Book recommendation: ‘The checklist manifesto’ by Atul Gawande
You can access a video version of this post.
I highly recommend this book for people who want to become better project managers.
In this book, surgeon Atul Gawande tells the story of working with the World Health Organisation to establish a surgery checklist to improve patient outcomes. The aim is to develop a checklist that could be used in any surgery, anywhere in the world, to reduce the likelihood of infection and other common negative outcomes for patients.
The book focuses on the idea that we live in a time of incredible specialisation in fields such as medicine with an abundance of technology and information to back up the work done. Despite this, negative outcomes in surgery are frequently caused by human error. Gawande notes that the problem for professionals now is not a lack of knowledge or expertise, the problem is knowing what knowledge to use and when. Hence, the value of having a checklist.
Gawande draws on examples from medicine, aviation and construction to highlight the importance of team work and decentralising power in projects. A single master builder cannot have all the relevant knowledge or complete all of the parts of a project. Instead, it is important that skilled people with various areas of expertise come together and communicate well to achieve success.
A publisher page for the book provides the following teaser:
One of the top ten greatest doctors in the world looks at the lowly checklist, and how this simple idea – which is free to reproduce – will revolutionise the way we approach problems, and help save lives.
Sensitive content warning
This book contains case studies of medical procedures, death and risks associated with surgery. It also talks about risks associated with aviation and provides case studies of crashes and near miss scenarios.
What I liked about this book
I was surprised and at times frustrated that so much human error occurs in surgery. The book highlights some areas of work where we expect the practitioner to be skilled and know the correct steps, and not overlook anything (surgery and aviation). The book provides many examples of how people who have performed the same highly complex and technical aspects of a job many times can overlook very minor steps. Gawande promotes the value of checklists to ensure that these fundamentals aren’t missed, especially in situations where there could be diffused responsibility because many professionals are working together (like in surgery).
Diffusion of responsibility is the phenomenon where a person is less likely to take responsibility for action or inaction when other bystanders or witnesses are present. The individual assumes that others either are responsible for taking action or have already done so.
https://en.wikipedia.org/wiki/Diffusion_of_responsibility
I also felt annoyed hearing that some surgeons think they are above being part of a team, using a checklist or being challenged by others in the operating room if things aren’t being done the way that they should be. Using a checklist does not reduce the autonomy or professional judgement of the professionals in a team. Instead, they can serve as a safety net to make sure the fundamentals are covered so that the experts on the project can put their energy into communicating, problem solving and dealing with the more complex aspects of the project.
The writing style
While reading the book, I was excited about the different places from which Gawande drew inspiration and knowledge to develop the surgery checklist. Gawande describes conversations he has had with people and where they were at the time. I felt like I was going on a journey of discovery with him. These discussions and cross field comparisons lead to some fascinating and practical project management insights.
I was compelled by Gawande going to people doing things well and trying to understand how they were successful. I liked the stories of the people involved and the idea of decentralising power in project management. I thought it was cool the way that the author drew parallels across seemingly different fields of practice that I never thought of as sharing transferable skills. Some of the examples resonated with my professional experiences. I also learned some new ways of thinking and some examples caused me to reflect on some of the errors I have made when leading projects.
Big problems were not overly simplified but they were made accessible. The risks of surgery and other areas were made clear through examples. And I liked that the people behind the stories were visible in this book. Gawande made the “so what” of the problem he was trying to solve very clear. Though the book was highlighting commonly made professional mistakes, the tone was never judgemental. There was always empathy for how complex real world problems are, why things can go wrong and even for why some professionals might not take up new knowledge and resources that could improve their practice.
I think I liked the construction section and expert the most in this book. He was straightforward, clearly skilled but without arrogance. He reflected on early learnings in his career to explain decisions he is making now. He advocated for standardisation in processes but gave the people on the ground the capacity to talk and guide decisions when the unexpected occurred.
Author note
This book was recommended to me by Dr Will Dobud. Cheers, Will!
If you enjoyed this book and think I might enjoy something similar that you have read, let me know. I love crowd sourcing good reads.
I have created a video version of this blog post…
Other nonfiction books I enjoyed and wrote about recently…
Photo by Kier in Sight Archives on Unsplash