Atul Gawande's brilliant book, The Checklist Manifesto, shows how introducing simple checklists in medicine literally saves thousands of lives and millions of dollars.
When doctors use checklists to remind them of the things that need to be done to keep patients alive and recovering, people are more likely to live. The truth is that we all forget things that matter.
The evidence is staggering. In one case, a critical care specialist introduced a checklist on dealing with central line infections. The items of things that doctors were supposed to do were simple enough: wash hands with soap; clean the patient's skin; put sterile drapes over the entire patient; wear a mask, hat, sterile gown and gloves; and put sterile dressing over the insertion site once the line is in.
The ten-day line infection rate went from 11 percent to zero. The checklist prevented 43 infections, 8 deaths and saved $2 million.
Checklists are one way of dealing with the complexity of life. There are too many things to remember to do and whether we do them, and in the right order, makes a tangible difference.
In medicine, missing key things out causes people to die. Where checklists are used - such as in flying aircraft - they are critical in keeping things running smoothly.
But while our own day-to-day life appears on the surface to be less complex than the day list of the average surgeon, it probably isn't. Take the average morning for a parent: get up, motivate your children, make breakfast, discuss niggling matters with your partner, eat breakfast, brew coffee, feed the animals, check the email, keep an eye on the weather, listen attentively to Today (particularly for the 7.10 and 8.10 interviews), catch up with young adult children, get into car, calculate whether you are likely to get to your destination not having filled up the car last night, get into work, find a parking space...
And then it really gets started. Say good morning, smile in the corridor, walk purposefully, motivate staff, be sensitive to mood changes, make small talk say something, deal with lateness at meeting, look confident under fire, check email.
Forgetting to do little things can knock everything out of balance. Take a simple catch up meeting.
And that's quite apart from whether you had an agenda, discussed real things and agreed a course of action. Getting the little things wrong could actually undermine any progress made altogether.
People who are good at meetings will have these things locked down. Others will flounder. If you do, find someone who is excellent and using their practice write a checklist and stick to it.
We may well need checklists for living because life is pretty complex. Like surgeons trying to keep ill patients alive, so we need to achieve certain things during the day. We need to keep our relationships thriving. We need to make a living. We need to keep an eye on threats - economic and personal. We need to think ahead and develop plans to deal with whatever is coming. We need to manage the most complex challenge of all - how we make the most of the 168 hours every week, keeping ourselves and others happy while still having fun and being productive.
The trouble is that there is no road map. We have lists for shopping to make sure we don't forget the sunflower seeds but there is no algorithm for life. So we make it up as we go along. We get bounced on the waves of others' moods and circumstances or we cause the waves.
But there will be optimal ways of having a good and productive day. Other people have brilliant relationships in their family. We should find out how, capture it in a list and use it to make sure we don't forget the things that really make a difference.
These are areas where even politicians fear to tread - our personal lives, our family lives, how we bring up our children. But when we consider how many families don't appear to be thriving, how many young people don't appear to be productive or how many adults simply fail to thrive (or behave in ways that are bad for them and for our society), then maybe it's time we opened up this can of worms.
While we might be reluctant to say that there is a "right way" to live our lives, it's clear that there are optimal ways if we want to maximise our earning power, convert our talents into capital and foster productive relationships. Judgements aside, there are good ways to do everything.
Sometimes we learn the best way to do things by watching people who are very good at life. Osmosis works. We absorb others' practice. But we are not always surrounded by excellent practitioners so it can be very hard to learn new ways of living. This can be exacerbated by Rumsfeld's Syndrome: we don't always know what we don't know.
Obvious things are not obvious to everybody. That's why checklists are really helpful.
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