The Checklist Manifesto - Book on a Page

**Created**:: [[2022-10-23 Sunday]] **Link**:: https://youtu.be/0jie6M_MFqQ **Duration**:: 12:42 ![The Checklist Manifesto - Book on a Page](https://youtu.be/0jie6M_MFqQ) # Summary The video discusses "The Checklist Manifesto," emphasizing the importance of utilizing checklists in complex fields like medicine to reduce errors and enhance patient safety. By illustrating the successes of implementing checklists in surgical settings, the video highlights how such simple tools can drastically lower rates of complications and save lives. The presenter argues that checklists not only help in managing tasks but also in improving communication and teamwork among professionals. # Key Takeaways - Checklists can help prevent avoidable deaths and complications in complex tasks, particularly in medicine. - The success of checklists in various industries, like aviation and construction, shows their potential in enhancing safety and coordination. - Effective checklists are concise, focused on critical tasks, and should facilitate team communication rather than overwhelm the user. # Content The U.S. alone has 150,000 deaths following surgery each year. This is more than triple the number of road traffic fatalities. Research has consistently shown that at least half of these deaths and major complications are avoidable. [* ](https://youtu.be/0jie6M_MFqQ?t=0) At the forefront of this issue is a surgeon who's passionate about improving these statistics. In his book, "The Checklist Manifesto," he makes the case that as simple as checklists might sound, they can be a strategy for overcoming failure. They build on the experience and knowledge of people but somehow also make up for our inevitable human inadequacies. [* ](https://youtu.be/0jie6M_MFqQ?t=21) To understand how failure can lead to fatality, consider the following: when was the last time you went on a business trip, and it was only at the hotel or the airport that you remembered you forgot your toothbrush at home? It wasn't because you didn't understand the importance of dental hygiene, but because you were distracted and forgot to pack it. Similarly, in medicine and surgery, simple mistakes can lead to fatalities, such as forgetting to administer the right antibiotics at the right time before surgery or neglecting to wash hands before placing a catheter. [* ](https://youtu.be/0jie6M_MFqQ?t=49) So, why do people fail? There are two reasons: ignorance, meaning that we only have a partial understanding of the world, and ineptitude, meaning that while the knowledge exists, we fail to apply it correctly. In both cases, checklists can serve as a successful tool. Medicine today is extremely complex; think of an intensive care unit. On average, 178 actions are performed on an individual daily. So how do you ensure that all these are done correctly despite all the distractions? [* ](https://youtu.be/0jie6M_MFqQ?t=101) We seem to be obsessed with having great components: the best devices, the best drugs, the best specialists, but pay little attention to how to make them fit together. A tool looked to two other industries—the aviation and construction industries—for references because these industries have managed to achieve an outstanding track record of safety. Checklists were invented after the Boeing Model 299 test flight crashed because it was too complex for one person to fly. The solution that finally addressed the challenge didn't require pilots to undergo longer training; they created a pilot's checklist. [* ](https://youtu.be/0jie6M_MFqQ?t=142) However, it is far from obvious that something as simple as a checklist could be of substantial help in a complex situation. Professionals are tempted to believe that their jobs are too complex to reduce to a checklist. In a complex environment, experts need to deal with two main difficulties: the availability of human memory and attention, especially concerning mundane routine matters that are easily overlooked, and people's ability to lull themselves into skipping steps even when they remember them. [* ](https://youtu.be/0jie6M_MFqQ?t=202) In one experiment to reduce central line infections at Johns Hopkins Hospital, Peter Pronovost decided to give checklists a try. He created a checklist with five simple steps to avoid infections when putting in the central line and authorized nurses to stop doctors if they saw them skipping a step on the checklist. A year later, they found that the line infection rate went from 11 to zero. In that one hospital, the checklist prevented 43 infections and eight deaths and saved two million dollars by providing a cognitive net to catch mental flaws of memory and attention. [* ](https://youtu.be/0jie6M_MFqQ?t=245) Have you ever wondered how hundreds of people are able to build a skyscraper that stands up straight even in an earthquake? How can the workers be sure they are constructing it properly? How can they ensure they have the right knowledge and that they are applying it correctly? In the past, master builders designed, engineered, and oversaw the construction, but by the middle of the 20th century, the master builders were gone. The variety and sophistication of advancements in every stage of the construction process had overwhelmed the abilities of any individual to master them. [* ](https://youtu.be/0jie6M_MFqQ?t=299) Construction companies use two main tools to manage complexity. The construction schedule is a line-by-line, day-by-day listing of every building task that needs to be accomplished, in what order and when. It is drawn up by a group of people representing each of the many trades, and it is like a succession of day-by-day checks. The submit or schedule is also a checklist that specifies communication tasks. Project managers deal with the unexpected by making sure that experts speak to one another and take one another's concerns into account when discussing unplanned developments and agreeing on the way forward in a situation. [* ](https://youtu.be/0jie6M_MFqQ?t=348) To resolve complex problems, you have to ensure that the critical people talk. In the aftermath of Hurricane Katrina, everyone was waiting for the government to step in, but a centrally controlled solution was not going to work. Lee Scott, the CEO of Walmart, realized that to handle this complex situation, he could not effectively issue instructions. Instead, he focused on ensuring that people communicated. Under conditions of true complexity, efforts to dictating every step from the center will fail; people need room to act and adapt yet cannot succeed as individuals. What is required is a mix of freedom and the expectation to coordinate. [* ](https://youtu.be/0jie6M_MFqQ?t=405) At Columbus Children's Hospital, they found that more than one-third of its appendectomy patients failed to get the right antibiotic at the right time. They created a checklist, but getting teams to stop and use the checklist to make it a habit was tricky. The director of surgical administration, who also happened to be a pilot, designed a small metal tent placed over the scalpel, which had the phrase “cleared for takeoff.” This served as a reminder to run the checklist before making the incision, and the surgeon could not start the operation until the nurse gave the okay and removed the tent. This was also a subtle cultural shift, giving the nurse the power to intervene, and in this way, the checklist also had the effect of distributing power. [* ](https://youtu.be/0jie6M_MFqQ?t=454) There are two types of checklists: do-confirm checklists, where team members perform their jobs from memory and experience often separately, but then they stop and pause to run the checklist to confirm that everything that was supposed to be done was done; and read-do checklists, where people carry out tasks as they check them off, much like a recipe. To ensure that checklists get used, you must define a clear pause point at which they are supposed to be used. Always, the pilot not flying starts the checklist because the pilot flying can be distracted by flight tasks and liable to skip it. [* ](https://youtu.be/0jie6M_MFqQ?t=515) Checklists must be tested in the real world. Additionally, checklists can facilitate the sharing of new knowledge as failures are investigated and better ways of doing things are learned. Getting the word out is far from assured, and incorporating the changes often takes years. The reason for the delay is usually not laziness or unwillingness; it is often because the necessary knowledge has not been translated into a simple, usable, and systematic form. [* ](https://youtu.be/0jie6M_MFqQ?t=580) Good checklists are precise, efficient, to the point, and easy to use, even in the most difficult situations. They do not try to spell out everything but provide reminders of the most critical and important steps. Keep your checklist to between five and nine items, focusing on the killer items. Ideally, your checklist should fit on a single page, free of clutter and unnecessary colors. A good checklist should take between 30 to 60 seconds to complete; they are not comprehensive how-to guides but are quick and simple tools aimed at buttressing the skills of expert professionals. [* ](https://youtu.be/0jie6M_MFqQ?t=633) Finding the balance is difficult; if you cut too much, you won't have enough checks to improve the process, but if you leave too much in, then the list becomes too long to use. You should try to focus checklists to ensure that people communicate and work as a team. Finally, bad checklists are vague and imprecise; they're too long, hard to use, and impractical. They treat people using the tools as incompetent and try to spell out every single step, which can turn people's brains off rather than turn them on. The difference between using a checklist signals the difference between an amateur and a professional. [* ](https://youtu.be/0jie6M_MFqQ?t=685) Finally, before closing this book on a page summary, I want to bring to your attention some relevant references from recent books that I've read. In "Building a Second Brain," Tiago Forte talks about pre-project and post-project checklists, highlighting that significant results are most often achieved not through complex one-off heroic missions but through simple workflows implemented consistently day in and day out. Checklists can be an engine to deliver these workflows consistently. I hope you found this book on a page summary helpful. I included a link to the book on a page in the video description. Also, in the video description, you'll find a link to my visual thinking workshop course, which focuses on the workflow for creating such book on a page summaries. Thank you for watching until the end. [* ](https://youtu.be/0jie6M_MFqQ?t=739) # YouTube Details ## YouTube Description #sketchnote #BookOnAPage #checklist #excalidraw #obsidianmd #pkm #productivity ✏️ Sign up for the Visual Thinking Workshop: https://www.visual-thinking-workshop.com/ 🚀 Cohort 4 starts on May 27. 📔 We will be summarizing Decoding Greatness by Ron Friedman into a book-on-a-page In this video, I provide a summary of Atul Gawande's book, The Checklist Manifesto. A high-resolution PNG version, plus the standalone excalidraw file, and the Obsidian-Excalidraw .md version of this BoaP are available here: https://ko-fi.com/s/67995228eb If you find my videos helpful, please say thanks by buying me a coffee: https://ko-fi.com/zsolt If you want to connect, you can reach me (@zsviczian) in the Obsidian Members Group (OMG) on Discord or on Twitter. The book on a page was created with the Obsidian-Excalidraw plugin. Timestamps -------------------- [00:00](https://youtu.be/0jie6M_MFqQ?t=0) Introduction [00:49](https://youtu.be/0jie6M_MFqQ?t=49) We are fallible [01:37](https://youtu.be/0jie6M_MFqQ?t=97) Why do people fail? [02:01](https://youtu.be/0jie6M_MFqQ?t=121) The Problem of Extreme Complexity [02:49](https://youtu.be/0jie6M_MFqQ?t=169) The invention of checklists [03:57](https://youtu.be/0jie6M_MFqQ?t=237) Central-line infections checklist experiment [04:59](https://youtu.be/0jie6M_MFqQ?t=299) Master Builders are extinct [05:48](https://youtu.be/0jie6M_MFqQ?t=348) Construction schedule & Submittal schedule [06:44](https://youtu.be/0jie6M_MFqQ?t=404) Wal-Mart & Hurricane Katrina [07:31](https://youtu.be/0jie6M_MFqQ?t=451) "Cleared for Takeoff" [08:32](https://youtu.be/0jie6M_MFqQ?t=512) Checklist best practices [11:31](https://youtu.be/0jie6M_MFqQ?t=691) References to recent BoaPs [12:18](https://youtu.be/0jie6M_MFqQ?t=738) Closing remarks How to -------- If you'd like to create a similar book on a page summary, check out these videos: How to create a sketch-note summary of a book with Excalidraw + Obsidian + Progressive Summarization https://youtu.be/n3dbH2c3l0M Part 2 Behind the Scenes 1/2: Note highlights and initial sketches. Creating the BASB Book on a Page https://youtu.be/KTsw020KFf0 Part 3 Behind the Scenes 2/2: Creating the final book on a page for Building a Second Brain https://youtu.be/Mo-o4c2pzYE Links -------- The Visual Thinking Workshop Course: https://www.visual-thinking-workshop.com/ Excalidraw Plugin: https://github.com/zsviczian/obsidian-excalidraw-plugin Obsidian: https://obsidian.md My blog: https://zsolt.blog Atul Gawande's book on Amazon: https://www.amazon.com/Checklist-Manifesto-How-Things-Right-ebook/dp/B0030V0PEW/ref=sr_1_1?keywords=atul+gawande+checklist+manifesto&qid=1666545050&qu=eyJxc2MiOiIxLjk2IiwicXNhIjoiMS42OCIsInFzcCI6IjEuNzMifQ%3D%3D&sprefix=atul+gawande+check%2Caps%2C1052&sr=8-1 ## YouTube Transcript [the U.S alone has 150 000 deaths](https://youtu.be/0jie6M_MFqQ?t=0) [following surgery each year](https://youtu.be/0jie6M_MFqQ?t=3) [this is more than triple the number of](https://youtu.be/0jie6M_MFqQ?t=6) [road traffic fatalities research has](https://youtu.be/0jie6M_MFqQ?t=9) [consistently shown that at least half of](https://youtu.be/0jie6M_MFqQ?t=12) [these deaths and major complications are](https://youtu.be/0jie6M_MFqQ?t=15) [avoidable](https://youtu.be/0jie6M_MFqQ?t=18) [is a surgeon who's passionate about](https://youtu.be/0jie6M_MFqQ?t=21) [improving on these statistics](https://youtu.be/0jie6M_MFqQ?t=24) [in his book The checklist Manifesto he](https://youtu.be/0jie6M_MFqQ?t=27) [makes the case that as simple as](https://youtu.be/0jie6M_MFqQ?t=30) [checklists might sound they can be a](https://youtu.be/0jie6M_MFqQ?t=33) [strategy for overcoming failure they](https://youtu.be/0jie6M_MFqQ?t=36) [build on the experience and knowledge of](https://youtu.be/0jie6M_MFqQ?t=39) [people but somehow also make up for our](https://youtu.be/0jie6M_MFqQ?t=42) [inevitable human inadequacies](https://youtu.be/0jie6M_MFqQ?t=45) [to understand how failure can lead to](https://youtu.be/0jie6M_MFqQ?t=49) [fatality consider the following](https://youtu.be/0jie6M_MFqQ?t=52) [when was the last time that you went on](https://youtu.be/0jie6M_MFqQ?t=55) [a business trip and it was only at the](https://youtu.be/0jie6M_MFqQ?t=57) [hotel or the airport that you remembered](https://youtu.be/0jie6M_MFqQ?t=60) [that you forgot your toothbrush at home](https://youtu.be/0jie6M_MFqQ?t=63) [it wasn't because you didn't understand](https://youtu.be/0jie6M_MFqQ?t=66) [the importance of dental hygiene but it](https://youtu.be/0jie6M_MFqQ?t=68) [was because you were distracted and you](https://youtu.be/0jie6M_MFqQ?t=72) [forgot to pack your toothbrush](https://youtu.be/0jie6M_MFqQ?t=75) [similarly in medicine and surgery simple](https://youtu.be/0jie6M_MFqQ?t=78) [mistakes can lead to fatalities mistakes](https://youtu.be/0jie6M_MFqQ?t=82) [such as forgetting to administer the](https://youtu.be/0jie6M_MFqQ?t=85) [right antibiotics at the right time](https://youtu.be/0jie6M_MFqQ?t=88) [before surgery or forgetting to wash](https://youtu.be/0jie6M_MFqQ?t=90) [hands before placing a catheter](https://youtu.be/0jie6M_MFqQ?t=93) [so why do people fail well there are two](https://youtu.be/0jie6M_MFqQ?t=98) [reasons one is ignorance meaning that we](https://youtu.be/0jie6M_MFqQ?t=101) [only have a partial understanding of the](https://youtu.be/0jie6M_MFqQ?t=105) [world and second is in aptitude meaning](https://youtu.be/0jie6M_MFqQ?t=107) [that the knowledge exists but we fail to](https://youtu.be/0jie6M_MFqQ?t=111) [apply it correctly in both cases](https://youtu.be/0jie6M_MFqQ?t=114) [checklists can be a successful tool](https://youtu.be/0jie6M_MFqQ?t=117) [medicine today is extremely complex](https://youtu.be/0jie6M_MFqQ?t=121) [think of an intensive care unit on](https://youtu.be/0jie6M_MFqQ?t=124) [average](https://youtu.be/0jie6M_MFqQ?t=128) [178 actions are performed on an](https://youtu.be/0jie6M_MFqQ?t=129) [individual daily so how do you ensure](https://youtu.be/0jie6M_MFqQ?t=132) [that all of these are done correctly](https://youtu.be/0jie6M_MFqQ?t=135) [despite all the distractions we seem to](https://youtu.be/0jie6M_MFqQ?t=137) [be obsessed with having great components](https://youtu.be/0jie6M_MFqQ?t=141) [the best devices the best drugs the best](https://youtu.be/0jie6M_MFqQ?t=144) [Specialists but pay little attention to](https://youtu.be/0jie6M_MFqQ?t=147) [how to make them fit together Val](https://youtu.be/0jie6M_MFqQ?t=150) [a tool looked to two other Industries](https://youtu.be/0jie6M_MFqQ?t=153) [the aviation industry and the](https://youtu.be/0jie6M_MFqQ?t=156) [construction industry for references](https://youtu.be/0jie6M_MFqQ?t=159) [because these two industries have](https://youtu.be/0jie6M_MFqQ?t=161) [managed to achieve an outstanding track](https://youtu.be/0jie6M_MFqQ?t=165) [record of safety checklists were](https://youtu.be/0jie6M_MFqQ?t=168) [invented after the Boeing model 299 test](https://youtu.be/0jie6M_MFqQ?t=170) [flight crashed because it was too](https://youtu.be/0jie6M_MFqQ?t=173) [complex for one person to fly](https://youtu.be/0jie6M_MFqQ?t=176) [the solution that finally addressed the](https://youtu.be/0jie6M_MFqQ?t=178) [challenge with model 299 did not require](https://youtu.be/0jie6M_MFqQ?t=182) [Pilots to undergo longer training they](https://youtu.be/0jie6M_MFqQ?t=185) [created a pilot's checklist](https://youtu.be/0jie6M_MFqQ?t=189) [but it is far from obvious that](https://youtu.be/0jie6M_MFqQ?t=192) [something as simple as a checklist could](https://youtu.be/0jie6M_MFqQ?t=195) [be of substantial help in a complex](https://youtu.be/0jie6M_MFqQ?t=198) [situation](https://youtu.be/0jie6M_MFqQ?t=201) [professionals are tempted to believe](https://youtu.be/0jie6M_MFqQ?t=202) [that their jobs are too complex to](https://youtu.be/0jie6M_MFqQ?t=205) [reduce to a checklist](https://youtu.be/0jie6M_MFqQ?t=209) [however in a complex environment experts](https://youtu.be/0jie6M_MFqQ?t=211) [need to deal with two main difficulties](https://youtu.be/0jie6M_MFqQ?t=215) [the availability of human memory and](https://youtu.be/0jie6M_MFqQ?t=218) [attention especially when it comes to](https://youtu.be/0jie6M_MFqQ?t=222) [mundane routine matters that are easily](https://youtu.be/0jie6M_MFqQ?t=225) [overlooked](https://youtu.be/0jie6M_MFqQ?t=228) [and people's ability to lull themselves](https://youtu.be/0jie6M_MFqQ?t=229) [into skipping steps even when they](https://youtu.be/0jie6M_MFqQ?t=233) [remember them in one experiment to](https://youtu.be/0jie6M_MFqQ?t=236) [reduce central line infections in Johns](https://youtu.be/0jie6M_MFqQ?t=239) [Hopkins Hospital Peter pronovo decided](https://youtu.be/0jie6M_MFqQ?t=241) [to give checklist a try](https://youtu.be/0jie6M_MFqQ?t=245) [he created a checklist with five simple](https://youtu.be/0jie6M_MFqQ?t=247) [steps to take in order to avoid](https://youtu.be/0jie6M_MFqQ?t=250) [infections and then putting in the](https://youtu.be/0jie6M_MFqQ?t=252) [central line and authorized nurses to](https://youtu.be/0jie6M_MFqQ?t=254) [stop doctors if they saw them skipping a](https://youtu.be/0jie6M_MFqQ?t=257) [step on the checklist](https://youtu.be/0jie6M_MFqQ?t=260) [a year afterward they found that the](https://youtu.be/0jie6M_MFqQ?t=262) [line infections rate went from 11 to](https://youtu.be/0jie6M_MFqQ?t=266) [zero](https://youtu.be/0jie6M_MFqQ?t=270) [in that one Hospital the checklist](https://youtu.be/0jie6M_MFqQ?t=272) [prevented 43 infections and eight deaths](https://youtu.be/0jie6M_MFqQ?t=275) [and saved two million dollars](https://youtu.be/0jie6M_MFqQ?t=279) [by providing a cognitive net to catch](https://youtu.be/0jie6M_MFqQ?t=283) [mental flaws of memory and attention and](https://youtu.be/0jie6M_MFqQ?t=285) [thoroughness checklists seem to be able](https://youtu.be/0jie6M_MFqQ?t=288) [to defend anyone even the experienced](https://youtu.be/0jie6M_MFqQ?t=291) [against failure in many more tasks than](https://youtu.be/0jie6M_MFqQ?t=294) [we realize](https://youtu.be/0jie6M_MFqQ?t=298) [have you ever wondered how hundreds of](https://youtu.be/0jie6M_MFqQ?t=299) [people are able to build a skyscraper](https://youtu.be/0jie6M_MFqQ?t=302) [that stands up straight even in an](https://youtu.be/0jie6M_MFqQ?t=305) [earthquake](https://youtu.be/0jie6M_MFqQ?t=308) [how can the workers be sure that they](https://youtu.be/0jie6M_MFqQ?t=310) [were constructing it properly](https://youtu.be/0jie6M_MFqQ?t=312) [how can they be sure that they have the](https://youtu.be/0jie6M_MFqQ?t=314) [right knowledge and that they were](https://youtu.be/0jie6M_MFqQ?t=317) [applying this knowledge correctly in the](https://youtu.be/0jie6M_MFqQ?t=319) [past Master Builders designed engineered](https://youtu.be/0jie6M_MFqQ?t=322) [and oversaw the construction](https://youtu.be/0jie6M_MFqQ?t=325) [but by the middle of the 20th century](https://youtu.be/0jie6M_MFqQ?t=328) [the Master Builders were dead and gone](https://youtu.be/0jie6M_MFqQ?t=331) [because the variety and sophistication](https://youtu.be/0jie6M_MFqQ?t=334) [of advancements in every stage of the](https://youtu.be/0jie6M_MFqQ?t=337) [construction process had overwhelmed the](https://youtu.be/0jie6M_MFqQ?t=341) [abilities of any individual to master](https://youtu.be/0jie6M_MFqQ?t=344) [them](https://youtu.be/0jie6M_MFqQ?t=347) [construction companies use two main](https://youtu.be/0jie6M_MFqQ?t=348) [tools to manage complexity the](https://youtu.be/0jie6M_MFqQ?t=350) [construction schedule is a line by line](https://youtu.be/0jie6M_MFqQ?t=353) [day by day listing of every building](https://youtu.be/0jie6M_MFqQ?t=355) [task that needs to be accomplished in](https://youtu.be/0jie6M_MFqQ?t=358) [what order and when it is drawn up by a](https://youtu.be/0jie6M_MFqQ?t=361) [group of people that represent each of](https://youtu.be/0jie6M_MFqQ?t=365) [the many trades and it is like a](https://youtu.be/0jie6M_MFqQ?t=367) [succession of day-by-day checks the](https://youtu.be/0jie6M_MFqQ?t=370) [submit or schedule is also a checklist](https://youtu.be/0jie6M_MFqQ?t=373) [that specifies communication tasks](https://youtu.be/0jie6M_MFqQ?t=376) [project managers deal with the](https://youtu.be/0jie6M_MFqQ?t=379) [unexpected by making sure that experts](https://youtu.be/0jie6M_MFqQ?t=382) [speak to one another and take one](https://youtu.be/0jie6M_MFqQ?t=385) [another's concerns into account when](https://youtu.be/0jie6M_MFqQ?t=387) [discussing unplanned developments and](https://youtu.be/0jie6M_MFqQ?t=390) [agreeing on the way forward in a](https://youtu.be/0jie6M_MFqQ?t=394) [situation](https://youtu.be/0jie6M_MFqQ?t=396) [to resolve complex problems you have to](https://youtu.be/0jie6M_MFqQ?t=397) [make sure that the critical people talk](https://youtu.be/0jie6M_MFqQ?t=401) [in the aftermath of Hurricane Katrina](https://youtu.be/0jie6M_MFqQ?t=405) [everyone was waiting for the government](https://youtu.be/0jie6M_MFqQ?t=407) [to step in but a centrally controlled](https://youtu.be/0jie6M_MFqQ?t=410) [solution was not going to work](https://youtu.be/0jie6M_MFqQ?t=413) [Lee Scott the CEO of Walmart realized](https://youtu.be/0jie6M_MFqQ?t=416) [that to handle this complex situation he](https://youtu.be/0jie6M_MFqQ?t=420) [was not going to be able to effectively](https://youtu.be/0jie6M_MFqQ?t=423) [issue instructions](https://youtu.be/0jie6M_MFqQ?t=425) [instead he worked on making sure that](https://youtu.be/0jie6M_MFqQ?t=428) [people talked under conditions of true](https://youtu.be/0jie6M_MFqQ?t=431) [complexity efforts to dictate every step](https://youtu.be/0jie6M_MFqQ?t=433) [from the center will fail people need](https://youtu.be/0jie6M_MFqQ?t=437) [room to act and adapt yet they cannot](https://youtu.be/0jie6M_MFqQ?t=440) [succeed as individuals what is required](https://youtu.be/0jie6M_MFqQ?t=443) [is a mix of freedom and the expectation](https://youtu.be/0jie6M_MFqQ?t=447) [to coordinate](https://youtu.be/0jie6M_MFqQ?t=450) [in Columbus children's hospital they](https://youtu.be/0jie6M_MFqQ?t=452) [found that more than one-third of its](https://youtu.be/0jie6M_MFqQ?t=454) [appendectomy patients failed to get the](https://youtu.be/0jie6M_MFqQ?t=457) [right antibiotic at the right time](https://youtu.be/0jie6M_MFqQ?t=460) [they created a checklist but getting](https://youtu.be/0jie6M_MFqQ?t=463) [teams to stop and use the checklist to](https://youtu.be/0jie6M_MFqQ?t=465) [make it their habit was tricky](https://youtu.be/0jie6M_MFqQ?t=468) [the director of surgical Administration](https://youtu.be/0jie6M_MFqQ?t=471) [who also happened to be a pilot designed](https://youtu.be/0jie6M_MFqQ?t=474) [a small metal tent that was placed over](https://youtu.be/0jie6M_MFqQ?t=478) [the scalpel and had this phrase on it](https://youtu.be/0jie6M_MFqQ?t=481) [cleared for takeoff](https://youtu.be/0jie6M_MFqQ?t=483) [this served as a reminder to run the](https://youtu.be/0jie6M_MFqQ?t=486) [checklist before making the incision and](https://youtu.be/0jie6M_MFqQ?t=489) [the surgeon could not start the](https://youtu.be/0jie6M_MFqQ?t=492) [operation until the nurse gave the okay](https://youtu.be/0jie6M_MFqQ?t=494) [and removed the tent](https://youtu.be/0jie6M_MFqQ?t=497) [this was also a subtle cultural shift](https://youtu.be/0jie6M_MFqQ?t=499) [giving the nurse the power to intervene](https://youtu.be/0jie6M_MFqQ?t=503) [and in this way the checklist also had](https://youtu.be/0jie6M_MFqQ?t=506) [the effect of Distributing power](https://youtu.be/0jie6M_MFqQ?t=509) [there are two types of checklists where](https://youtu.be/0jie6M_MFqQ?t=512) [they do confirm checklist team members](https://youtu.be/0jie6M_MFqQ?t=515) [perform their jobs from memory and](https://youtu.be/0jie6M_MFqQ?t=518) [experience often separately but then](https://youtu.be/0jie6M_MFqQ?t=520) [they stop they pause to run the](https://youtu.be/0jie6M_MFqQ?t=523) [checklist to confirm that everything](https://youtu.be/0jie6M_MFqQ?t=526) [that was supposed to be done was done](https://youtu.be/0jie6M_MFqQ?t=528) [with the read do checklist people carry](https://youtu.be/0jie6M_MFqQ?t=532) [out the tasks as they check them off](https://youtu.be/0jie6M_MFqQ?t=536) [like a recipe to ensure that checklists](https://youtu.be/0jie6M_MFqQ?t=539) [get used you must Define a clear pause](https://youtu.be/0jie6M_MFqQ?t=542) [point at which the checklist is supposed](https://youtu.be/0jie6M_MFqQ?t=545) [to be used](https://youtu.be/0jie6M_MFqQ?t=548) [always the pilot not flying starts the](https://youtu.be/0jie6M_MFqQ?t=549) [checklist because the pilot flying can](https://youtu.be/0jie6M_MFqQ?t=552) [be distracted by flight tasks and liable](https://youtu.be/0jie6M_MFqQ?t=556) [to skip a checklist](https://youtu.be/0jie6M_MFqQ?t=559) [checklists must be tested in the real](https://youtu.be/0jie6M_MFqQ?t=561) [world also checklists can facilitate the](https://youtu.be/0jie6M_MFqQ?t=564) [sharing of new knowledge](https://youtu.be/0jie6M_MFqQ?t=568) [as failures are investigated and as we](https://youtu.be/0jie6M_MFqQ?t=570) [learn of better ways of doing things](https://youtu.be/0jie6M_MFqQ?t=573) [getting the word out is far from assured](https://youtu.be/0jie6M_MFqQ?t=576) [incorporating the changes often takes](https://youtu.be/0jie6M_MFqQ?t=580) [years](https://youtu.be/0jie6M_MFqQ?t=583) [the reason for the delay is usually not](https://youtu.be/0jie6M_MFqQ?t=584) [laziness or unwillingness the reason is](https://youtu.be/0jie6M_MFqQ?t=586) [more often that the necessary knowledge](https://youtu.be/0jie6M_MFqQ?t=589) [has not been translated into a simple](https://youtu.be/0jie6M_MFqQ?t=591) [usable and systematic form good](https://youtu.be/0jie6M_MFqQ?t=594) [checklists are precise they are](https://youtu.be/0jie6M_MFqQ?t=597) [efficient to the point and easy to use](https://youtu.be/0jie6M_MFqQ?t=600) [even in the most difficult situations](https://youtu.be/0jie6M_MFqQ?t=602) [they do not try to spell out everything](https://youtu.be/0jie6M_MFqQ?t=605) [but provide reminders of the most](https://youtu.be/0jie6M_MFqQ?t=607) [critical and important steps](https://youtu.be/0jie6M_MFqQ?t=610) [keep your checklist to between 5 and 9](https://youtu.be/0jie6M_MFqQ?t=613) [items focusing on the killer items](https://youtu.be/0jie6M_MFqQ?t=617) [ideally your checklist should fit on a](https://youtu.be/0jie6M_MFqQ?t=620) [page free of clutter and unnecessary](https://youtu.be/0jie6M_MFqQ?t=623) [colors](https://youtu.be/0jie6M_MFqQ?t=626) [a good checklist should take between 30](https://youtu.be/0jie6M_MFqQ?t=627) [to 60 seconds to complete](https://youtu.be/0jie6M_MFqQ?t=630) [they are not comprehensive how-to guides](https://youtu.be/0jie6M_MFqQ?t=633) [but they are quick and simple tools aim](https://youtu.be/0jie6M_MFqQ?t=636) [to buttress the skills of expert](https://youtu.be/0jie6M_MFqQ?t=639) [professionals](https://youtu.be/0jie6M_MFqQ?t=642) [finding the balance is difficult because](https://youtu.be/0jie6M_MFqQ?t=643) [if you cut too much you won't have](https://youtu.be/0jie6M_MFqQ?t=646) [enough checks to improve the process but](https://youtu.be/0jie6M_MFqQ?t=648) [if you leave too much in then the list](https://youtu.be/0jie6M_MFqQ?t=651) [becomes too long to use](https://youtu.be/0jie6M_MFqQ?t=654) [you should try to focus checklist to](https://youtu.be/0jie6M_MFqQ?t=656) [ensure that people talk and work as a](https://youtu.be/0jie6M_MFqQ?t=659) [team finally bad checklists are vague](https://youtu.be/0jie6M_MFqQ?t=663) [and imprecise they're too long they're](https://youtu.be/0jie6M_MFqQ?t=666) [hard to use they're impractical](https://youtu.be/0jie6M_MFqQ?t=670) [they treat people using the tools as](https://youtu.be/0jie6M_MFqQ?t=673) [dumb and try to spell out every single](https://youtu.be/0jie6M_MFqQ?t=676) [step they turn people's brain off rather](https://youtu.be/0jie6M_MFqQ?t=679) [than turning them on the difference](https://youtu.be/0jie6M_MFqQ?t=683) [between using a checklist signals the](https://youtu.be/0jie6M_MFqQ?t=685) [difference between an amateur and the](https://youtu.be/0jie6M_MFqQ?t=688) [professional](https://youtu.be/0jie6M_MFqQ?t=690) [finally before closing this book on a](https://youtu.be/0jie6M_MFqQ?t=692) [paid summary I want to bring to your](https://youtu.be/0jie6M_MFqQ?t=695) [attention to relevant references from](https://youtu.be/0jie6M_MFqQ?t=697) [recent books that I've read](https://youtu.be/0jie6M_MFqQ?t=700) [in building a second brain Thiago Forte](https://youtu.be/0jie6M_MFqQ?t=702) [talks about pre-project and Pros project](https://youtu.be/0jie6M_MFqQ?t=706) [checklists](https://youtu.be/0jie6M_MFqQ?t=709) [and in how to take smart notes zinc](https://youtu.be/0jie6M_MFqQ?t=710) [irons makes this point that significant](https://youtu.be/0jie6M_MFqQ?t=713) [results are most often achieved not](https://youtu.be/0jie6M_MFqQ?t=717) [through complex one-off heroic missions](https://youtu.be/0jie6M_MFqQ?t=720) [but through simple workflows implemented](https://youtu.be/0jie6M_MFqQ?t=723) [consistently day in Day Out](https://youtu.be/0jie6M_MFqQ?t=727) [checklists can be an engine to deliver](https://youtu.be/0jie6M_MFqQ?t=731) [these workflows day in day out I hope](https://youtu.be/0jie6M_MFqQ?t=735) [you found this book on a page summary](https://youtu.be/0jie6M_MFqQ?t=739) [helpful I included a link to the book on](https://youtu.be/0jie6M_MFqQ?t=741) [a page in the video description also in](https://youtu.be/0jie6M_MFqQ?t=744) [the video description you'll find a link](https://youtu.be/0jie6M_MFqQ?t=747) [to my visual thinking Workshop course](https://youtu.be/0jie6M_MFqQ?t=750) [which focuses on the workflow for](https://youtu.be/0jie6M_MFqQ?t=752) [creating such a book on a page summaries](https://youtu.be/0jie6M_MFqQ?t=755) [thank you for watching until the end](https://youtu.be/0jie6M_MFqQ?t=759)