Every once in a while you read a book and you just can't help thinking - this one is a game changer. The Checklist Manifesto is one of those books. It's a book with an unbelievably simple premise, the use of checklists improve decision making. OK, I know that seems obvious. However, it's really quite amazing how the author, Atul Gawande, demonstrates this in industries as diverse as medical, building, and airlines.
Everybody has heard the story of how Captain Sully Sullenberger landed US Airways Flight 1549 in the Hudson River in January 2009. What little people realize is how from day one, pilots are taught to use checklists for just about everything - routine gate departures, rough weather landings, and even ditching your plane in a river. When Sully was interviewed, he often would say "he was just doing his job". Sounds like a guy with a lot of humility. But the reality was that he truly had trained for this. After the plane lost both engines, the copilot immediately began running through checklists attempting to restart the engines, while Sully prepared to land in the river.
Mr. Gawande is a trained surgeon. Surgeons get more education and training than just about any other profession. They perform hundreds of operations per year. They save countless lives. As Alec Baldwin said in the movie Malice, "When I'm in the operating room, I am God".
Unfortunately, medical errors are one of the leading causes of death in the United States. One might think that because there are so many medical procedures, that of course there will be errors, that's just the percentages. That is certainly true. However, Mr. Gawande sets out to prove that these errors are avoidable by implementing checklists at certain key times during any surgical procedures. In what should be getting way more attention in the press, Mr. Gawande conducted a landmark study in 8 hospitals all over the world. A baseline study was done to determine the number of errors that occur during surgery and recovery. And then checklists were implemented. Surgeons didn't want them, they knew how to do their job, they had been educated, trained, and performed these operations before. However, the simple act of running through their version of the "pre-flight" checklist was mandated. The results are simply outstanding. Less errors, less complications, more lives saved. Not just a small percentage but drastic changes in error rates.
The building industry has known about checklists for a long time. That's why you don't hear about buildings falling down all the time. Everything is on a checklist.
My key takeaway from the book is that checklists need to be a key part of what we do everyday at Billtrust, the outsourced billing company I work for. We already have checklists at some places - our Project Management team has one they call the "Business Requirements Document" that they use to onboard new customers. But I know our sales team doesn't. Why not have one including key steps like:
- Identified all the key decision makers - check.
- Do I know who has to sign the contract - check.
- Have they bought into the cost savings analysis - check.