The Unreasonable Power of Checklists

One of the main lessons from *Thinking: Fast and Slow *is that we tend to be more overconfident than we should be. In most cases, we can afford to be this way because the consequences of failing are not too bad. But some professions cannot afford this luxury.

One day over breakfast, a medical resident asked how Dr. Apgar would make a systematic assessment of a newborn. “That’s easy,” she replied. “You would do it like this.” Apgar jotted down five variables (heart rate, respiration, reflex, muscle tone, and color) and three scores (0, 1, or 2, depending on the robustness of each sign). Realizing that she might have made a breakthrough that any delivery room could implement, Apgar began rating infants by this rule one minute after they were born. A baby with a total score of 8 or above was likely to be pink, squirming, crying, grimacing, with a pulse of 100 or more—in good shape. A baby with a score of 4 or below was probably bluish, flaccid, passive, with a slow or weak pulse—in need of immediate intervention. Applying Apgar’s score, the staff in delivery rooms finally had consistent standards for determining which babies were in trouble, and the formula is credited for an important contribution to reducing infant mortality. .Thinking: Fast and Slow, Kahneman

High stakes mean that margin of error is low.

Surgeons and pilots must minimize error because of high stakes. And they love checklists.

If your work doesn’t save lives, it’s okay. You can still improve the quality of what you produce.

There are 2 types of checklists:

DO-CONFIRM— everything is done from memory, then stopped and checklist is checkedREAD-DO— you carry out the tasks as you readThe Checklist Manifesto, Atul Gawande

Before starting checklist:

• Set clear objectives
• Define a pause point to put checklist into action
• Choose type of list – Do-confirm/ Read-do List
• Designate person to put checklist into action

Developing Checklist:

• Keep it short. Less than 10 items
• Focus on Killer Items (critical points)
• Use Simple Language
• 1 Page Only
• No Clutter, distracting colors
• Sans Serif Font

Testing Checklist:

• Get feedback from experience
• Make sure it fits workflow and detects errors at the right time
• Make sure it is not time consuming
• Re-test and fix until it works consistently
• Fix schedule for future fixes

The benefits of using checklists is not only that you reduce error (almost to zero), but that you free up mental space for other more important things. If you had to spend time worrying about what you may have forgotten to do, you’ll forget about the things that you really want to do.

YARPP List

Related posts:

1. Will It Fly Summary (7/10)
2. Modern Man in Search of a Soul Summary (8/10)
3. Part 2: Stir Up The Transgressive and Taboo (The Art of Seduction)
4. Chapter 19: And They Lived Happily Every After (Sapiens)