The Checklist manifesto is written by Atul Gawande. Through his research and work with the WHO they have published the “Safe surgery saves lives” checklist, that aims to improve post-surgery outcomes for all patients worldwide. They have shown statistically significant, and large % increases in positive outcomes when checklist is followed. The books follows several real wold examples of how checklists have been used across industries to ensure things are done right, and conversely adverse outcomes when they are not followed.

Inception

Checklists are heavily use in the construction industry, which is both complicated and complex (in this context I mean large construction projects, skyscrapers etc). The basic skills required to make the building are similar, but no two buildings are alike. Typically known for a waterfall nature, they follow a checklist of tasks to be done in a set sequence in order to achieve success. But even the waterfall nature of consturction unexpected complication happen, e.g., the ground may get depressed due to the weight of the building unexpectedly causing changes to the building under construction. Given the complexity and multi-skilled nature of today’s construction, structural engineer, architect, plumber, building regulations, etc., it is impossible for one person to make the appropriate decision on how to deal with it. So, they use another checklist, communication checklists as a forcing function, to ensure that the people with the right skills come together and consider all possible ramifications, options and sign-off on the deviation to the plan. This is good to know, but construction is a multi-month or a multiyear process. How do we apply this in our fast passed world?

Learning from aviation checklist: Brevity

Aviation on the other hand is extremely fast paced and high stakes. Checklists are extensively used, form the routine, take-off and landing, to the unexpected once in a lifetime, bird strike on both engines. The learning from aviation checklists is to use them as a list of critical stuff that must be done, thus allowing the pilots to focus on other important stuff, like flying the plane. They are not all encompassing, turn your brain off checklists. They are usually short, generally 5-6 steps and never more than 10-12. It is hard to imagine pilots facing off losing 100% of engine power in mind air, running through a checklist, but incredibly that is what they are trained to do, because planes are complex and interconnected systems. It is very easy to miss steps, especially if one has not faced the same situation before.

Conclusion: Checklist as forcing function

Essentially checklist should be designed as a forcing function, forcing the group to ensure certain critical things are done, or crucial discussions are had with the right people. What those things are or who we need to talk to depends on the context of the task and is best designed with the people using those checklists. It is more than likely that our initial checklists will need to be refined. The aviation checklists mentioned above are not static, but ever changing, evolving from aviation advances, regulatory changes, and feedback.

When designing a checklist, we need to assess what is it we want to achieve, what are some critical things that are getting missed or what are the key steps we want to ensure happen? What are the assumptions people have going into a situation that need to be validated before we all jump in and start doing?

These will help us get those essential but crucial elements out of the way and get focused on our job

Link to book on Book Depository