Tuesday, February 04, 2014

Canonical Business Books: The Checklist Manifesto

The problem with business books is that they are like lessons on how to draw an owl. (See Seth Godin's blog post on this subject, but the diagram below should explain what I mean.) 





My beef with business books is that they tend to promise so much and oversimplify a solution while providing too many details to support a thesis that is usually based on generalities. Like, "if you do this (author's thesis here), your business will be wildly successful." The supporting examples provided are usually squished in to prove the author's thesis, but taken in a different context could prove other entirely different theses. 

Usually, a business book will make a fine point, one that could be synthesized into a 2-page document, while the rest of the book will leave me feeling like I wasted my time. After making its point, there are chapters of support (always good) but the examples given, even while they seem like "classic" examples that occur in every company, never seem to resonate well. The chapters will end with a conclusion like..."See? All you have to do is x, y, and z and your company can follow in the glory of [stereotypical big companies here]." 

The problem is...in reality, there's always a whole lot more tweaking to do. There's no easy, one-size-fits-all answer.  

Nevertheless, there are some good business books that offer some great lessons. Dr. Atul Gawande's The Checklist Manifesto is not really a business book, as the author writes more about medicine than business, but it's a book about doing better work. And in the end that's what all business books do. 


The Checklist Manifesto identifies the greatest problem of our age: Information. We have too much of it. Complexity is the very real and detrimental side effect of this technological world we have created. While it's tempting to go hide in the mountains--I do this every weekend--we have to deal with the complexity we created and the disappointing fact that we created all this technology to make our lives easier but in essence our lives are palpably more complicated than they were even 10 years ago. Though we aren't serfs working on a plantation, we do still spend an inordinate amount of time working, despite the fact that technology is a tool, meaning that it should help us accomplish tasks faster. But don't fret about all the work we've created for ourselves. There is a solution to the work we have created for ourselves and it's a simple one: The Checklist. 

The Checklist Manifesto's premise is that up until recently humanity's greatest problem was ignorance. Now it's ineptitude. Or eptitude, making sure that we apply the knowledge that we do have consistently and correctly to whatever problem we are trying to solve. The most recent anecdote I can offer that illustrates this principle is what happened during a meeting at work a few weeks ago when somebody stated that we don't have the specs for the approved products of Big Time Customer X. A colleague quickly got on his Smartphone and bam, there were the engineering specs for approved products for Big Time Customer X. There is too much information out there and it's too easy to Google it, and yet sometimes it's so overwhelming we don't even think to look, nor do we know how to filter the bullshit, and apply the knowledge that to which we have such easy access.

The goal is not to be crushed by this information but to learn how to synthesize it, communicate it, and use it well. 

Following the lead offered by aviation, Dr. Gawande offers some evidence of the power of checklists and proffers advice, given his experience in medicine working with the World Health Organization, on how to effectively implement checklists in our complicated lives. 

The idea of using checklists stems from the early history of aviation. After the test flight of the B-17, which crashed killing several people, pilots realized that, with 4 engines and all the related controls and gauges, there was too much information for one pilot to handle. Pilots have been well aware of the idea that memory and judgement are unreliable and fallible, and it's interesting that other professions have been slow to realize this important point.

Checklists have now become an essential element of aviation. Dr. Gawande narrates his visit with Boeing's "checklist writer," who relates  the thousands of situations for which there are checklists and the very scientific process of writing checklists. There is an inherent tension between brevity and effectiveness. Too short and there's no guidance. Too long and it's not a checklist--it's a novel (tl;dr might be the response). 

Once you have everybody's input and analyzed all possible situations, you get it onto one page, with big, clear font, and you laminate it. 

Writing checklists involves the two basic principles of writing: 1) Know your audience; and 2) Anticipate reader questions. And it's really an art. Especially given how much information we have to do deal with. 

Another point Gawande makes is that that we don't just need checklists but co-pilots to read them to us. "That's not my problem" is the worst thing you can hear when working with a team and step 1 to avoid hearing this statement is to know each member of your team and to understand the purpose of your team, so you don't have to hear that awful phrase. When the team knows each other and has a shared purpose, an awful lot of problems can be avoided. It's surprising how many surgeries take place without doctors and nurses knowing each others' names, as Gawande describes operations he has observed and gives statistics on how often not introducing each other takes place in the operating theater. Shocking!

Indeed, the greater the improvement in teamwork, the greater the drop in complications. 

There's also importance in what you don't need to put on checklists. There needs to be room for judgement, especially in complex operations. 

Dr. Gawande distinguishes between simple (several steps, baking a cake), complicated (multiple moving parts, launching a rocket), and complex (dealing with the human element), and it's an important distinction. Complex processes require the greatest room for judgement.

It's amazing how a one-page document can have such a huge effect. Subsidiary benefits of checklists include standardization, which makes it easier to develop metrics and measure progress. Gawande describes how incorporating checklists at one hospital reduced their line-infection rate from 11 percent to zero. In this particular hospital they prevented 43 infections, 8 deaths and saved $2 million. Just with a one-page checklist. 

My favorite anecdote from the book involved the rock band Van Halen, who was very specific in their extremely detailed contracts with concert venues. Each step was very critical to setting up and accommodating their sound equipment. They would write deep in their contracts on like page 17 that in their dressing room they wanted a bowl of M&Ms, but without a single brown M&M. In other words, someone would have to remove each brown M&M by hand. This demand wasn't because the band was made up of egomaniacs (or maybe it was), but because not following this step showed if a venue followed the band's very specific, step-by-step process. Van Halen ended up cancelling a show in Colorado when the venue forgot to remove the brown M&Ms, because they knew that the venue was not detail-oriented enough to follow their process. 

Another excellent point is Dr. Gawande's observation that we are obsessed with having great components but pay little attention to making them fit together well. This is true of medicine, which is what he is referring to with this point. Optimizing a system isn't about optimizing parts, but making things work well together. He gives the example of trying to build the world's greatest car with car parts: the engine of a Ferrari, the brakes of a Porsche, the suspension of a BMW, the body of a Volvo. And what we get is a really expensive piece of junk. The same is true of putting together teams of workers or athletes or even musicians. It's always how you put together the talent, rather than the individual talents of each member. 

In a world in which we live with too much information, it's important to make things as short and clear as possible. Use bullet points. Anticipate reader's questions. If the inquisitive reader wants to know more, give them a link. But, otherwise, repeat the mantra with me: 

  • One page
  • Massive font 
  • Big space between points 
  • Laminate it!


Dr. Gawande's thesis (Life is complex. We need checklists) is spot on and you should read his book if making checklists is truly an interest of yours, but I just saved you 200 pages of his detailed  descriptions of surgical operations, which are very interesting and insightful, but let's face it: There's too much to read out there. Which is why we need checklists! 


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