Subscribe to the Three Star Leadership Blog

The Working Supervisor's Support Kit is a collection of information and tools to help working supervisors do a better job. It's based on what Wally's learned in over twenty years of supervisory skills training.

Follow me on Twitter

For weekly tips and resources pointers, check Wally's Three Star Leadership Letter

Find out more about having Wally speak to your company or convention.

Find out more about Wally's coaching services.

The Checklist Manifesto: How to get things right is a smoothly written book that builds on two basic premises. The first is that we we've learned the best way to do many things, but we often fail to do them well because of our human limitations.

To illustrate this, Gawande tells several stories. The most compelling and powerful is the story of a young Swiss girl who was trapped beneath the ice in a pond. She was under water so long that, as recently as a couple of dozen years ago, that would have been it. Her body would have been retrieved from under the ice and she would have been pronounced dead.

Not so today. The girl is transported to a hospital where she is brought back to life. That's a miracle, but as Gawande points out it's also a story of a very complex mission. To get the result

Scores of people
Needed to perform thousands of procedures
Correctly
In the right sequence
And with the right timing.

If any of the procedures was omitted or done incorrectly or out of order or too early or late, the result would have been different. We know a lot. Putting it to work can be tough.

The second premise is that simple checklists are the way to make human beings able to master the complexity. Indeed, the subtitle for the book is "How to get things done right."

Gawande first uses the illustration of Peter Pronovost and his simple checklist for a single medical procedure. The results were almost miraculous. When the checklist for that procedure was tested in Michigan, infections declined by two thirds almost immediately.

That sets the stage for chapter 2, "The Checklist." Gawande opens with the story of the Boeing Model 299. Originally the plane was "too complex for one person to fly." But then, some pilots came up with the idea of using a checklist as a memory aid to make sure that everything necessary to prepare to fly this multi-engine airplane got done. Checklists are the secret to getting complex tasks done well.

Chapter 3, "The End of the Master Builder," does two things. It compares the situation in medicine today to the situation in the construction industry when buildings became too complex for one person to know, remember, and evaluate all the details. Gawande describes the use of checklists in construction to assure that steps are complete and to deal with exceptions, issues and problems.

Chapters 4 and 5 return to the introduction of surgical and related checklists in medicine. Gawande describes the difficulties of putting an effective checklist together.

That leads to chapter 6, "The Checklist Factory" which brings us around again to aviation checklists. In this case the author visits the part of the Boeing Corporation that develops, tests, and revises checklists for all Boeing aircraft.

Chapters 7 and 9, primarily about medical checklists bracket a chapter on "The Hero in the Age of Checklists." There, Gawande uses the story of flight 1549's "Miracle on the Hudson" to make his case for checklists as guides for actions and sources of teamwork.

Make no mistake. Gawande is writing The Checklist Manifesto as a physician and as a call for increased use of checklists in the practice of medicine. That is a noble cause, but it may not what you're looking for from the book. And it leads to several problems.

The first problem, unless you're in the medical field, is that you will have to do a bit of work to define for yourself how what Gawande tells us relates to what you do every day. If you want to cut right to the chase, read chapters 2, 3, and 6. There's also a discussion of checklists in venture capital investing in chapter 7. They're worth the price of the book.

Another problem is that, for Gawande, everything becomes a checklist. Checklists are checklists, of course. So are To Do lists. So are protocols. So are recipes. So are information gathering forms. If that bothers you, skip this book.

Since his purpose is to encourage the use of checklists in medicine, the checklist becomes the hero. One instance is in his telling of Wal-Mart's response to Hurricane Katrina.

Wal-Mart authorized its store managers to do whatever they could to help people. Many did simply amazing things. Wal-Mart's logistical team got supplies into the area while FEMA was still in the press conference stage. That's great, but I'm still scratching my head trying to understand what that all had to do with checklists.

The story of US Airways flight 1549 and the "Miracle on the Hudson," is told in the same way. Checklists are the hero. But that position doesn't stand scrutiny. 

There were several things that contributed to the miracle. One was the professionalism and calm of the entire flight crew, as Captain Sullenberger, who got almost all the media credit hastened to point out again and again and again.

There were also Sullenberger's flight skills. There was the technology that helped him execute the perfect glide slope. And there was a bit of luck. Checklists were part of the story, but hardly the hero.

This is a superbly written book. Dr. Gawande is an excellent storyteller. He also uses his own learning as a kind of frame story to introduce other stories. You can enjoy it as a way to stimulate your thinking in an enjoyable way.

But, unlike Gawande's other books, The Checklist Manifesto takes some work to draw out the practical material and apply it in your own world. If that's your main goal for reading the book, you can skip right to the more useful chapters.

Wally's Working Supervisor's Support Kit is a collection of information and tools to help working supervisors do a better job. It's based on what Wally's learned in over twenty years of supervisory skills training. Click here to check it out.