Book Review – “The Checklist Manifesto: How to Get Things Right” by Atul Gawande

I had earlier read two engrossing books by Atul Gawande – Complications and Better. So when I saw The Checklist Manifesto while browsing in the neighborhood library, I decided to pick it up looking forward to an interesting read (some reviewers had strongly recommended it). The title also indicated that it may a good book to review for this weblog.

Well, I was partially right – it was suitable to post a review on this blog. So, here goes…

The main theme of the book/ book summary is as follows:

  • Over the years, many activities have become extremely complex.
  • Even experts struggle to master and remember all the tasks they have to perform.
  • Use of checklists can minimize human errors of oversight. In many cases this it can improve the performance significantly.
  • Use of checklists can also help the experts focus on the difficult, tricky parts of a situation, rather than worry about the mundane activities.
  • There is need to create better checklists, organize them for easy use and ensure that they are used.

The author uses examples from multiple industries and situations. The best ones are from hospitals and medical emergencies (Dr Gawande is a surgeon :-)). There are other examples from the airline industry (where pilots use checklists for normal as well as abnormal situations), construction industry, retail, and restaurants.

There is a whole chapter dedicated to research where the impact of the use of checklists in hospitals was studied. The research showed that there was a significant reduction in deaths (47% reduction) and major complications (36% reduction) for surgical patients. One interesting finding was that though only 80% of the hospital staff found the checklists useful, 93% of them said they would want a checklist to be used if they were themselves getting operated!

The book sometimes extends the concept of “checklist” beyond its normal usage. Here are a few examples of things that are treated under the concept of checklist in the book (though I believe they are different concepts, with their own place in “how to get things right”):

  • Preparing detailed project plans, dependencies, action items, schedules and list of deliverables (example of a building construction project)
  • Use of collaboration meetings (of experts) to handle non-routine situations (e.g., a building floor developing unforeseen problems)
  • Empowerment for doing something extraordinary (how Wal-Mart employees went beyond their formal authority to help people affected by Hurricane Katrina)
  • Use of focus, expertise and wits (how a pilot saved lives by crash landing on Hudson river in 2009 – by focusing on flying the plane, not on using a checklist!)

In trying to bring everything under the umbrella of “checklists”, the author dilutes the concept and utility of checklists as well as other equally important concepts of detailed planning, collaboration, empowerment, dedication, competence and focus. Maybe the title “The Process Manifesto” would have been more apt.

For people who are already convinced about the use of checklists, procedures, plans, collaboration meetings, etc., this book can provide you with interesting examples to relate to process skeptics in your organization. It can also provide process trainers with interesting case studies to relate to the class. You may also consider gifting this book to colleagues who resist the use of formal processes – the book is an easy read and is able to hold the reader’s attention reasonably well.

If you are looking for readymade checklists that will help you reach some level in CMMI®/ People CMM®, then this book is not for you :-).

Those who have read Gawande’s earlier books – Complications and Better may find The Checklist Manifesto a bit disappointing – it is not as engrossing as the earlier two. This is possibly because the earlier books focused primarily on hospitals, medicine and healthcare based scenarios, where Gawande has accumulated loads of experience. And in Checklist, he provides examples from other industries (aircraft manufacture, real estate, retail stores, restaurants, and so on) where he may not have had the same level of familiarity and insight.

Here are some details of the book, in case you want to get your hands on it:

By the way, you DON’T need a Kindle device to read a Kindle ebook.

Book Cover ImageBook Title: The Checklist Manifesto: How to Get Things Right

Author: Atul Gawande

ISBN-10: 1846683130

ISBN-13: 978-1846683138

Publishing Date: Jan 2010

Publisher: Profile Books

Available at: Amazon.com, Amazon.in, and Flipkart

Available as eBook in Amazon Kindle.

By the way, you DON’T need a Kindle device to read a Kindle ebook.

Other book reviews uploaded on the same blog:


I am Rajesh Naik. I am an author, management consultant and trainer, helping IT and other tech companies improve their processes and performance. I also specialize in CMMI® (DEV and SVC), People CMM® and Balanced Scorecard. I am a CMMI Institute certified/ authorized Instructor and Lead Appraiser for CMMI® and People CMM®. I am available on LinkedIn and I will be glad to accept your invite. For more information please click here. To get email alerts for new posts, click here to subscribe.