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The Checklist Manifesto

How to Get Things Right

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

Drawing from his experience as a general surgeon, Atul Gawande’s The Checklist Manifesto (2009) reveals startling evidence on how using a simple checklist can significantly reduce human error in complex professions such as aviation, engineering and medicine.

Key idea 1 of 7

Checklists help prevent serious but easily avoidable mistakes.

An operating theater team in San Francisco met with dire circumstances when treating a man for what they thought was a shallow stab wound. It was only after a surgeon’s incision, when the patient started spilling out copious amounts of blood, that they noticed the wound measured a foot long. It was, in fact, a bayonet injury the man had received at a Halloween costume party. Unfortunately, before the surgery, none of the medical staff had remembered to ask what kind weapon was used.

The man survived the injury; however, mistakes and misinformation in medicine happen with scary regularity and can result in serious complications or deaths. In the United States, over fifty million surgeries are performed per year, and more than 150,000 of these patients die after their surgery. According to studies, around half of these complications and deaths are avoidable.

So how can we reduce the number of mistakes being made?

Rather than spending millions on the latest medical technology, the answer is much simpler: use a checklist.

Checklists are as simple as they sound: a list of steps to be completed when carrying out a procedure. Surprisingly, it is the obvious steps – stuff that everyone should know – that are often most crucial and yet forgotten or skipped. The checklist functions as a safety net to make sure we catch the obvious stuff, such as asking, “What kind of weapon was used?” before we proceed any further. Once the basic stuff is checked off, we are mentally better equipped to tackle the more complex or unpredictable issues that are unique to each patient.

If a checklist had been used in the above bayonet injury case, the medical team would have been better prepared for any nasty, bloody surprises.

Checklists help prevent serious but easily avoidable mistakes.

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