Atul Gawande begins his latest book, The Checklist Manifesto, by bringing to our attention an epistemological crisis of sorts. In his view, most of our history has been marred by errors of ignorance, which came about because we just didn’t possess the knowledge to solve many problems. Today, on the other hand, we are more likely to commit errors of ineptitude. Ineptitude seems a bit harsh here, and I prefer to think of them as errors resulting from cognitive limitations, but the point is that we now know so much, we can’t seem to wield this knowledge effectively to solve modern problems. We face a serious knowledge management problem.
Gawande’s solution for this crisis is the humble…checklist. He offers a number of convincing stories, from such domains as aviation and surgery, where checklists have saved lives and saved money – and makes the much bolder claim that checklists might have universal applicability, a claim that might want to sew his case up a little neater than might be possible. The book, as well as it’s companion website, offers a number of example checklists and even a checklist checklist, which provides a summary of checklist design guidelines.
However general Gawande’s thesis may be, anyone who has ever had any significant interaction with our healthcare system will recognize the crisis of expertise that is at the heart of his manifesto. It is a serious problem, worthy of serious attention. And Gawande has made a smart contribution to the discourse, which, at the same time, happens to be entertaining.