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TOP 500 REVIEWERon February 23, 2013
Atul Gawande is a physician interested in improving surgical practice. He reviews surgical cases with disastrous outcomes that could have been prevented and cites research claiming that nearly half of deaths that occur in surgery are in fact preventable. We read a detailed analysis of a drowning accident in which the young victim's life was saved against all odds. Why? Because the hospital staff had discussed and practiced the procedures to treat cold-water drowning ahead of time. They used no new knowledge; they just coordinated and communicated more effectively.

Gawande examines how human beings do things. There are two reasons we fail at complex tasks. The first is ignorance. We correct it by conducting research and building schools to increase our knowledge. The second and more common reason for failure is ineptitude--the right knowledge is available, but we do not apply it correctly. People continually forget, are distracted, or skip steps because they seem unimportant. This problem lurks below the radar; we don't recognize it, let alone try to solve it. Instead we send people off for more training to increase their knowledge.

What is needed instead is a simple way to remind people of what they know at the right time to make a difference. We have an answer, we just aren't using it. "Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification, but also instill a kind of discipline of higher performance."

The author examines checklists used by airline pilots, building contractors, investors and other physicians. In these professions work has become too complex for even a talented individual to perform alone. Teams of skilled experts must manage both communication and complexity to succeed. They do both with checklists. These checklists make people stop and think at "pause points" to ensure that the right things have been done. They get coworkers to bond as a team by requiring them to talk to each other. As a result, people become comfortable enough to speak up when they see a potential problem.

Chapter Six, The Checklist Factory is the instructional meat of the book, with recommendations that help us develop good checklists. There are direct guidelines about brevity and clarity. There are also process guidelines about identifying common mistakes and fine-tuning a checklist with field testing. He distinguishes between READ-DO checklists, which march novices through the tightly specified steps of rote tasks, and DO-CONFIRM checklists, which provide checkpoints for experienced professionals solving complex problems in coordinated groups. Both have their place, but DO-CONFIRM checklists have the most potential to make a difference.

There are barriers to checklist use. They have a serious user acceptance problem. Many accomplished professionals consider themselves virtuosos who don't need help from other people at all, let alone somebody else's checklist. To many others checklists seem too mundane to make a difference. The author works hard to persuade us. His own research on checklists in operating rooms finds significant drops in death rates, post-operative infections, and other outcome measures. He highlights successes at prominent hospitals to encourage wider acceptance, asks administrators to impose requirements, and calls on nurses to help change the culture of the operating room. The idea is slowly catching on.

Gawande wishes we would move more quickly. "In the money business everyone looks for an edge. If someone is doing well, people pounce like starved hyenas to find out how. Almost every idea for making even slightly more money ... gets sucked up by the giant maw almost instantly. Every idea, that is except one: checklists."

I learned some things from this book and highly recommend it. Give it at least a quick look, starting with Chapter 6. It has the potential to make you even better at what you do best.
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on January 6, 2017
This is a wonderful book! Descriptions of how checklists can help are provided for surgeries, airlines and building skyscrapers in this easy to read book. As an investor I can see how checklists can help in that field as well as many others. A checklist can help make a very difficult job a little easier by ensuring that more critical items are not missed. As I age and the inevitable surgeries appear on the horizon I am pleased that checklists in surgery theaters have taken root and are being widely used. A very simple tool that can help eliminate or reduce catastrophic errors. The book will leave you thinking about applications in your own field of expertise. I believe that can only lead to improvements in a wide range of activities. This is a book that will help in any endeavor where complications can occur and should be eliminated early on in the process. A very worthwhile read.
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on November 24, 2014
This is a great book, especially for people that work in very detailed based industries. It was recommended to me to read this book by a senior engineer at a competing company. The products that we produce in our industry need to be accurate, but with the amount of detail required there is always little things missed. The solution to this problem is a checklist. Your checklist won't be perfect when you start, but it will grow and get better. Once you have a checklist, you go through it and everything on that list should be addressed.

And you don't have to use this for work related items too. I've started to develop checklists for "traveling", so I never forget anything.

I seen some complaints from people saying that this is nothing more than stories. It's true. The concept of making a checklist doesn't take up many pages, but really the point is to make the case for them. I found the examples and stories quite helpful with determining how to best write out a checklist, the situations that matter and to make better checklists.

If you end up repeatedly missing details within work and life, I recommend reading this book and start making checklists. It will really help.
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on March 24, 2017
One of the most effective and inspiring books I have read in years.
The incredible benefits resulting from such a simple idea are truly fascinating and proof positive in the value of process.
The world certainly needs its genius but process makes the genius attainable to all of us who follow in their footsteps.
A wonderful, wonderful read.
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on April 6, 2010
An excellent read and opens ones eyes to how the simplest of mistakes cause the greatest problems and how easily they can be avoided:
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on September 19, 2011
The book has an out-of-the-box-thinking vibe that does an excellent job convincing the reader of the benefits of using checklists in all walks of life and especially in the medical field. It is written by a curious and imaginative doctor whose observations of other professional domains - and introspective questions about inefficiencies in his field - lead him to challenge the status quo in medicine and champion the cause of a rigorous approach to the multitude of situations faced by MDs.

Given the rigor, routine, and repetitiveness associated with checklists, I expected the book to be boring and essentially read it because of nice reviews in the press, but Dr. Gawande does an excellent job, through real life examples, at emphasizing the advantages and 'coolness' of his cause. On rare occasions, the book becomes redundant with too many examples and statements aimed to hammer the point of the author, but by and large it was a pleasant read and one that got me seriously thinking about the future of humans and technology.

Recommended for anyone who believes in progress.
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on January 2, 2017
Some interesting stories, but the book gets VERY monotonous...I basically had to stop reading as I felt like I was reading the same chapter over and over again getting beaten in the head about the same principles.
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TOP 500 REVIEWERon May 7, 2010
This book seems to make a pretty strong case for the use of checklists. Of course we are exposed to more and less effective uses of checklists through the course of this book, and Gawande's experience limits us primarily to the realm of surgery, although he does get us out of the operating where he can.

The key to the believability of what he proposes here is a communication checklist and also a warning not to use checklists to do our jobs for us (i.e. don't put everything on the checklist, just key tasks that mustn't be missed or that are more frequently missed).

Of course, the challenge is in the implementation, which takes more work than making the case.
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on January 21, 2011
Gawande's Checklist Manifesto is one of the most helpful books I've read in the past 5 years. In very entertaining and persuasive style, he lays out how activities as complex as brain surgery can benefit from something as simple as a 5 step verbal checklist. More interesting than a simple "how to" guide, the book traces Atul's efforts to bring checklists into the Operating Rooms of the world, covering the research he did, his successes and, more importantly, his failures so that we may see how to implement this simple tool in our own lives. After reading this book, I can't see how any job couldn't benefit from a checklist in some manner.
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on February 2, 2011
Who knew a book about checklists could be so darn interesting?!? I bought this book because I'm a huge fan of Atul Gawande's writting but admittedly was not at all convinced on the subject matter. I thoroughly enjoyed the book and was amazed at the point he so eloquently made about the power of checklists. I am now left contemplating how I could integrate checklists in my practice of audiology. My only complaint regarding the book is that it was not long enough!! The book is now on my husband's bedside table which says alot because I don't think we've ever shared a book before!
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