled on a test flight, turned on one wing, and exploded. The crash, attributed to ‘pilot error, killed 2 of the 5 crew members. This prompted Boeing to come up with an ingeniously simple approach: they created a pilot’s checklist. It is worth noting that using a checklist for takeoff was about as odd as using a checklist to back out of your garage.However, flying this new plane was too complicated to be left to the memory of any person, no matter how expert. The test pilots made checklists for takeoff, flight, landing, and taxiing, and armed with the checklist, flew a total of 1.8 million miles without one accident. The army ultimately ordered almost 13,000 planes.Like flying, many areas of our lives and work have become “too much airplane for one person to fly.”Faulty memory and distraction are a constant danger in “all-or-none processes” like going to the shop to buy ingredients for a cake, piloting a plane through a takeoff, or treating a sick person in the hospital. “If you miss just one key thing, you might as well not have made the effort at all,” says Gawande.Another human danger you may well recognize, is allowing yourself to skip steps even when you remember them. You skip steps because it has never been a problem before – until one day it is.Checklists can provide protection against such lapses, as they remind us of the minimum necessary steps.Professors Zimmerman and Glouberman distinguish between 3 different kinds of problems: the simple, the complicated, and the complex.‘Simple problems’ are ones like baking a cake from a recipe with a few basic techniques you need to learn. Master them and you most likely will have success.‘Complicated problems’ are like sending a rocket to the moon. There is no straightforward recipe, and success usually requires many people and great expertise. Unanticipated problems are common, and timing and coordination become serious concerns.‘Complex problems’ are like raising a child. You can’t repeat and perfect the process as you can with rockets. Every child is unique, and while expertise is valuable, it is not sufficient. The outcome remains highly uncertain.The value of checklists for simple problems is self-evident: that is why we have a shopping list. But much of the most critical work people do, is not simple. Checklists help prevent failure especially when the problems combine everything from the simple to the complex.The real value of checklists is in conditions of true complexity, where the knowledge requirements exceed that of any individual, and unpredictability reigns. Commands and control from the centre will fail. Under these conditions, not only are checklists a help, they are essential for success. In these complex situations where individuals must exercise their own judgement, this judgement will be enhanced by checklist procedures.Bad checklists are vague and imprecise, too long and hard to use. They are written as if the people using them are stupid, and they try to spell out every single step. Good checklists, are precise and begin with the premise that a checklist cannot fly a plane. That is why, faced with catastrophe, pilots are astonishingly willing to turn to their checklists.Checklists come in two forms: DO-CONFIRM and READ-DO. Using a DO-CONFIRM checklist, people do jobs from memory and experience, then stop and check. Using a READ-DO checklist, people carry out the tasks as they check them off, like a recipe.To get value from checklists, they must make sense for the particular situation. A rule-of-thumb is to keep it to between five and nine items, simply worded, and exact.Does this work? This was rigorously tested in the World Health Organization’s ‘safe surgery’ research across a variety of hospitals of different sizes, rich and poor, in countries from Tanzania to the US. In this carefully constructed study, a 2-minute, 19 step surgery checklist, resulted in an immediate drop in infection and mortality in thousands of operations in 8 participating hospitals. Major complications dropped 36%, and deaths fell by 47%.That is how much a checklist can add to the skills of highly trained, highly skilled surgeons. It is worth a serious try in your business. You will get startling results too.Readability Light —+- SeriousInsights High +—- LowPractical High +—- Low*Ian Mann of Gateways consults internationally on leadership and strategy, and is the author of the recently released Executive

⭐I was an air force pilot and a project manager so I appreciate the value of checklists. This book was a confirmation of my already well-established convictions. I was expecting something more practical rather than a series of vignettes. Read this to better understand the vital purpose and flexibility of checklists usage in pretty much every walk of life.

⭐Atul Gawande is a physician interested in improving surgical practice. He reviews surgical cases with disastrous outcomes that could have been prevented and cites research claiming that nearly half of deaths that occur in surgery are in fact preventable. We read a detailed analysis of a drowning accident in which the young victim’s life was saved against all odds. Why? Because the hospital staff had discussed and practiced the procedures to treat cold-water drowning ahead of time. They used no new knowledge; they just coordinated and communicated more effectively.Gawande examines how human beings do things. There are two reasons we fail at complex tasks. The first is ignorance. We correct it by conducting research and building schools to increase our knowledge. The second and more common reason for failure is ineptitude–the right knowledge is available, but we do not apply it correctly. People continually forget, are distracted, or skip steps because they seem unimportant. This problem lurks below the radar; we don’t recognize it, let alone try to solve it. Instead we send people off for more training to increase their knowledge.What is needed instead is a simple way to remind people of what they know at the right time to make a difference. We have an answer, we just aren’t using it. “Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification, but also instill a kind of discipline of higher performance.”The author examines checklists used by airline pilots, building contractors, investors and other physicians. In these professions work has become too complex for even a talented individual to perform alone. Teams of skilled experts must manage both communication and complexity to succeed. They do both with checklists. These checklists make people stop and think at “pause points” to ensure that the right things have been done. They get coworkers to bond as a team by requiring them to talk to each other. As a result, people become comfortable enough to speak up when they see a potential problem.Chapter Six, The Checklist Factory is the instructional meat of the book, with recommendations that help us develop good checklists. There are direct guidelines about brevity and clarity. There are also process guidelines about identifying common mistakes and fine-tuning a checklist with field testing. He distinguishes between READ-DO checklists, which march novices through the tightly specified steps of rote tasks, and DO-CONFIRM checklists, which provide checkpoints for experienced professionals solving complex problems in coordinated groups. Both have their place, but DO-CONFIRM checklists have the most potential to make a difference.There are barriers to checklist use. They have a serious user acceptance problem. Many accomplished professionals consider themselves virtuosos who don’t need help from other people at all, let alone somebody else’s checklist. To many others checklists seem too mundane to make a difference. The author works hard to persuade us. His own research on checklists in operating rooms finds significant drops in death rates, post-operative infections, and other outcome measures. He highlights successes at prominent hospitals to encourage wider acceptance, asks administrators to impose requirements, and calls on nurses to help change the culture of the operating room. The idea is slowly catching on.Gawande wishes we would move more quickly. “In the money business everyone looks for an edge. If someone is doing well, people pounce like starved hyenas to find out how. Almost every idea for making even slightly more money … gets sucked up by the giant maw almost instantly. Every idea, that is except one: checklists.”I learned some things from this book and highly recommend it. Give it at least a quick look, starting with Chapter 6. It has the potential to make you even better at what you do best.

⭐This is more than a book, it is a groundbreaking transformation. Having worked in the wider healthcare sector for over 30 years (not a clinician), you understand the levels of authority, the egos, and intransigence of senior medical consultants, especially in relation to their juniors and nurses. The challenge has been, to inculcate something so obvious and relatively easy to implement, causes concerns that much of hard-earned experience and intellect can be reduced to checklists. Surely we need as many fail-safes as possible when peoples lives are at risk.Atul Gawande has presented compelling evidence that checklists can have a dramatic impact on quality of care and healthcare outcomes. He has shown that this is repeatable around the world and not just in the poorer regions. If an aircraft pilot fails, he goes down with the plane. If the same consequence was applied to the failure of a medical consultant – we’d have checklists in every hospital tomorrow!

⭐The checklist manifesto seems to be the favourite productivity book of some people. I came across it because I saw someone rave about it on Twitter. However, I feel a bit lukewarm about it. First, I think that the book is too long. There are many examples and anecdotes about the usefulness of checklists, but, in my view, they achieved little more than repeating the point that checklists can be a powerful tool. Second, the actual practical advice for designing useful checklists is too short. This practical advice could be summarised in less than a page. Third, the application of checklists in all different areas is quite common knowledge now. This might be in part attributable to the book, which came out quite a while ago. I think it would be great to update the book with some expansions that are more contemporary. For instance, the use of templates to structure processes and thinking could be discussed alongside checklists. I think the book is still a worthwhile read, especially for readers who are not familiar with checklists or for readers with a medical background who may enjoy the many examples from that area.

⭐This is the second book of Atul Gawande’s I have read. I really enjoy his easy ability to illustrate his points with relevant stories and particularly in this book using the Hudson River plane incident as an example.He has given me food for thought around the use of checklists in my own work. I feel inspired to develop one at least for myself which I may then be able to pass on to my team.I enjoy the philosophical approach he has to life, medicine and writing.I thoroughly recommend this book as not only thought provoking but also an enjoyable read.

⭐First, a quick warning. If you are squeamish, be careful with the early chapters. There are some graphic details that left me feeling a little out of sorts.The book is enjoyable and well written. Parts of it race along like a thriller, especially the recounting of the “miracle on the Hudson” case.Unfortunately, the book wasn’t what I was hoping for. I came into the book thinking that checklists seemed logical and I want to learn how to craft them. Instead, the book mostly provided anecdotes that supported the idea of having checklists in the first place.I really want to implement these in my life, but the instructions were minimal. Asides from learning about “do confirm” vs “read do” lists, and the fact that lists are fewer than nine key items, I’m non the wiser how to benefit from them in my job.That being said, I enjoyed the read and bravo to the author for pioneering something so important in surgery.

⭐As the title suggests, The Checklist Manifesto outlines the benefits of using checklists in various situations from the perspective of Atul Gawande, a leading surgeon. Atul sets out to find a solution for the problem of complexity in medicine by objectively researching different contexts, from project managing extremely complex building developments to piloting planes. A large emphasis is placed on situations such as disasters, where time is of the essence and there is a limited time to react to the situation at hand, much like would be found in the operating theatre, where the basis of the book originates.I enjoyed the methodical approach of following Atul on his journey, trying to get to the crux of checklists, how (or if!) they are beneficial to situations and how a balance can be struck between having sufficient information to be useful whilst not overbearing the user to the point where the list becomes disregarded. He uses examples such as investment fund managers, third world disease prevention schemes, professional kitchens, and of course hospitals whilst using various statistics to bring the narrative to life.A number of real world disasters are cited which keep the book gripping and interesting, and help to outline the reality the checklists aren’t to make the user into a methodical robot, but how it helps to strike a balance between communication, delegation and preparation. The bottom line of the theme is that the effects of using checklists are subtle taken on an individual situation basis, but in unlikely circumstances or taking the statistical data over a large number of samples, a clear picture gets painted. Checklists, particularly in the context of surgery or plane mishaps, are fundamental to team cohesion and just by taking the simple of step of introducing names before surgery or a flight can have a profound effect on achieving desirable outcomes.I enjoyed reading this book and would recommend it, it does provoke thought into how checklists could be used in other situations and the problem of the human ego that leads dismissal of procedures that can have profound beneficial effects.

Keywords

Free Download The Checklist Manifesto: How to Get Things Right 1st Edition in PDF format
The Checklist Manifesto: How to Get Things Right 1st Edition PDF Free Download
Download The Checklist Manifesto: How to Get Things Right 1st Edition 2009 PDF Free
The Checklist Manifesto: How to Get Things Right 1st Edition 2009 PDF Free Download
Download The Checklist Manifesto: How to Get Things Right 1st Edition PDF
Free Download Ebook The Checklist Manifesto: How to Get Things Right 1st Edition