Humans make mistakes, it’s part of our brand. Along with potato salad, income tax and Bluetooth toasters, mistakes are part of what make us us.
But mistakes can also cost lives. And while there is a certain amount of shit that will always just “happen” on any given day, many of our bigger booboos are preventable.
Over 50 million surgeries are performed each year in the US. Of that number, around 0.3% will result in a death, and around half of those deaths are avoidable. 0.15% doesn’t sound like a lot, but it equates to 75,000 people dying needlessly every year.
When we look at big events like deaths, we often want to attribute them to big causes. That’s why people look for conspiracies around assassinations – it just doesn’t make sense that something so monumental can be caused by something so mundane.
But that’s often the way of things, and mistakes are no different.
We make mistakes for two main reasons: ignorance and incompetence. Some mistakes we make because we don’t know what it takes to do a good job. And others we make because we know what it takes; we just didn’t do it for some reason. Maybe we skipped a step because we thought it wouldn’t matter, or time was ticking and we needed to get something out the door.
As I write this, America’s mascot in chief – the one who looks like a piece of burnt toast as opposed to the one who looks like a pickled scrotum – has ordered that his new Air Force One plane be ready now because he wants it. Part of the delay in getting the new 747s airborne is a bunch of safety checks, which Trump would ostensibly rather bypass if it means he can play with his new toy quicker.
We’ll talk about flying in a bit, but I mention this, not to open another can of political worms at you, but to make the point that mistakes happen when we skip important steps.
OK, so fine, mistakes happen. How do we stop them, or at the very least, dramatically reduce the probability of them happening?
Atul Gawande
Let’s turn our attention back to those 75,000 people dying preventable deaths every year in the US. That was the state of affairs surgeon Atul Gawande was confronted with in 2009 when he was asked to look into ways surgeries could improve. He studies other industries and found that the simplest, dumbest thing is the solution. Make a list.
Now, surgeons are careful, methodical, and have brains packed full of history and anatomy and chemistry and probability… they’re clever dudes, is the point. Now, if you tell a clever dude that the first thing they need to do is check that they’ve got the right patient, they’re probably going to give you a look that would wither an oak tree.
So the fact is, it’s questions like “do we have the right patient?”, or “do we know which side of the body we’re operating on?”, or “do we have the right blood on hand?”, that are so basic that people often don’t think to check.
Now, we’re a few minutes in at this point, and you might be wondering what all this has to do with your work. Well, tell me you’ve never made a typo in an important email – or, heaven forbid, sent a text slagging someone off to the very person off whom you are slagging – tell me you’ve never done that, and you have my permission to skip this one.
But my suspicion is maybe you’ve made the odd unforced error, and it’d be handy to know how to put some guard rails in place, like the bumper lanes I insist on when I go bowling.
So, back to our surgeon, Atul Gawande.
Atul qualified as a medical doctor in 1995, the year that brought us Cotton Eye Joe and Boombastic. Within three years he’d start work as a staff writer for the New Yorker, and in the early 2000s would begin looking into mistakes in medical practice.
Part of that research led him to the story of a three year-old Austrian girl whose life was saved after she fell in a frozen pond. An hour and a half after her rescue from what would otherwise have been certain death, they got her heart beating again, and after 24 hours she was breathing normally.
The girl would go on to make a full recovery, and the case was written up in a medical journal. When Gawande tracked the girl’s doctor down, he discovered that the medical team had a checklist – as did the ambulance crew and telephone operators – for these sorts of emergencies. The checklist is what saved this young girl’s life.
Gawande went on to research how effective simple checklists were, and in 2009 published The Checklist Manifesto, which would go on to become a New York Times bestseller.
Captain Joe
Joe Diebolder is a pilot and aviation YouTuber with over 1.7 million subscribers. He uses checklists in three key areas: flying planes (natch), publishing his YouTube videos, and running his morning routine.
If you’ve heard my episode on eating the frog, you’ll be familiar with some of this, but his routine starts with a list of his top 5 tasks for the day, in order of importance. He then works through them one by one, ensuring that each task is fully complete before moving to the next.
In surgeries, this can cause delays, as Atul discovered for himself. But if you’re going to operate on someone’s leg, you want to make sure you’ve got the right one – or the left one – even if it takes you a little bit longer to double-check.
Captain Joe says a good checklist item defines what “done” looks like, so if “exercise” is on your morning routine checklist, you’ll want to write “run for half-an-hour” next to it, for example. We’ll talk more about that specific example in a bit.
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How to make an effective checklist
Firstly, we want to make them as short as possible. There should be around 5 to 9 items that need to be completed, and it shouldn’t really take more than a minute to read. Any longer than that, and we’re liable to get distracted. I can’t think why, in an age when it’s not enough to watch one TikTok video at a time; we now have to watch our Graham Norton clips on one half of the screen while someone builds a Minecraft tower on the other.
So, checklists need to be simple, but they’re not dummies’ guides. If you use shorthand to get your stuff done, you should use that shorthand in your checklist. If you’ve encountered SOPs (standard operating procedures), these differ from checklists because checklists are supposed to be followed by people who already have the requisite knowledge, but need reminding not to skip the basics.
Next up, you want to define some pause points. These are moments where you stop and make sure everything’s done before you move to the next stage.
If you’ve ever had to send an email newsletter to more than 5 people, you’ll know the sense of abject terror that accompanies the clicking of the Send button. I mean, it doesn’t matter because however much you scour your copy for typos, some Braniac will invariably drop you an FYI to point out your error. And it’s usually the same person each time. Thank you Frances.
The work of sending an email newsletter might not end once you’ve hit the big Send button – you might then want to cue up some social posts or create a graphic for the website version. In that case, one pause point in your newsletter checklist comes just before you hit Send.
Pilots have a number of pause points: one before the plane starts to move, one before the wheels leave the tarmac, and one for when the little light goes on to tell the flight crew they can dish out the snacks.
Identify your killer items
Speaking of snacks, you’ll no doubt have heard the story about Van Halen and their demands concerning brown M&Ms. If you’re unaware, it was a rule written into their contract stating that the band should be given a bowl of M&Ms, with all the brown ones removed.
Turns out, this wasn’t a story of rock ‘n roll excess, but a rather prudent safety precaution. If a venue the band were going to perform at had read the rider fully and delivered said bowl of de-browned M&Ms, they could be assured they were dealing with people who sweated the small stuff.
But if that request went ignored, so the logic went, what other more important details might the venue have missed? We’re talking about stuff like lighting and pyrotechnics where, if the right safety precautions aren’t followed, people could get seriously hurt.
These are what, in Checklist Manifesto terms, might be called your “killer items”. These are the things that absolutely positively have to be done at all costs. You may not be Eddie Van Halen, but if you’re going to go out and play the guitar in front of people, you definitely want to make sure you’ve packed your plectrum. And your guitar, for that matter.
Working in a team
Now, if you’re working with a partner or a team, your checklist should follow one of two paths. Either someone needs to read off each item and then complete it, or they need to complete the step and confirm it’s been done. Communication is essential, and you might want to consider getting someone else to sign off on the checklist.
Lastly, you need to keep your checklists up-to-date. This can be a pain in the bum, but if you’re constantly skipping a step or remembering to do something slightly different because your procedures have changed but the checklist hasn’t, that could land you in some pretty hot water.
Now, checklists aren’t just useful for avoiding mistakes, they can also be handy operating manuals for life in general.
Captain Joe, our YouTubular pilot, uses them to manage his morning routine. List of jobs for the day? Tick. Exercise? Tick. Breakfast? Tick. And so on.
Like I said earlier, defining the action is good practice, so not just saying what should be done, but maybe how you know it’s done. So, “Clear inbox” might be on your daily checklist, so in order for that to be ticked off, that means filing, replying to, delegating, or deleting the stuff in your inbox before marking that item as done.
We’re gonna get into clearing your inbox next week, by the way. And if you thought my Bullet Journal episode might’ve ruffled some feathers, just you wait til I start in on Merlin Mann’s crowd.
Celebrate the win
After every successful completion of a task, Joe’s copilot confirms it’s done and Joe shouts “Yeah buddy” and does a little victory pose. I mean, that’s what the TED Talk version of Joe does, at least. That feels like one of those things they teach in seminars, but each to their own.
And while we’re picking nits, let’s be real about a few things. Checklists are boring, and they slow us down. You’re a creative person; you don’t want to be bogged down by a bunch of bureaucracy. you wanna be in flow.
But I think, once you get used to it, the checklist actually becomes part of the process. We talked a bit about pen and paper in that Bullet Journal episode, and there’s something really satisfying about writing an item down and ticking it off, or drawing a big line through it. Some people even write down todo items that they’ve already to-done, because putting a big fat tick in the box gives them that little endorphin hit. I know it might come off a bit wanky, but stuff like that does work. It does for me at least.
Another way to think about checklists is like the designated driver that lets you have a good night. A good checklist means past you is taking good care of future you. Because let’s face it, past you is a genius, whereas future you is an idiot.
Every time you complete a checklist, you’re proving your mastery. You’re showing you can not only get the work done, but do it consistently. That might please a boss well enough, but it’s a great signal to send to your brain. Because the more your little lizard brain truly believes you know what the shit you’re doing, the more you’ll genuinely feel it, and the less like an imposter you’ll feel.
Now, your day might not be compatible with someone like Captain Joe’s. Turns out I’ve never so much as said three words to a pilot, let alone had a drink with one, so I can’t imagine our days have similar structures.
But if you have a day job, checklists can help you ship work with fewer mishaps, which can get the higher-ups off your back. But you can still have a morning routine based on checklists. OK, so you can’t delay getting the bus to work because you needed to complete your morning 5k, so instead of putting “Run a 5k” down on your checklist, just write down “Run for 30 seconds”. Insanely low bars like this are what help you get better over time, but that’s a subject for another day.
Now lastly, don’t overload your checklist. Only put on the stuff that absolutely needs to be done, not the stuff it would be really great to accomplish today. Too many things and you’ll end up being disappointed if you’re not able to finish them. This isn’t a todo list after all.
Listen to what your body’s telling you. In the language of chronic illness, if you don’t have the spoons to get through your checklist, you done made it too long. You’re gonna have days when even getting the bear minimum done is hard enough, so why make that your everyday experience? Pear it back, and look after yourself, man.
It’s the small things like this that help us accomplish the big things. Frameworks and systems like this give us the safe structure we can play within. If you do any kind of work that crosses a threshold, like writing a blog, singing in front of an audience or running a food truck, checklists help protect you from that threshold, making sure that only the best of what you do is seen by the world.
And with that, I’m marking this episode done. Tick.
Thanks, Ayesha
Ayesha Khan hosts the podcast Every Single Sci-Fi Film Ever*, and leant her voice to my silly opening skit.
Every Single Sci-Fi Film Ever*Film History Podcast · 28 Episodes · Updated Biweekly