I have just finished reading a fascinating book called “The Checklist Manifesto” by Atul Gawande, a general and endocrine surgeon at Brigham and Women’s Hospital and leader of the World Health Organization’s Safe Surgery Saves Lives program. In this book, Gawande looks at industries including aeronautics, finance, construction, and healthcare with the aim of understanding why, with so much knowledge at their fingertips, these industries are still prone to failure. The reason, he says, is simple: the volume and complexity of knowledge today has exceeded our ability to properly deliver that knowledge to others. His solution is even simpler: use a checklist.

Gawande details his own experience of being charged with reducing rates of deaths and readmission rates following surgery. He started by looking at what most commonly went wrong during surgery (for example, not giving the antibiotic in the timeframe necessary for it be in the bloodstream at the time of operation) and at the communication between members before, during and after the procedure. Based on the success of a flight checklist developed by the military aeronautic industry after a crash of a test model 299 bomber in 1935, he set about creating a checklist that tried to tackle the complexities of surgery. After much trial and error, in the end it all boiled down to a 90-second checklist that reduced death and readmission rates by more than 30% in eight hospitals around the world at virtually no cost and for almost any kind of operation.

As Gawande says “We are all plagued by failures – by missed subtleties, overlooked knowledge, and outright errors. For the most part, we have imagined that little can be done beyond working harder and harder to catch the problems and cleanup after them. We are not in the habit of thinking the way the army pilots did as they looked upon their shiny new Model 299 bomber – a machine so complex no one was sure human beings could fly it. They too could have decided just to “try harder” or to dismiss a crash as the failings of a “weak” pilot. Instead, they chose to accept their fallibilities. They recognized the simplicity and power of using a checklist. … When we look closely, we recognize the same balls being dropped over and over; even by those of great ability and determination. We know the patterns. We see the costs. It’s time to try something else. Try a checklist.”