All My Heroes Use Checklists

Atual Gawande, M.D. has a new book - - The Checklist Manifesto: How to Get Things Right (2010). All of his books have the context and theme of the medical profession - - he looks at the world of medicine the same way Malcolm Gladwell looks at the entire planet - - they both see links and interfaces the rest of us miss. Gawande’s insight into problems and issues that he faces in his profession should be enlightening for engineers. The medical profession and the engineering professions both have the same genetic makeup and come from the same branch of the professional tree. We are both linked to the world and practices of applied science - - our foundations and roots are in the same soil. The two professions utilize science and technology to solve problems - - in both cases they are dealing with people problems. One is concerned with curing and treating water borne diseases - - the other is focused on treating wastewater and the safe delivery of drinking water. Both live in the world of tight linkages among science, technology, and people.

Gawande is a huge proponent of checklists - - mainly because the world has changed so much. The sheer volume of material, the complexity, and the interconnections of systems - - we all live in the era of professional information overload. What information overload is consuming should be rather obvious: It consumes the attention of its recipients. We have produced a professional world where a wealth of information creates a poverty of attention. Technology and complexity has exceeded our individual ability to conduct our professional responsibilities in a correct, safe, and reliable manner.

This is where the old checklist comes into play - - the low-tech idea of outlining the basic steps and procedures for a process or project. Take the complex and reduce it to routine steps on a checklist. Gawande’s “Perfect Checklist” would consider five critical elements - - (1) Include all “stupid but critical” tasks so they’re not overlooked, (2) Make it mandatory for team members to let others know when they complete one of those tasks – think linking a low-tech idea to a high-tech platform, (3) Empower subordinates to question their superiors about the checklist, (4) Allow for improvisation in unusual circumstances (the word “improvisation is probably going to be the word of the year), and (5) Thoroughly test-drive your checklist before putting it into practice.

Flight 1549 demonstrated the power of experience, skill, and professional cooperation. It also demonstrated the power of the checklist - - Captain Sullenberger and his co-pilot followed a detailed emergency checklist that greatly improved their chances of survival. The professional creed for the world of professional complexity and information overload may just be - - teamwork, preparation, skill, discipline, and a checklist.