The Power of a Checklist

Usually it takes me atleast a few days if not weeks to complete a book. But this one, took just a day.

Disclaimer: I am a firm believer and follower of checklists and todos to the point that my memory is completely handicapped without one!

So when I picked up Atul Gawande's The Checklist Manifesto, I was pretty sure that I would understand his logic and reason for dedicating a whole book to a mundane thing as a checklist.

His book demonstrates the successes in terms of life-saving, effectiveness and efficiency across professions from those in which split second decisions can decide the fate of someone's life and time is a luxury to others where one can spend as much time as needed to create perfection. Medicine, aviation and disaster relief to architecture and construction, restuaurant business, music industry.... How does one build a 100-storey building without accident or how does one produce 300 mouth watering perfect dishes in four hours or how does one assure safety of passengers in a plane with failed engines?

Gawande's theory on checklists is that it is a reminder of those seemingly simple tasks which tend to get forgotten or overlooked. It is not a comprehensive to-do guide. Therefore it cannot be very long and tedious. It has to be short enough that it will be referred to and not add to the workload. Secondly, the secret of an effective checklist is that it ensures communication within the team. This takes cares of the unpredictable! Very often checklists cannot predict what will go wrong and something always does. So it ensures that the teams talk to each other at important junctures of the project and hopefully come up with some strategies to overcome the problems.

In the case of medicine, one of the things he has studied is central line infections before and during surgery which have emerged as one of the main causes of surgical failure. A checklist was developed and had to be read out loud in the operating room. Therefore he distinguished between DO-CONFIRM tasks and READ-DO tasks. One of the first was that everyone in the room must introduce each other. This somehow contributed in making the strangers in the room
feel like a team. Other tasks were checking if the antibiotic was given in the right time frame, or the gloves were changed etc. Studies later showed that after using such checklists, there was a dramatic drop in such infections and the hospitals actually saved millions in costs.

Another interesting example is from the music industry. Van Halen signed very detailed contracts with the organisers with some weird clauses-one being that there should be a bowl of M&Ms without the brown ones in the dressing room. This was a just a symptom of what else could be possibly wrong! If the organisers ignored a simple task as separating the brown M&Ms, they most likely also failed to follow instructions in other-often more disastrous tasks-like the stage or equipment etc.

I already put this in practice. One thing I realised with my checklists is that they are long and detailed. Now I wanted to keep it that way but what I did was that I added a last page with the "FINAL CHECK" where I listed the 5-6 key points which can make the campaign a success of a failure and one of the points was that the team has predicted the possible disasters and has strategies in place to deal with them.

Well will this work or not? I am not sure, but its worth a try. Sometimes the solutions to our problems need not be as complicated.

The Market for Local Guides

Despite all the pleasures of seeing new sites, one annoyance that I least look forward to is the rush of tourist guides that surround and hound you. Usually these would be young dudes who claim to show you all the sites at a very enticing price. Recently at Jaipur, we were also approached by "government approved" tourist guides with even a proper name tag. The dilemma facing the average Indian tourist seems quite serious: do you choose the government guide who has a fixed charge or you choose the unlicensed young dude at sometimes even half the price?

If you look at the service that these guides provide, its basically history of the particular monument and if you are lucky some additional stories as a value addition! The guides also differentiates their service as per language, we could hear guides rattling off Japanese, Spanish, German...you name it. A new competitor on the scene-the audio guide-is also giving taking away some (not that much as audio guides are largely preferred by foreign tourists) clients. Since I am a big fan of the audio guide and Parth of the live version, potential guides often try very hard to persuade me to change my mind, my favourite one, "Madam, see the audio guide cannot answer your questions, you only listen!" So given the competition but just from other guides but also from this machine, one can understand that this is a market of the "survival of the most persuasive"!

Now the question is of authenticity of information and fair price. How do you know whether what you are being told is accurate and secondly what you are being charged is a fare price? One can say that competition can improve quality, but then how do I really know whether the information being shared is authentic or not? Also how does the government certificate ensure that the information provided is authentic or not?

Well wouldn't this make for an interesting research on your next trip?