Book Club #1: The Checklist Manifesto

checklist
Surgeon, author, former staff writer for The New Yorker, Atul Gawande has written three bestelling books, Complications: A Surgeon’s Notes on an Imperfect Science, Better: A Surgeon’s Notes on Performance and, his latest, The Checklist Manifesto: How to Get Things Right (2009). This last book has changed my life.

The Checklist Manifesto writes a riveting and powerful account of how industries such as medicine and aviation save lives using checklists. It’s a simple message. The whole book could really be summed up with this statement: Use Checklists; they work… and they can be more effective if done right. This is not a self-improvement or self help book. It’s not a book on productivity or efficiency. But it will make you more productive… and efficient. Believe it or not, it’s hard to put down. As a producer/director/editor, building checklists into my workflow has been a game changer (more on that later).Gawande writes a bit like Malcolm Gladwell – entertaining, engaging with great themes and stories illustrate a greater truth about the world. In this case, Gawande describes how the professional world has become more complex. In his field, medicine, there was a time, shortly after the discovery of Penicillin, that people felt that a pill could be invented that cured all ills. Of course, many pills DID fix problems (Aspirin for headaches, Salvarsan for syphilis, Birth Control Pills for little monsters, etc) and the assumption was, we’d keep inventing pills for diseases such as cancer, Alzheimer’s, the common cold, AIDs, etc. But then we discovered that many, many more maladies could be treated with a complex series of tasks, that have to be administered in just the right order. One action out of place or forgotten, one question that was not asked, and the patient could be dead. But the right tasks done in the right order, THAT is the magic pill!Though the examples of how the checklist has transformed medicine are fascinating, Gawarde extends his thesis into the work of construction and aviation, where myriad things can go wrong with disastrous results (it’s truly staggering the number of things that can down a plane). The book shows how pilots use checklists to avert air disasters and save the lives of thousands of passengers when something as innocuous as a door latch fails (yes, there is a checklist for that and it’s succinct!)

Humans have spent hundreds of years being ignorant of knowledge we take for granted. Gawande’s field, medicine was especially a joke, where doctors would routinely kill people because they didn’t know how to properly wash their hands. The mistakes made, were errors of ignorance (mankind didn’t know certain things)… but today, doctors are more often making errors of ineptitude (mankind knows these things, it’s just we’re not using them properly). The book makes the distinction that – in today’s world, life is very complex and our mistakes are caused because we don’t have the right processes in place… we get sloppy, we rely on faulty memory, or the fact that we’ve been lucky so far. We forget – or neglect – to do the things we know we should do. So checklists become a valuable part of fixing mistakes of ineptitude. They work in the field of medicine AND TV/film production. A doctor can’t possibly remember the myriad steps to take a patient from admission through surgery, and I can’t possibly remember the hundreds of shots it takes to make up a Television pilot. The most simplified, complete checklist fixes that.

“It somehow feels beneath us to use a checklist, an embarrassment. It runs counter to deeply held beliefs about how the truly great among us – those we aspire to be – handle situations of high stakes and complexity. The truly great are daring. They improvise. They do not have protocols and checklists. Maybe our idea of heroism needs updating.”

People are fallible. Mistakes occur. Egos get the best of us and we don’t believe something we’ve done dozens of times before can be done wrong this time. But checklists can create a process where mistakes don’t occur. If groups are working together, confusion can also be eliminated, and communication can be facilitated by members of the group following a simple checklist (keep it simple… a long or complex checklist can sometimes offer it’s own problems). If the unexpected occurs, checklists can be there to deal with such events. The book details how Captain Chesley “Sully” Sullenberger used a checklist and a team process to save hundreds of lives on Flight 1549, for the Miracle on the Hudson, when his plane hit a flock of birds, disabling both engines, causing him to have to land an Airbus A320 on water.

The solution may be painfully simple. And why right an entire book to remind people to make a To-Do list? Because as experts in our field of work, we require tools. The checklist is not a tool of the weak or forgetful, it’s a tool to wrangle and manage the complexity of a well-exucuted work life and to focus us on writing down the steps necessary to do the best job. Like anything else, doing a checklist right requires practice, and a commitment to personal excellence. But the kind of planning that it takes to make checklists leads to a zen quality of a master. A world class chef is still a chef even when he’s using a recipe, or step-by-step guide to creating one of his many masterpieces, just as a doctor, lawyer, filmmaker or musician is still an expert if they build a process.

“Despite showing (hospital) staff members of the benefits of using the checklist, 20% resisted stating that it was not easy to use, it took too long and felt it had not improved the safety of care. Yet, when asked an additional question – would you want the checklist to be used if you were having an operation – a full 93% said yes.”

HOW I USE THIS INFORMATION:

My method: I use the app Evernote for Mac, which creates easy-to-add checklist boxes. Since it syncs over all my devices, I can have an updated checklist on my phone, iPad, and Laptop and they all reflect the same checklist – and how much I’ve gotten done in a day. When I’m in the field, I usually take the script and break it down into components: shots I need to get, lines I need to make sure the actors/real people say, etc. I don’t print it out, because I’m always carrying my phone, and the list is on my phone. And my computer is right by the monitor anyway, so the same list is synced in both places. In post, when I start cutting and/or use other editors, I use the same process to make sure each beat is cut, and scored. I usually try to keep lists to hierarchical order – what’s most important or challenging is done first (this method came about after reading Eat That Frog, the book by Brian Tracy in which he advises to do the toughest tasks first, and leave the easier stuff to later when your brain starts to become fried, and you start to get a real hunger for a big bowl full of procrastination. So when cutting, I try to tackle the toughest scenes first. Then, after I turn in a cut, we have to deal with multiple notes from multiple execs. This is where the well thought out checklist really helps. Since notes are often conflicting (one exec wants a scene one way, and another wants it the opposite way), I put a lot of time in making a checklist of how to accomplish the notes. I first, clarify the notes so I’m sure I understand them, and figure out how to deal with conflicts (e.g. can the junior execs notes be negated by a more senior exec’s notes?). So ideally, you can turn in another cut after seeing that the checklist of notes has been all checked off. Following a checklist in this way gives you a record of what you’ve done and that peace of mind feeling you get when you put a little check mark in a box.