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Tuesday, July 09, 2013

The Checklist Manifesto: A Book that Altered How I View the World

Perhaps I am late to the party, as it came out in 2009, but I recently finished reading The Checklist Manifesto, by Atul Gawande, and it changed how I view the world.  Gawande is a surgeon, but he wrote this book for a general audience to probe how checklists can help to eradicate simple errors in the increasingly complicated things that we do.

As Gawande recounts, we live in a world of tremendously complex knowledge, yet we still make many harmful mistakes.  Surgeries cause infections.  Planes (unfortunately, as this past weekend's news reminded us) crash.  Investors make poor decisions.  How can we fix these problems?

The idea is quite simple:  use a checklist.  Well-constructed checklists, when employed at pause points in a complex process, help to ensure that we do not allow our huge array of knowledge to cloud the routine but essential steps we must perform in a given procedure.  Buildings do not generally collapse because engineers use checklists at each step in the building process.  Implementing a simple checklist in the operating room significantly reduces infections. Charles "Sully" Sullenberger used a checklist to successfully land his damaged plane in the Hudson River.  (It is not clear whether the Asiana Airlines pilots in this past weekend's crash used a checklist once they realized they were in danger.)

Yet we still do not use checklists on a routine basis in lots of things that we do.  

Indeed, at a instinctual level checklists are often anathema to many people.  Surgeons generally reject checklists because they believe they are the "experts" and know how to run their operating rooms.  I experienced a knee-jerk anti-checklist mentality myself without even realizing it:  The day after finishing the book I was on the telephone with an after-hours nurse hotline to ask a simple question about an allergy medicine, and I became very frustrated when the nurse kept asking me seemingly-unrelated questions about my symptoms.  She continued to probe me on an array of irrelevant matters that, I thought, had nothing to do with my issue.  Only after I hung up did I realize -- she was using a checklist!  Sure, I might actually have a simple question regarding a medicine, but someone else calling with that same issue could be experiencing a more serious health issue that required immediate attention.  Using a checklist could allow the nurse to catch the emergency situations.

Almost every endeavor we undertake could benefit from a checklist.  Law is no exception. Litigators could use checklists in a deposition or when questioning a witness on the stand.  Commercial lawyers can employ checklists at different stages of the dealmaking process.  Brief writers might look to a checklist to ensure they include all of the necessary elements in their written submissions.  We often tell law students to create checklists for their exams to make sure they are hitting all of the issues.  But although there are obvious benefits, checklists are generally underused.

This is certainly true in my own field of election law.  This all leads to one of my current research projects, an article tentatively titled "A Checklist Manifesto for Election Day."  My initial research shows that states and counties provide poll workers with long, detailed training materials but no easy-to-use checklist to which they can refer on Election Day.  Yet, as the continued flurry of post-election litigation demonstrates, we make election mistakes in every election.  Perhaps a checklist can help.

It is rare that a book I read for pleasure turns not only into a research agenda but also changes the way I view so many aspects of what we do as a society.  Faithful readers (hi Mom!), are there other books that have had same affect on you?  Do you use checklists?

Posted by Josh Douglas on July 9, 2013 at 01:09 AM in Books | Permalink


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We took a lot of these ideas and made them a reality for Tallyfy. In fact, we're talking to various US law firms about use cases ranging from litigation checklists through to due diligence. Besides that, many other sectors are interesting for us - such as consulting, professional services, manufacturing, etc.

Please let us know if you'd like to trial our tool to make these ideas a reality - http://tallyfy.com

We were funded by the Chilean government. Recently, we also received grant funding from the US government.

Posted by: Amit | Aug 11, 2014 8:54:28 AM

Daniel Gilbert's Stumbling on Happiness had a similar effect on me. One insight I remember well is that we are not good predictors of what will make us happy in the future; nor are we good at remembering accurately what made us happy in the past. Gilbert's book spurred me to write, after a significant amount of research into cognitive psychology and behavioral economics, my article called Nobody's Fools: The Rational Audience as First Amendment Ideal.

Posted by: Lyrissa Lidsky | Jul 10, 2013 11:31:52 AM

Actually, as I understand it, others in the cockpit were using the 30 page checklist for "what to do when your engines stall" while Captain Sullenberg focused on piloting the plane as a glider and negotiated for a safe place to land. Still, you make a good point about the place of checklists in the transformation of aviation. And Captain Sullenberg's conduct makes a good point about using all of the resources on your team, especially in a crisis situation. This last quality principle may have relevance for the Asiana crash as well

Posted by: Ann Marie Marciarille | Jul 9, 2013 11:47:22 PM

"Litigators could use checklists in a deposition or when questioning a witness on the stand. Commercial lawyers can employ checklists at different stages of the dealmaking process."

They don't could, they do. Just google: "due diligence checklist."

Posted by: anon | Jul 9, 2013 2:31:31 PM

Two that spring to mind:

1) The Fifth Circuit has a checklist for preparing Anders briefs, which it strongly encourages counsel to use.

2) The Benchbook for U.S. District Court Judges has "outlines" for conducting various proceedings (such as taking guilty pleas and imposing sentences) that are effectively checklists by another name.

Posted by: Brad Bogan | Jul 9, 2013 1:11:07 PM

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