LEIGH FORBES: Books of all Sorts

Checklist Manifesto: How to Get Things Right


by Atul Gawande.

Citing examples of its use in the hospital where he works (and elsewhere), Atul Gawande illustrates how the checklist can be an extremely valuable tool in the decision-making process, particularly in complex and changing situations (such as Accident & Emergency). By listing the most vital information to be gathered, in what order, and at what point in the process, the checklist increases the chances of those involved developing an accurate picture of what’s happened, keeping track of what’s happening at that moment, and making informed decisions about what’s most likely to happen next.

The scenarios Gawande cites mostly concern healthcare (he’s a doctor), but the checklist can help in any area of life where it’s important to correctly access a varying mass of information in a short space of time (another example is in pre-flight checks). He admits it’s not the answer to everything, and that it can take a lot of experimentation before any particular checklist is as effective as it can be, but he puts forward a convincing argument. He also discusses the problem of trying to get senior and long-standing professionals (e.g. surgeons) to change their behaviour, from relying on their own experience, judgment, and instinct, to putting a great deal of trust in a sheet of paper. But the results can be outstanding.

(This book recently came in handy, when my daughter had an accident at school. The information I was given [verbally] at hand-over was not enough for me to make an informed decision about her condition [besides, with loudly distressed child, I struggled to take in the information I was given]. Had I known then, what I knew later, I would have taken her straight to hospital. Instead, there was a delay in getting her the attention she needed. In retrospect, I thought about this book, and went looking for a head-injury checklist that could be used another time. Happily, the school welcomed the idea, and I hope it might make a difference in the future.)


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