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The Checklist Manifesto

How to Get Things Right

Atul Gawande

Picador

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A New York Times Bestseller

In his latest bestseller, Atul Gawande shows what the simple idea of the checklist reveals about the complexity of our lives and how we can deal with it.

The modern world has given us stupendous know-how. Yet avoidable failures continue to plague us in health care, government, the law, the financial industry—in almost every realm of organized activity. And the reason is simple: the volume and complexity of knowledge today has exceeded our ability as individuals to properly deliver it to people—consistently, correctly, safely. We train longer, specialize more, use ever-advancing technologies, and still we fail. Atul Gawande makes a compelling argument that we can do better, using the simplest of methods: the checklist. In riveting stories, he reveals what checklists can do, what they can’t, and how they could bring about striking improvements in a variety of fields, from medicine and disaster recovery to professions and businesses of all kinds. And the insights are making a difference. Already, a simple surgical checklist from the World Health Organization designed by following the ideas described here has been adopted in more than twenty countries as a standard for care and has been heralded as “the biggest clinical invention in thirty years” (The Independent).

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Book Excerpts

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1. THE PROBLEM OF EXTREME COMPLEXITY

Some time ago I read a case report in the Annals of Thoracic Surgery. It was, in the dry prose of a medical journal article, the story of a nightmare. In a small Austrian town in the Alps, a mother and father had been out on a walk in the woods with their three- year-old daughter. The parents lost sight of the girl for a moment and that was all it took. She fell into an icy fishpond. The parents frantically jumped in after her. But she was lost beneath the surface for thirty minutes before they finally found her on the pond bottom.

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Media

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How to Perform the WHO Safe Surgery Checklist

Atul Gawande and his team demonstrate how to properly use the WHO Safe Surgery Checklist.

How NOT to Perform the WHO Safe Surgery Checklist

Atul Gawande and his team demonstrate how NOT to use the WHO Safe Surgery Checklist.

Better by Atul Gawande--Audiobook Excerpt

Listen to this audiobook excerpt from Atul Gawande's book The Checklist Manifesto: How to Get Things Right. The New York Times bestselling 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.

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Atul Gawande on The Daily Show	Atul Gawande on The Colbert Report
Atul Gawande on Democracy Now!	Atul Gawande on PBS Newshour

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Reviews

Praise for The Checklist Manifesto

“I read The Checklist Manifesto in one sitting yesterday, which is an amazing tribute to the book that Gawande has crafted. Not only is the book loaded with fascinating stories, but it honestly changed the way I think about the world. It is the best book I’ve read in ages.”—Steven Levitt, author of Freakonomics

“Few medical writers working today can transmit the gore-drenched terror of an operation that suddenly goes wrong—a terror that has a special resonance when it is Dr. Gawande himself who makes the initial horrifying mistake. And few can make it as clear as he can what exactly is at stake in the effort to minimize calamities.”—The New York Times

“Even skeptical readers will find the evidence staggering. . . . Thoughtfully written and soundly defended, this book calls for medical professionals to improve patient care by adopting a basic, common-sense approach.”—The Washington Post

“A persuasive champion of his cause.”—The Economist

“The Checklist Manifesto is beautifully written, engaging, and convincingly makes the case for adopting checklists in medicine, a project to which Gawande has devoted significant time over the last several years. . . . It is in many ways the most personal of his books, a direct call to action to change the way health care is delivered through straightforward and simple, yet proven, means. It is a call that deserves to be heard and heeded.”—Journal of the American Medical Association

“Gawande deftly weaves in examples of checklist successes in diverse fields like aviation and skyscraper construction. . . . Fascinating reading.”—New York Times Book Review

“This is a brilliant book about an idea so simple it sounds dumb until you hear the case for it. Atul Gawande presents an argument so strong that I challenge anyone to go away from this book unconvinced.”—The Seattle Times

“Fascinating . . . presents a convincing case that adopting more checklists will surely help.”—Bloomberg News

“Gawande argues convincingly and eloquently.”—San Francisco Chronicle

“The scope goes well beyond medicine. . . Read this book and you might find yourself making checklists for the most mundane tasks—and be better off for it.”—BusinessWeek

“A vivid, punchy exposition of an intriguing idea: that by-the-book routine trumps individual prowess.”—Publishers Weekly

“Maintains the balance between accessibility and precision. He manages to be vivid without being gruesome. . . . —The Guardian (UK)

“Riveting and thought-provoking.”—The Times (UK)

“Eye-popping. . . Gawande writes with vigor and clarity.”—New Haven Advocate

In the Press

Atul Gawande's 'Checklist' For Surgery Success : NPR
The surgeon and writer talks about the massively complicated process of keeping patients alive and shares his simple solution for how that process might be streamlined. Gawande's newest book is called The Checklist Manifesto.
- NPR

Top surgeon Atul Gawande urges doctors to use 'The Checklist' - USATODAY.com
Harvard Medical School's Atul Gawande has written a book about how a simple checklist -- much like the ones pilots use -- can save lives.
- USA Today

Reviews from Goodreads

Mark rated it

May 27, 2012

This book encapsulates, affirms, and extends my experiences with checklists and procedures that began while I was a nuclear power plant operator for the U.S. Navy, where verbatim procedural compliance is one of the keys to power plant safety. I advocate the use of checklists and procedures in IT... ...more

Craig rated it

Apr 20, 2012

Who would have ever believed that David Lee Roth (yes, of Van Halen fame) possessed the insight and intelligence of Boeing test pilots from the 1930s? Certainly not I, and Dr. Gawande himself expressed delighted shock when he learned of the details of their similarities. It all boils down to comp... ...more

Christine rated it

Apr 8, 2012

This frustrates me to no end: beginning of chapter 6, over halfway through the book, he begins "Some time after that first miserable try, I did what I should have done to begin with. I went to the library and pulled out a few articles on how flight checklists are made." I should be happy that he... ...more

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About the Author

Atul Gawande

Atul Gawande is the author of Better and Complications. He is also a MacArthur Fellow, a general surgeon at the Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and an assistant professor at Harvard Medical School and the Harvard School of Public Health. He lives with his wife and three children in Newton, Massachusetts.

Atul Gawande