A small, low cost, autonomy-preserving intervention that yields dramatic improvements in a desired outcome. Where have I heard this before?
Gawande describes his discovery of the checklist, its benefits, and the difficulties to design a good one so that it is actually used. With Gawande being a general surgeon the book is rather focused on his medical work. Though his narrative also adds insights from airline pilots – who has not heard of the pre-flight checklist? – and construction, and, superficially, finance.
The obvious benefits of catching small oversights with a checklist that even, no, especially trained and experienced professionals often commit seem surprisingly dramatic in medicine. Yet, I was more impressed with a, for a lack of better expression, nudge that was/is implemented with the help of a checklist and not with the direct impact of the checklist itself: Actors (i.e. the surgical team, the different specialist builders) are made to talk to each other (and learn each others’ names) and share responsibility. Indeed, responsibility and therefore decision power is redistributed from the top to the bottom. That, I believe, is a major driver for the success of groups.
Bottom line: The checklist manifesto is not a gripping thriller, it is not intended to entertain. Similar to a checklist it may seem a bit dry. And maybe there is even too much detail when Gawanda writes about his personal experiences with patients. It is interesting, though. Eye-opening even. And yes, I would like to have more checklists (or reliable, written rules and procedures that would serve as checklists) for my own work – sometimes, for the administrative parts.