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The Checklist Manifesto

How to Get Things Right

By Atul Gawande
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  • Contains 8 key ideas
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The Checklist Manifesto 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 8

Progress in human understanding has become increasingly complex and overwhelming.

Imagine being treated for a heart attack in the 1950s. Medical knowledge of what caused heart problems was so sparse back then that you’d simply be prescribed pain relief and bed rest. Oh, and if you wanted to puff on those cigarettes during your recovery, that was fine too.

Fortunately, human knowledge has greatly expanded since then. As little as 60 years ago, doctors were fairly clueless about treating heart attacks, whereas today we have numerous methods of doing so, including blood pressure medications, cardiac catheters and even open-heart surgery. We also have a whole host of ways to prevent heart problems in the first place, from cholesterol-lowering drugs to increased exercise.

However, in complex areas like medicine, our broad knowledge base has become a double-edged sword. According to the World Health Organization, we have now defined over 13,000 syndromes, diseases and injuries. Add to that the thousands of drugs and procedures available to treat patients and we see that no one doctor or medical team can possibly master all the medical knowledge we have accumulated.

This leaves us with a problem of ineptitude. That is, we are struggling to consistently remember, organize and apply the right knowledge in the right way. Surgeons and nurses alike are under immense pressure to master the latest medical technology, deal with multiple patients at once, and carry out the vast number of steps needed to perform complicated medical procedures with precision. As they are doing this, they must simultaneously cope with the unexpected reactions and outcomes that occur when dealing with sick people.

Clearly a new kind of tool is needed if we are to make use of our vast medical knowledge and avoid potentially fatal human errors.

Progress in human understanding has become increasingly complex and overwhelming.

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