Why more people don’t use checklists (and why you should)

Last weekend, I read The Checklist Manifesto: How to get things right by Atul Gawande. Gawande makes a very interesting case of how complex operations from fields as diverse as aviation, construction and surgery can be made safer and more efficient through the use of a surprising low-tech tool: The checklist. Pilots swear by checklist and the use of checklists in flights is the reason why air travel still remains the safest way to travel.

Just a checklist

I picked up the book because I have always been intrigued by the power of checklists. A to-do list is afterall a checklist. Gawande would go further and refer to a to-do list as a READ-DO type of checklist but we will leave that for now. The Author led a team that with funding from the WHO produced a checklist in 2008 that was shown to reduce the rate of surgical accidents such as infection and operating on the wrong side of the body or the wrong patient (these things happen). Surprisingly, despite having the research to back up his claims, his checklist has not seen the rate of acceptance among the medical community that we would have expected. He dedicated an entire chapter analysing the reasons for this.

I found that chapter very helpful because I feel it also explains why more people don’t use to-do lists despite them having been shown to make their lives easier.

“It somehow feels beneath us to use a checklist, an embarrassment……………………. The truly great are daring. They improvise. They do not have protocols and checklists.”

The Checklist Manifesto, Page 173.

Every surgeon knows the risks inherent in opening up a human body and poking inside while keeping the person alive. However, they would rather believe they are different and are not likely to make those mistakes the checklist was designed to help them avoid. Surely those mistakes only happened to other doctors at other poorly-equipped hospitals. We all tend to have a rosy view about our capacity and competence. We all want to be the hero who doesn’t have time for things as mundane as a checklist. We’d rather claim to be able to improvise on the spot.

“Checklists get the dumb stuff out of the way. The routines your brain shouldn’t have to occupy itself with.”

The Checklist Manifesto, Page 177.

A checklist is designed to free mental resources not constrain them. Remembering to stop by the store on your way back from work to buy eggs is “dumb stuff.” Until you get back home tired and enter the kitchen only to realise you have to go out again because you forgot to buy eggs. If only you had written that in a checklist.

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