The Checklist Manifesto

  • by Atul Gawande
  • Narrated by John Bedford Lloyd
  • 6 hrs and 8 mins
  • Unabridged Audiobook

Publisher's Summary

The New York Times best-selling author of Better and Complications reveals the surprising power of the ordinary checklist.
We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies - neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple 90-second variant has cut the rate of fatalities by more than a third.
In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.
An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential for anyone working to get things right.


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Customer Reviews

Most Helpful

Checklists for Complicated and Complex Tasks

As a University professor of mathematics, mine is a simple job. There's little that's complex or complicated about it. So it would seem that Atul Gawande's new book, the Checklist Manifesto, would have little too offer my professional self. And this is OK, because Dr. Gawande expresses his ideas through anecdote and imagery, making the reading of his essays such a pleasure. This along with my wife's penchant for list-making, drew me to chose this book as the 'listen' for our 1200 mile holiday drive to visit family.

In the book, Dr. Gawande explores the way checklists can affect the handling of complicated and complex tasks by trained professionals. What he learns, through personal investigation and professional involvement with the World Health Organization, is that simple (and thoughtfully constructed) checklists can have a striking impact on the quality and volume of work of a group of professionals. Examples he explores include piloting modern commercial airplanes, managing the construction of a large building, providing rapid-response medical aid, rates of infection in hospital intensive care units, complication rates arising from surgery, and identifying prospect companies for investment by a large investment agency. In each of these cases, he shows how having and using thoughtfully designed (or evolved) checklists reduces errors and increases a group's ability to work as a team.

This latter effect is somewhat surprising and counterintuitive, but it makes a whole lot of sense with Dr. Gawande explaining it. So I'll leave that to him. The book is definitely worth the six hours of listening-time. The hard-copy version is probably a quicker read. As you read the book, I'll be thinking about how these ideas can be used in higher education and in the service of teaching mathematics and the sciences.

Epilogue: Though the book is good, the production of this audio book is uneven.
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- Jason Miller


I work in IT, and up to now I've managed without checklists. Not any more. As soon as I finished listening to this audiobook, I created six or seven checklists and will begin "field testing" them this week. Gawande's stories are gripping. Many of his examples come from surgery or aviation -- situations where lives are at stake -- and he effectively makes the point that even when disaster looms, a disciplined adherence to the checklist can minimize the effects.

He caps off the book with a harrowing story of a mistake he made as a surgeon: a laparoscopic procedure to remove an adrenal gland went awry, leading to a massive bleed-out. Except that the patient didn't bleed out completely, because the pre-op checklist had caught the fact that the required units of blood weren't on hand, and the situation was rectified before the knife went down.

One of the advantages of the checklist, he says, is its ability to transform a disparate group of people into a coordinated team. This is nowhere more apparent than in his detailed account of the crew's actions during the famous plane-landing-in-the-Hudson incident. The press wanted to play up the heroism of the captain, but the captain himself insisted, over and over again, that it was a group effort, and that the crew's ability to stick to the protocol under duress is the real story.

Next time I go in for surgery myself, the last thing I'm going to ask before the anesthesia kicks in is: "Do you guys have a checklist?"
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- Tad Davis

Book Details

  • Release Date: 12-22-2009
  • Publisher: Macmillan Audio