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12 of 12 people found the following review helpful
5.0 out of 5 stars A great discussion on the use a check lists
This book puts forward a very compelling case for the use of simple check lists to assist in healthcare. These check lists should not be the controlling factor but should act as an aid to helping improve the levels of care given. This is an idea which has been received quite well in the healthcare profession in the U.K. With checklists for bothe Pre and post operative...
Published on 17 Jun. 2010 by John Nunn

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19 of 21 people found the following review helpful
3.0 out of 5 stars An opinion well expressed
The author makes a clear case for the advantages of using checklists in some types of work, showing situations where their introduction had very good results. He discusses what type of tasks are better suited to be assisted by checklists and how a good checklists are made.
You will find good ideas on how to make good checklists, but do not expect recipes (or...
Published on 19 Aug. 2010 by JaiCle


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12 of 12 people found the following review helpful
5.0 out of 5 stars A great discussion on the use a check lists, 17 Jun. 2010
By 
John Nunn (Warwickshire) - See all my reviews
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This book puts forward a very compelling case for the use of simple check lists to assist in healthcare. These check lists should not be the controlling factor but should act as an aid to helping improve the levels of care given. This is an idea which has been received quite well in the healthcare profession in the U.K. With checklists for bothe Pre and post operative procedures being part of Lord Darzi's recommendations.

I first came across this book after Atul Gawande appeared on the Daily Show with John Stewart, and the common sense arguments that he put forward for the use of checklists were very compelling. Their use in scenarios such as Pre-flight have been invaluable and saved counless lives, and not by being monotonous list that dumb down procedures but provide an aide memoir to a skilled individual which helps ensure no critical element of a procedure is overlooked.
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7 of 7 people found the following review helpful
4.0 out of 5 stars It Just Makes Sense, 17 May 2013
By 
prisrob "pris," (New England USA) - See all my reviews
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As a professional nurse, I realize that life has become so complicated, that I want to give the best care possible, and that I need some help. Atul Gawande, is not the first person to come to the realization that checklists are the way to go. He has, however, written about his experiences brilliantly.

I have been involved in many health care improvement projects. This has all led to the realization that the way I practice my craft has changed enormously. One of the most important of these realizations is that we need to include the patient in every aspect of care. After all, is that not why we are here, for our patients? Who better to give us expertise from their advantage point. Dr Gawande has gone a step further and has looked at other professions and how they have overcome the complexities of their profession. The airlines, he discovered use checklists. Now, checklists can be cumbersome, you need to be able to make a checklist that is concise, does not take much time and will be used. Nurses understand that change with physicians can be a black hole. Often, each physician thinks their way of 'doing things' is the best. To corral them into using a checklist takes expertise and good outcomes. What Dr Gawande gives us is that by using a simple checklist for surgeons, outcomes for patients improved 46%. Unbelievable results. However, Dr Gawande has also told us that there has not been one day since he started using checklists that he realized he and his team might have overlooked a step. Certainly, not every step would have avoided a death, but each step will give better outcomes.

Such a simple thing, really, checklists. Busy people, caught in the complexities of life can change their ways and can produce better outcomes by using a simple checklist. Don't we make checklists when we go to market? Realizing, of course, we can't remember everything we need. Ah ha! A moment of recognition- it could work for any aspect of our life. Saving lives is Dr Gawande's method, but making our lives simpler and more productive is just as important. An ah ha moment in reality!

Highly Recommended. prisrob
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74 of 78 people found the following review helpful
5.0 out of 5 stars A defence of rational, systems-thinking approach to handling complex problems, 1 Feb. 2010
By 
S. Yogendra "Shefaly" (UK) - See all my reviews
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Atul Gawande's The Checklist Manifesto: How To Get Things Right has come close on the heels of Umberto Eco's The Infinity of Lists. Both are about lists and both admit to the ability of lists to bring about order and control. Both books attracted me because I am a consummate checklist-maker. Despite my prejudicial preference for lists and reading about lists, it is a credit to the quality of Atul Gawande's writing that the book kept me absorbed for the 3 hours it took to read all 193 pages of it.

The author proposes "checklists" as a functional tool to deal with the limitations of human knowledge and the possibility of making mistakes in the face of complex problems. Using stories from construction management, airline piloting and disaster management, and surgery, he shows how checklists can be used to break down complex tasks into simpler steps, thus helping prevent expensive mistakes. The author delves further into two kinds of lists (Do-Confirm or Read-Do) using a story from how the airline manufacturing industry writes their "user manuals".

Early on, he points out that checklists are not some silver bullet, and that there is judgement involved. Some situations may benefit from checklists, while others may not need any. Later in the book, he also admits that to many, lists are protocols and embody rigidity. He then proceeds to illustrate why this needn't be so and to demonstrate the importance of team work and how checklists enable that discipline, especially in disasters.

I found Chapters 7 and 8 most fascinating. The stories told so far describe the complexity of the work/ task itself but these two chapters introduce another layer, that of institutional complexity.

Chapter 7 details the WHO sponsored study to examine if checklists made any difference to safety, infections, post-surgery deaths in 8 quite disparate hospitals around the world. The results, from using the checklist, regarding reduction in technical problems, complications, infections and deaths were encouraging, for all cultural settings and even allowing for the Hawthorne Effect.

In Chapter 8, much mainstream media coverage of Jan 2009's "Miracle on the Hudson River" is debunked while the author tells the story of the pilots Sullenberger and Stiles and their calm use of appropriate procedures, while their cabin crew prepared passengers for and then monitored safe evacuation, to strengthen his thesis. The other half of Chapter 8 particularly resonated with me because I work with investors and entrepreneurs. I was fascinated by the stories of the 3 investors who have incorporated checklists into their investment decisions, favouring dispassionate analysis over irrational exuberance, so to speak.

The title is deceptively simple for this is a profound book, written accessibly and clearly. It is a defence of rational, systems-thinking approach to solving complex problems, to creating team work and collegiality amongst narrow specialists while ensuring desirable outcomes, no matter what the setting. Managers, entrepreneurs, investors as well as professional project managers such as event planners would do well to read, ponder and practise the idea proposed by the book.
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16 of 17 people found the following review helpful
5.0 out of 5 stars How simple things make huge impacts, 23 Feb. 2010
By 
Jonathan Kettleborough (Cheshire, England) - See all my reviews
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October 30th, 1935. It doesn't seem that special a date until you realise that the consequences of a plane crash that day which raised the comment "too much airplane for one man to fly" resulted in the creation of a pilot's checklist to ensure that all the correct elements of the plane were checked and set in accordance with safe flight.

And so what you may ask? Well a number of years later the acclaimed surgeon Atul Gawande used the checklist to reduce death, injury and hospital re-admittance by dramatic amounts as his book ably testifies. But it's not just the medical profession that have benefitted from the humble checklist. Atul found checklists developed, used and refined by restaurateurs (if you don't follow the recipe then things change over time), builders, business investors (the checklist helps them keep their head, and their money) and even rock bands (there's truth in the M&M story after all!).

Within his book, Atul describes example after example where the simple checklist saves lives, increases profits and maintains quality.

This is an exceptionally well-written book with simple messages that can be translated into all walks of life. Excellent!
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3 of 3 people found the following review helpful
5.0 out of 5 stars So simple but so effective, 18 Jan. 2011
By 
Damaskcat (UK) - See all my reviews
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How do you attempt to deal with a complex situation? Have a checklist in place. It won't solve all problems in all situations but it may well prevent an emergency becoming a disaster. The author investigates how checklists are used in the building trade, medicine and flying aircraft among other examples. I found it really fascinating how a simple list can eliminate common errors and how checklists can be used to help people deal with such situations as aircraft crash landings.

One of the examples which raised the hairs on the back of my neck was the author's detailed description of the plane crash from which everyone escaped alive where the pilot landed on the Hudson River in New York. Here checklists - how to restart an engine and how to prepare for a landing on water played a big part in assuring the safety of passengers and crew as well as the supreme teamwork of all the crew members. As the author explains checklists help to bring a team together and make them work as a team.

Where checklists are involved the whole team working on the situation are expected to provide input. If the most junior member of the team spots a problem they are expected to bring it to everyone's attention and the problem needs to be solved before they can move on. In an operating theatre it is clear that a checklist will help to stop errors or omissions happening and the biggest problem in using a checklist may be getting everyone involved in the process. Surgeons - including himself as the author freely admits - are reluctant to think anything can go wrong in their operations.

The author worked with the World Health Organisation to bring in a system of checklists for use in operating theatres around the world and he was a stunned as anyone at the way the use of checklists reduced infections, reduced complications and reduced deaths wherever they were used. Even in the most well run and hi tech hospitals in the first world checklists improved outcomes. This is a fascinating book which may well give the reader an insight into how checklists can be used in their own sphere of expertise.
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3 of 3 people found the following review helpful
5.0 out of 5 stars Discipline in a world of complexity, 24 Oct. 2010
By 
I. P. Gearing (UK) - See all my reviews
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If you were to seek to categorise the genre of this book you could do worse (though maybe not grammatically) than describe it as a "What done it". Let me expand by referring to the end of the book.

Atul Gawande, surgeon, author, ends with a brief study of US Air Flight 1549 "The Miracle on the Hudson" as a compelling study of expertise (though he more catchingly labels it heroism) in the uber-complex world of aeronautics. It ended well because it was designed to end well and the key players knew what the script was (and calmly played their roles, which, given the circumstances, qualifies as heroism for me). Compare this then (which Gwande might usefully have) with Air Florida Flight 90 which ditched in the Potomac because of what Goldstein et al (Yes! 50 Secrets from the Science of Persuasion) call "Captainitis" where the authority, experience and self regard of the Captain of that flight led him to overrule the concerns of his co-pilot on icing and the consequent events ended tragically in ice bound waters of the Potomac.

For the Captain of Air Florida 90 read "Surgeons" and you have the basics of the problem that he is addressing. A very high percentage of flights end in safety. Most surgery ditto. Both are area of considerable expertise but for very different reasons, with this expertise goes great responsibility and when you are the smartest person in the room you don't need to ask anyone else. Goldstein et al refer to Watson and Crick and Rosalind Franklin in their contrasting styles where Franklin was the top researcher in the field of Microbiology.

Surgery maybe a set of standards and routines but patients, annoyingly, refuse to comply with the text books when it comes to treatment. Better, then, not make things worse through mistake, but mistakes happen; mistakes maim and kill.

Chaos theory maintains that the biggest factor on outcomes are the conditions prevailing at the outset. This is the area within surgery that Gawande points his scalpel. The tick list, correctly assembled, correctly maintained and correctly implemented can be used to focus on the small but necessary details that, in retrospect, form piquant moments of truth - opportunities to manage the quality of outcomes through attention to those vitally important initial conditions. Right first time. Proactive rather than reactive. Feed-forward control. Pick your own labels.

Using examples from a variety of fields (which some have felt repetitive)Gawande seeks to show that this is one solution to the increasing complexity of the modern world, where experts know more and more about less and less, the rise of the so called "Super specialists", but still a world where experience and knowledge have to come together in often far from ideal conditions in order to get a result. The key is team and the tool is the tick list.

Overall a thought provoking book and a worthwhile reference piece applicable to any number of professions.
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5 of 5 people found the following review helpful
5.0 out of 5 stars Outstanding!, 21 Feb. 2010
By 
W. Harrod "Valuta" (Angus, Scotland, UK) - See all my reviews
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A great example of a simple tool having a huge impact in a complex environment.

The real value is in considering your own complex challenges, working to understand what really makes a difference, then finding a simple way to use it!

Simple, not easy.
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19 of 21 people found the following review helpful
3.0 out of 5 stars An opinion well expressed, 19 Aug. 2010
The author makes a clear case for the advantages of using checklists in some types of work, showing situations where their introduction had very good results. He discusses what type of tasks are better suited to be assisted by checklists and how a good checklists are made.
You will find good ideas on how to make good checklists, but do not expect recipes (or checklists!) for doing them.
I usually expect this type of books to be quite repetitive, getting the message through in a few pages and then repeating it over and over. This is not the case, being quite enjoyable to read.
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3 of 3 people found the following review helpful
5.0 out of 5 stars How to acheive reliability, 30 Aug. 2010
Gawande is a gripping writer and captivates the reader whilst taking you through a journey. A collection of stories that, together explain how we might raise the bar in what we can achieve if we are prepared to make a leap. The leap is not complicated but requires us as 'experts' to accept that mastering complexity requires us to admit we are human and fallible. We can then fix the numerous simple tasks with a checklist and improve our response to the unexpected with an appropriate communications 'checklist' to ensure all members of the team are empowered to act as appropriate. An excellent read
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2 of 2 people found the following review helpful
4.0 out of 5 stars Good ideas but a bit long, 18 Feb. 2013
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I really enjoyed this book, the stories from areas such as medicine, airlines and construction keep the pages turning, and looking back a few months after finishing it had a real impact on the way I approached a number of areas in my working life. That having been said, much like many books in this genre, it essentially contains one really good idea that is then overwritten into a book. Two hundred pages to describe someting that could probably have been done in about thirty. But would still recommend to those who have an interest in dealing with an area of work where mistakes/failures are due to the amount of knowledge required to perform successfully, as opposed to tryying to use the system to improve the capability of those undertaking the work.
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The Checklist Manifesto: How to Get Things Right
The Checklist Manifesto: How to Get Things Right by Atul Gawande (Audio CD - 22 Dec. 2009)
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