The Checklist (2007)

http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande?currentPage=all

by bearwithclaws • 15 years ago

78 25 15 years ago

wr1472• 15 years ago

Atul Gawande wrote the Checklist Manifesto (http://gawande.com/the-checklist-manifesto) which goes into a lot more detail about all this. I would thoroughly recommend reading it if you want to improve how you get stuff done.

RyanMcGreal• 15 years ago

It's a fantastic book that literally changed my life. I've incorporated checklists deeply into my workflows, to the extent that when I start a new project, the first thing I do is generate a checklist to work against. The number of casual errors, oversights and other preventable errors I make has dropped precipitously. Call it Checklist-Driven-Development (CDD).

prakashk• 15 years ago

+1 for the Checklist Manifesto. Gawande is an excellent writer. I liked his other books, particularly Complications (http://gawande.com/complications).

adolph2• 15 years ago

The checklist for checklists seems like gold for making certain a group of people are on the same page when making checklist items.

http://www.projectcheck.org/checklist-for-checklists.html

r00fus• 15 years ago

From that same site [1], you can see a collection of checklists [1], one of which is the actual checklist that Pronovost created at Johns Hopkins Hospital.

[1] http://www.projectcheck.org/checklists.html

danso• 15 years ago

I second-thirded-n'ed this recommendation...the closing chapter in which Gawande describes how a checklist prevented a patient from dying on him in surgery is just gripping.

There's also excellent sections on construction...such as how project managers make and disseminate decisions at a breakneck pace in skyscraper construction.

yummyfajitas4• 15 years ago

Checklists (or scripts) also work well in education:

http://www.jefflindsay.com/EducData.shtml

http://www.mathematicallycorrect.com/honestft.htm

http://www.projectpro.com/ICR/Research/DI/Summary.htm

kgroll• 15 years ago

And, as patio11 suggests, in deploying code.

From his Mixergy interview (4/30/10) [1]:

``I have a physical checklist for when I’m doing a deployment. It’s, off the top of my head maybe six commands long; one, two, three, four, five, six. I check them off; dink, dink, dink, dink, dink. And then after I do that, I have the other checklist to verify that it actually took, you know the things that I did that had the expected effect. I missed doing that once because I was exhausted at the day job and, sure enough, that was my biggest down time in four years. So I’m trying to be better at it in the future.''

[1] http://mixergy.com/patrick-mckenzie-interview/

yummyfajitas4• 15 years ago

True, though I generally treat such checklists as a code smell. Ideally all the items should live in your makefile.

[edit: added emphasis to the word "ideally".]

jmcqk62• 15 years ago

Project Follow Through contained several major problems, but it doesn't take a researcher to recognize the biggest problems of Direct Instruction.

Scripted curriculum might sound good to some people, but it has two major flaws: first, it destroys any possibility of differentiated instruction. Secondly (and related), it insures mediocre performance by students.

Scripted curriculum tells teachers exactly what to do during every moment of the day, from hand gestures to exact words. In most places that implement this, any deviance from the script is grounds for reprimand.

How many HN users would like to learn in this environment? How many of you think you could learn like this? I'm willing to wager that many of you would answer 'no' to both of these questions.

yummyfajitas4• 15 years ago

Project Follow Through contained several major problems...

For example?

...first, it destroys any possibility of differentiated instruction.

No, it merely destroys the possibility of ad-hoc differentiated instruction. I know a girl who teaches DI. She showed me her script and it contained differentiated instruction - "Try { block (a) } catch { try block (b) }."

Block (a) and Block (b) are different instructional scripts. They are also told to directly answer questions when the student has them.

Secondly (and related), it insures mediocre performance by students.

I'd love to see some sort of argument for this.

How many HN users would like to learn in this environment? How many of you think you could learn like this?

Actually, I suspect many HN users learn from a method like this. I certainly do, although I skip the middleman and just read the book directly.

This is also the exact same method that, for example, Salman Khan or ai-class.com uses. The only difference is that he performs the script as well as writing it.

However, you are correct that punishing deviation from the script is a bad idea. Rather, teachers should be punished for bad performance. This gives teachers an incentive to stick to the script, unless they are quite sure their ad-hoc methodology is superior to the expert methodology.

nhebb• 15 years ago

I have a number of checklists I use, from deployment to form design, but the practice that has had the biggest impact for me is creating on-the-fly checklists while I'm coding. I often set out to do one thing and realize there are four or five other things that need to be implemented or changed. I used to try to keep track of everything in my head, but when your mental todo list starts looking like a complicated digraph, that just isn't effective. Now I don't code without a scratch pad by my side.

hello_moto2• 15 years ago

HN-ers, listen to this business proposition (this is not a sarcasm, but this is an idea, a perspective if you will).

Find one of the productivity books, preferably ones that are quite popular. Implement a software, web-app, mobile-app, desktop-app, plugins, whatever, based on such books.You'll get instant userbase that love your software.

Rinse-and-repeat.

There are a few productivity tools based on GTD out there. Looking at the checklist-for-checklists link that adolph mentioned in this thread reminds me of Trello. Seems like a simple money making scheme don't you think?

adolph2• 15 years ago

Thanks for the reference to Trello. That looks interesting and I'm trying it out now.

I think that one of the challenges in the business proposition you make is the translation from paper to screen, somewhere between Gawande and Tufte.

zefhous• 15 years ago

It's a good idea, but not so simple to actually get traction...

A couple years ago I was hired to build a checklist web app based on Atul Gawande's book, The Checklist Manifesto. Being the very idea that you're referring to here it's a very relevant example.

The guy who hired me has invested a lot of time and some money into trying to get traction but nothing has come of it. Granted he's probably not done everything perfectly, but he's put a lot of time into seeding the site with public checklists for different subjects and trying to get people using it.

As far as I know nobody uses the site. It's not that great but it provides some basic value and is definitely a minimum viable product including revisions, public and private checklists, ability to share and collaborate with others, pdfs, etc.

For those curious the site is here: http://expertchecklists.com/

AdamFernandez• 15 years ago

I think all of these checklist ideas are great, but does anyone have any suggestions regarding how to make the decision makers in the medical community pay attention? It sounds like there are possible opportunities here.

peteretep• 15 years ago

I used to travel a lot for work. My "Master Packing List", has meant I no longer find myself meeting clients without, say, a belt, or socks, or laptop charger, etc.

tom_b• 15 years ago

Challenge HN: Share your checklist for training yourself to be a better hacker. Or to have more successful projects.

GFischer2• 15 years ago

I guess that a hospital is like the military in that there has to be clearly delineated chain of command, but some points raised in the article could be solved by empowering doctors and especially nurses:

"chlorhexidine soap, shown to reduce line infections, was available in fewer than a third of the I.C.U.s. This was a problem only an executive could solve"

If nurses and doctors were empowered, that problem probably wouldn't have arisen.

I agree that other solutions are more in executives' territory: "they persuaded Arrow International, one of the largest manufacturers of central lines, to produce a new central-line kit that had both the drape and chlorhexidine in it."

ArbitraryLimits• 15 years ago

I don't know about that. The main point I got from the article is that when doctors are more empowered they disdain the checklist and mess up more.

GFischer2• 15 years ago

I'm not taking away from the checklists, which sound like a great improvement :) .

It was an observation about the executives.

kylemaxwell• 15 years ago

I've seen this many times and it never gets old.

The Checklist (2007)

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