Not all checklists, Dr. Gawande advises, are good. Some are vague and imprecise. They are too long and hard to use, with too many items to check, and thus impractical.
"They are made by desk jockeys with no awareness of the situations in which they are to be deployed. They treat people using the tools as dumb and try to spell out every single step. They turn people's brains off rather than turn them on," he observes.
Good checklists are precise, but easy to use even in difficult situations. They don't try to spell everything out. A checklist, he notes, can't fly a plane. "Instead, they provide reminders of only the most critical and important steps - the ones that even the highly skilled professionals using them could miss. Good checklists are, above all, practical," he explains. Good checklists also encourage co-operation. They nudge people to work together.
Much of the book is focused on checklists for surgery - including a detailed look at the development of the WHO checklist on safe surgical care - and he highlights the importance of teamwork in an operating room. A checklist ensures that nothing is forgotten in that pressured environment. As well, surgery has become specialized, so there are often many surgeons working together, along, of course, with nurses.
Simply including on the checklist the requirement that everybody introduce themselves before the operation seems to create an atmosphere of collaboration among the specialist physicians, and the nursing staff are also then more willing to point out to a surgeon when he or she is about to slip up. In construction, Dr. Gawande found that the checklists used for major buildings also include practices designed to ensure communication.
The subject and title of the book might suggest it's written in bullet form, like a checklist, but nothing could be further from the truth. In New Yorker style that readers of Malcolm Gladwell, in particular, will be familiar with, he makes all his points through stories. He gives you an evocative manifesto that will convince you of the importance of checklists in important routine processes - including your investments, by the way - but, ironically, he doesn't break from his writerly style even to provide you with a checklist of how to construct a checklist, which some of us might have enjoyed.
In Addition: Grant McCracken, a research affiliate at MIT who also taught at McGill University, believes companies need someone like him - a cultural anthropologist - to divine what is happening with all the dizzying trends swirling in the marketplace. In Chief Culture Officer (Basic Books, 262 pages, $33.95), he stresses that CEOs don't want "a charming survey of contemporary culture" from the new high-level executive he is proposing every company establish. But the book, unfortunately, is that: a charming - highly charming, actually - survey of contemporary culture that I suspect most executives would find a waste of time. And for understanding the marketplace, it may convince them that having a chief marketing officer, as is the current practice, is sufficient, if not preferable, to a culture wizard.
Just In: Two new books look at the strengths U.S. President Barack Obama brings to his position: Leadership The Barack Obama Way (McGraw-Hill, 273 pages, $30.95) by leadership development consultant Shel Leanne, and Inside Obama's Brain (Portfolio, 278 pages, $31), by freelance journalist Sasha Abramsky.
Leadership experts Marshall Goldsmith and John Baldoni and editor Sarah McArthur bring contributions from various authorities in The AMA Handbook Of Leadership (Amacom, 269 pages, $35.95).
