Checklist Manifesto paints an facinating journey of a surgeon who discovered checklists. The book explores checklists across industries and applications, but one lesson pervades them all: use checklists to distribute power.
It’s quite impressive how many industries Dr. Gawande explores in his book: construction, aviation, finance, venture funds, and medicine. Each of them showing major results from checklists.
The book highlights several checklist qualities distilled from all that experience. Good checklist
- aren’t a step-by-step how-to. They prioritize and refresh key points, leaving experts to judge the rest
- encourage discipline, bringing clarity and consistency to the most essential
- are clear, efficient, and usually very short
- encode the obvious but critical
- define clear context for application, sometimes called “pause points”
He also highlights useful existing checklist techniques
- Read-do vs Do-confirm styles
- Routine vs emergency: Define a very short set of routine checklists and an extended index of short checklists for emergencies
- Tasks vs communication: In addition to routine steps, a good set of checklists can mitigate the unforeseeable issues by making sure people communicate
- Teams should read and confirm checklists aloud
- Even using personal, unshared, checklists improves outcomes
Empowering with checklists
One idea recurred over and over in Checklist Manifesto. It’s also the idea that excited me most: checklists distribute power.
Checklists that encode the “obvious but critical” are encoding knowledge everyone can agree is important. These lists highlight shared understanding and promote efficacy in the most essential work functions. Such lists also set a clear basis for members of a group to call each other out, especially when there’s temptation to cut corners.
Even better, administrators can ratify such checklists. If properly backed, such checklists empower those in lower power positions to speak up to those over them. This frees the team to focus on more creative work because they don’t have to fight for the fundamentals. Couldn’t tell you how may times I’ve had to fight for tests in software. Fighting for process that should be standard is deeply demoralizing and undermines a general sense of efficacy.
Checklist manifesto also noted how a simple check-in of name, role, and expected issues improve outcomes for unexpected incidents. It sounds absurdly simple, but it was measured to be consistently effective.
The key is improved communication. First, people don’t communicate well if they don’t know each other’s names and roles. It’s simple but critical and easy to miss in a rush. Remove chance and make sure the team knows each other. Second, requiring each member to speak has an “activation effect”, people are more likely to speak up if they’ve already spoken. Dr. Gawande takes this even further and suggest the leader should not start a checklist. Staring with someone with less power communicates group responsibility and participation.
Better Wrong Than Vague
I can’t resist the connection to Design of Design. After all, I wrote a whole series elaborating on how to prefer to be wrong rather than vague.
Part of the power of checklists is clarifying what’s important and writing it down. This is even more true when the checklist is short or shared by a team. Refining the checklist to only the most powerful options is a difficult. It forces us to prioritize and agree on what matters most.
Conversely, it also highlights what’s not so important and can be left up to expert judgement. Clarity and autonomy is classic empowerment.
I’ve been experimenting with checklists for a while. I love clarifying the essence of processes. I was blown away by the clarity Checklist Manifesto brought to the utility of checklists. Checklists shouldn’t destroy creativity. Done well, they bring a clarity that empowers. Checklists embody a clear shared understanding that should distribute power, unite teams, and save our expertise for the hard stuff.