Do Checklists Really Matter?


I recently read a book called The Checklist Manifesto by Atul Gawande. At the time this book was recommended to me, I was thinking through better ways to do QA/QC at Interstates. The author is a brilliant surgeon and Associate Professor at Harvard Medical School. He starts out by sharing a few intense stories from the operating room and how as a surgeon, you can expect to encounter the unexpected. I feel that the industry we are in has many parallels to the stories he told. But after reading this book, I really have no desire to have any medical procedures done in the future. He has many interesting points early on in the book that stuck with me as I continued to read and as I continue to work through our quality re-framing.

Failure

Why do we fail? The 2 main reasons we fail (as humans) are ignorance and ineptitude. Ignorance because some things are simply beyond our capacity. Even with the technology we have today, our understanding and physical strength is limited. Ineptitude because we have failed to properly apply knowledge that already exists.

Balance

The balance of these 2 reasons has shifted dramatically over the last 20 years. Science and inquisitive human beings have filled in many gaps in knowledge that previously existed. This means we used to not know, so we could claim ignorance. But, now we do (or should) know, yet we don’t always apply the knowledge at the right time or at the right level.

Know-How

We have established incredible know-how. However, that know-how is often unmanageable. There is SO much information that solving a seemingly simple issue can easily become riddled with complexity.

Checklists

Developing a checklist is not necessarily meant to reduce this complexity, it is meant to be an aid when a task is too complex to carry out reliably from memory alone. Capturing the steps required and sequence in which to do them aids in consistency and reduction of error.

Reading this book has changed my point of view on checklists. Now, when I see or need to fill out a checklist, I know that each of those items was likely placed there for a reason. Someone had previously learned that it is what is required to have a successful outcome.

Have you read The Checklist Manifesto? What do you think?

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Dave Taylor, Interstates Director of Planning and Prefab