Reddit reviews The Checklist Manifesto: How to Get Things Right
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The Checklist Manifesto How to Get Things Right
Dr. Atul Gawande, who is a surgeon who also writes for the New Yorker, wrote a book called The Checklist Manifesto. It's about how the use of checklists, which are drawn from the aviation community, can do a lot to reduce complications in healthcare. It's an interesting read.
The Checklist Manifesto: How to Get Things Right, by Atul Gawande. This one?
I generally like Ted's posts and I really dislike adding process to software development. However, saying "no process" is overly simplistic.
Some of the things glossed over:
In short (and it's a huge topic), in most cases, IMHO, it comes down to a tradeoff: what's more important, not ever fucking up or maintaining speed and flexibility. Unfortunately, leads/stakeholders on most projects think that not ever fucking up is the absolute priority, while realistically it's not.
Again, this is a broad topic, so I will just add a couple of things without going too deep:
The Checklist Manifesto is a great book on the subject.
Not sure if really relevant, but in other fields where attention to detail is vital they use checklists. For example, even pilots who have been flying for years use checklists.
I see your point. Little mistakes can happen to anyone and some small slips can have grave consequences, that's why sometimes simple actions require checklists, given the disastrous impact an error can have, no matter how improbable.
Still, in this case, I maintain you're totally inept. This cannot happen unless you're still unlicensed, a noob training and not legally able to drive [in which case it wouldn't be your fault, as someone is responsible for your training].
Or, you know... if you're an imbecile.
>Once routine settles in, people become lazy, and laziness leads to accidents…
Exactly. This happens pretty much everywhere. Hospitals, airplanes, etc etc.
There is an interesting book regarding this called "The checklist manifesto"
If you haven't read it yet, I definitely recommend The Checklist Manifesto.
Exactly what I was going to recommend. Fantastic book.
I'd like to post just a bit of clarification on this expiration from a developer perspective - firstly with some addition details on the code-signing certificates specifically and secondly some speculation on how oculus got here.
Think of this scenario - you have an application that you built and seldom release updates, maybe once per year. Additionally, you don't have an auto update mechanism in your application so your users have to seek out an update. This means some users may never update, some may update every 3 or 4 versions, or some may update every version.
Even if you are diligent on keeping your certificates up to date, you can't go back and put the new certs in old versions of your software as the public key is baked into the executable. What this means is inevitably your code signing certificate will be renewed and some users will have software with an old, expired certificate. This is why the certificate timestamp mechanism exists - the certificate says "this executable was produced by ABC Software on 1/1/2010" but the countersignature/timestamp says "this signature was valid on 1/1/2010 when it was signed and verified by Symantec on 1/1/2010".
Now, with all that said above one of the things I left out was the amount of details that go into building and releasing software. Many times these details are figured out once and then put into an automated build system such as TeamCity, Jenkins, or TFS. Many times when a process like a build gets automated, it gets handed off at some point and all the details that led up to its creation are no longer in someone's head. This can lead to details getting dropped or missed even when they're extremely important. More than likely the certificate signing is deep in the build chain and the details are obscured.
One important thing to mention is Oculus DOES have an automatic update mechanism in their software so deploying updated executables with renewed certs is much easier for them. This doesn't mean that their renewed cert gets added to their build chain but that they at least have the ability to push updates more regularly than my example.
Does this excuse Oculus? Not at all, but I don't believe there should be calls for people to resign over something like this. While it's an unfortunate outage, this is a great opportunity to teach an individual engineer (or set of build engineers/managers) and learn as an organization. Rest assured mistakes like this happen all the time especially when automated processes and approvals are in the chain without a checklist at the end of the process. One of the books we recommend to our clients when we are going through process and quality improvement is The Checklist Manifesto. For some insight into what might be going on at Oculus right now this is a great youtube video about debugging in production by Bryan Cantrill, a former Sun engineer who is now CTO at Joyent
When i first read your rant, I was a bit annoyed, but working through it, it became clear that you are pointing to some of the weak spots that a lot of other practitioners have also noticed. fx a lack of coherent definitions, people practising "nudging" without any idea of what it is, a systematic lack of knowledge of the psychology behind the interventions.
So please read everything below here with the kindest voice you can make in you mind. :) Text is a horrible medium for some things.
>He did a great job explaining that "Nudges" are subtle changes to the environment that do not require effort from the Nudger or the Nudgee. Indeed, they work implicitly by acknowledging underlying (system 1) psychological processes. Examples he gave were classics: painting a fly on a urinal, traffic stripes to slow drivers, defaults in organ donation.
I thoroughly agree that many people don't understand what nudges are. It's understandable that lay people don't know, as they have very little reason to care at all about it. However, I also see many practitioners and even academics that somehow comes to very different ideas about what nudging is, but seems to have no interest in forming or accepting a proper definition.
To this point I have to add that I have never seen anywhere, that a critical part of a nudge is that it is (1) subtle, (2) confined to being changes in the environment or (3) effortless for everyone involved.
At (1); there is several examples of nudges that work particularly because they are not subtle. Think of trucks backing up making beeps. A clear attention-grabbing nudge, using an audio version of the fly in the urinal. Not at all subtle though.
At (2); Changes in psychology, that does not stem from direct environmental change can also be regarded as nudges. People get a lot less critical of different ideas when they are horny. :)
At (3); There is a classic prompt for increased sales, where you are offered a complimentary good at checkout. "Do you want a lighter with those cigarettes?". everyone involved knows that lighters available, but still the sales increase when the prompt is in place. It does require continual effort from the sales person however. Better examples might come to mind later.
> Folks who worked in the NHS wanted to come up with structural challenges like figuring out ways to rearrange doctor's (GP's) check-up routine
This is a dream scenario for any choice architect to work with. If you ever read The Checklist Manifesto you will see that there is tremendous opportunity in structuring rutine tasks more.
To repackage and replicate preexisting nudges, is one of the most promising ways of figuring our what parts of the nudges actually works and in what way. As artifacts of the ways people process information and not the information itself, nudges are usually not sector specific, meaning, that the same ideas that works really well in tax collecting, might be worth a shot in healthcare as well.
Most people will learn some very valuable lessons about what kind of nudges that makes the most sense, when they have to test them. Having the experiment as an integral part of implementation of any behavioural intervention is whats going to change the world, by showing that you can do more than raise awareness or make laws, and that it will actually have an effect. The bad ideas will fade, and the good ideas will stand strong. :) (Hopefully)
Don't worry As a lot of people might be considering nudging a fad, it has been gaining considerable ground in the last 10 years, and behaviourally informed interventions is now fast becoming a part of the "standard" public policy toolkit. Because it has proven merits, it will remain in one way or another. However the name might change. :)
One of them was The Checklist Manifesto. I read this one and really enjoyed it.
There's influence from a lot of different techniques, but they key for me is having a checklist to follow so that when I start working, I don't have to think about it or make decisions. It's just mindlessly going down the list of steps I have to take and checking things off.
I picked this up from The checklist manifesto
Humans as a whole have a shit track record when it comes to performing small, routine tasks reliably. That has little to do with intelligence; it's true for doctors, pilots, and everyone else, too. If you're interested in some reading, check out The Checklist Manifesto for a writeup on the efforts that go into getting people to remember to perform small tasks that ensure they or their patients don't die.
From that perspective, a contraceptive method that requires the user to perform a 30-second task reliably every single day is a high-failure approach. Studies I've seen that track pill compliance typically find that a great majority of users regularly skips doses, and younger users (who are unfortunately more likely to conceive) miss the most doses--several a month on average in some data sets. Perfect use is not a relevant statistic for a sizable majority of users.
+1 for Checklist Manifesto (https://www.amazon.com/Checklist-Manifesto-How-Things-Right/dp/0312430000)
Also Tim Wu's Attention Merchants (https://www.amazon.com/Attention-Merchants-Scramble-Inside-Heads/dp/0385352018)
and AGM's Chaos Monkeys (https://www.amazon.com/Chaos-Monkeys-Obscene-Fortune-Failure-ebook/dp/B019MMUAAQ)
edited to add that I'm currently reading "Predictive Marketing: Easy Ways Every Marketer Can Use Customer Analytics and Big Data" (https://www.amazon.com/gp/product/B01AOOH2MA/) to get down with CDP's...
I've implemented them with my team, and we're starting to roll them out across IT. Each person figures out the best way that works for them, and then they've developed checklist for everything they do. One person on my team has a checklist for reading email, and one sending email, they are both posted next to his monitor. It's overkill for me, but for him it fixes one of his biggest gaps, e-mail communication. Previsouly he would upset almost everyone who recieved an e-mail from him, now nobody gets upset. His e-mail checklists address one of his gap areas, something that was becoming a career derailer.
There is a bestselling book on this:
I use http://todotxt.com/
Great book to read for this is the The Checklist Manifesto. Might also give you ideas of how to approach it. Details how this fixed errors in Aviation industry and Surgery. It is pretty short and full of good info on how to look at things.
I honestly think any kind of customer service. That is where I was able to develop a lot of soft skills. Volunteering for a nonprofit thrift shop or something like that would give you a good start and would be minimal hours.
In addition, taking on a leadership role in anything (a local chapter of rotary, etc.) can be very good experience.
That being said, a certain amount of soft skills will have to do with personality type and personal motivation. I was personally motivated to go out of my way to attain leadership positions throughout my high school and college years and have been overall successful with it.
One book I see recommended a lot is How to Win Friends and Influence People. Dale Carnegie has a lot of other books as well that pertain to your interests.
Also, my work has a special obsession with The Checklist Manifesto and The Advantage. The equity firm that owns my company requires all managers and higher ups to read those two books, so obviously they've got something going for them!
> but there is no standard thing for surgery.
It's "below" many doctors. But this is not a new concept. See the book "The Checklist Manifesto."
It is estimated that at around 44,000 to 98,000 people a year die from preventable medical errors. Imagine an airliner filled with people going down in the French Alps on a weekly basis. Don't you think that everyone would put their foot down and do something about it?
But for some reason doctors and the medical establishments they belong to are given a complete pass.
Well, if you're actively working on Mr. Smith's case or file or whatever, I would do the two minute task. As I said, if it's important to log your progress for a project, I would definitely do it. If you have a template that you use for many customers, I would personally create a checklist and then attach a copy of that checklist to every person's file. That way you can see whether or not you've done X or Y for any given customer. I'm a huge proponent of checklists. If you're interested, I would seriously recommend The Checklist Manifesto.
Atul Gawande - Better, Complications, and checklist manifesto.
Sandeep Jauhar - Intern
Jerome Groopman - How doctor's think
Michael Collins - Hot lights, cold steel and Blue collar, blue scrubs
Samuel Shem - House of God
Brian Eule - Match day
Paul Ruggieri - Confessions of a surgeon
Emily R. Transue - On call
Okay so I was in the same position you are in right now. I wanted to read as much as I could because I truly found it fascinating. I read these books and I'm glad I did. These books just give you an idea of how hard doctors work and what the life of a doctor is like. Another recommendation is Anthony Bourdain's Kitchen Confidential. It has nothing to do with medicine but I read it and I think you should too. He talks about the life of a chef and how perfection and long long hours are demanded of him. I feel like there are some overlaps between the different settings. Chef/doctor and Restaurant/hospital. Anyways, This list should last you a long time. Hope you enjoy.
Edit: Added links.
there are 3-4 books that I keep at least 2 copies on-hand of, because they are informative and I like giving them to people with no expectation of giving them back.
Ok this sounds like I am talking about religious texts - they aren't. They are:
- Normal Accidents: Living with High-Risk Technologies
- The Checklist Manifesto: How to Get Things Right
- The Bogleheads' Guide to Investing
- The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns (Little Books. Big Profits)
The first two are must-reads for engineers working in any kind of system, be it computers, electronics, mechanical, or people systems (project management, etc)
The last 2 I tend to recommend to people who think that reasonable investment awareness and decisions requires a lot of specialized knowledge and attention
>After a few dates we realised that we still love eachother and that not maintaining our relationship was the biggest mistake we made.
On this point specifically - I ran into a similar problem many years ago. Like 6 months into my marriage, the honeymoon period was over, as they say. All relationships have their ups & downs & it's super easy to feel like quitting when you feel like there's nothing left. We talked it over & looked at the situation & realized that we weren't dating each other anymore. When you're married, you're just kind of there at home all the time, so why go out & why put any effort into anything? The chase was over, you got what you wanted, end of story, right?
As it turns out, actively doing things together is what helps you bond & grow (this is only obvious once the lightbulb goes off in your brain, haha!), whether it's dating or moving in or fixing up an old house or having kids or whatever. The core thing that we realized was that we weren't actively planning out any kind of one-on-one time, so - as dumb as this sounds - we setup a weekly appointment for a date. We were both very busy at the time with our respective jobs, but we made it a point to carve out a date night every week. We alternated who planned it, so it was my job to figure out dinner & an activity every other week. That way, the job load was split, we both had to put some effort into doing something fun together, and it was a surprise what we'd be doing together on the weeks when I didn't have to plan.
Sounds pretty lame, but it worked AWESOME! It also opened my eyes to the concept of "plot vs. story", especially regarding checklists - checklists were the plot, the required parts, the engine - to keep the story moving; checklists were NOT the purpose or meaning of the story! It's super easy to get those confused, because using things like a personal productivity system requires interaction with the system's controls on our part, and we get duped into feeling like the system is the point, not the output of the system, which is getting stuff done & enjoying stuff!
Being kind of a free-range artist growing up, things like checklists & schedules were mentally & emotionally extremely demotivating for me. Mainly, they felt super restrictive. I didn't like feeling tied down to a schedule or locking out my options. As it turns out, in practice, that is not the case at ALL! As it turns out, living by checklists & alarm reminders is like having a secret superpower! One of the books that really cemented this concept into my brain was The Checklist Manifesto by Atul Gaw:
Adopting checklists with triggers across the spectrum of my life & my responsibilities proved to be a real gamechanger in several ways:
I lived an incredibly reactive life before adopting a checklist-based personal productivity system; using checklists allowed me to be proactive & actively decide not only what I wanted to invite into my life, but how I wanted to experience things & what kind of results I got. The system we implemented in our marriage was pretty simple & outwardly boring, but had profound impacts on our relationship, because we weren't just on reactive cruise-control anymore, we were proactive about taking adult control over our lives. I've since applied these basic concepts to pretty much every aspect of my life:
The list goes on & on & on. We have to be aware of what all of our personal situations are, and then we have to decide how we want to tackle each situation, and the way we implement that, after the decision-making is done, is via trigger-driven checklists (in my case, mostly via smartphone alarms). This creates a shift from "bah, I have to do this" to "what do I have the opportunity to do right now?". For example, when I was in school, having things broken down like that into step-by-step lists of next-action items mean that I suddenly had the opportunity to knock out my homework right away & get it done early, rather than procrastinating & putting it off day after day & letting it build up to horrific levels of work, lol.
So I had a very distorted view of what checklists really were & what they really meant in my life. I thought they were restrictive, when in reality, it was my own poor, non-productive behavior that was trapping me in crappy situations, like having to stay up late to do homework because I goofed off first & being tired the next day, or having my relationship drift apart because I wasn't treating it like a living thing & feeding & caring for it on a regular basis. All of which simply boil down to checklists with alarms, haha!
I'll only advise on the "how to write checklists" portion, by recommending this really excellent read: The Checklist Manifesto
Seriously. I thought I was good at writing procedures until I read this book. Now I'm good at writing procedures.
Here's a good book on the subject: "The Checklist Manifesto" by surgeon Atul Gawande (M.D., M.P.H., FACS). He's written a lot on the subject of process and environment and the role they play in medicine and elsewhere.
The long and short of it is that checklists and repetition have huge positive influences on outcomes.
We all want to do well, but we also all want others to think we're doing well. That's why it seems like everyone else is doing better: they're trying to make it look like that. They're managing their image. It's like Facebook, when your friends are only posting the good things that happen to them, and it looks like you're the only one anything bad happens to.
Unless you're a celebrity, you are your own harshest critic.
> Medical school, for me, has been a never-ending cycle of wanting so badly to be better, trying, failing, and barely making it to the next course.
Why did you keep trying each time you failed or nearly failed? What made you think it would be any different the next time? Here's my theory: because you believe you have the potential to succeed. That's the paradox of ADHD, the blessing and the curse: it's not that you try, fail, and assume you're just not capable. You try, fail, and believe that you failed despite being capable. This is the dangerous part - if you didn't fail due to lack of skill or knowledge or innate intelligence, you and others assume it must be a character flaw. This is why people with ADHD are often labelled "lazy" instead of "stupid." People look at a person with dyslexia, and it looks like they're trying hard but still failing, so they assume that person is stupid. People look at a person with ADHD, and it looks like they're doing fine for a bit, but then they just get distracted and stop trying - if only they had a bit of self-discipline, they'd do fine. So they assume that person is lazy and weak-willed.
Hidden in all these negative perceptions is an important but easy to miss fact: if it's not clear that someone has the potential to succeed at something, then people don't blame them for failing or wanting to give up. It's clear that you have incredible potential. You're in med school at 24 despite having ADHD and depression. You've accomplished a lot, and you know you can succeed. That's why you're hard on yourself.
> I have to believe it will get better. I don't believe it right now but I have to eventually.
There's a huge difference between not believing you can, and not believing you will. If you don't believe you can do something, then it's very easy to say, "why bother trying?" It's logical, if a bit defeatist. It's how many people live their lives, content because they don't think they could do better. If you don't believe you will do something, that just means you could do it, but when you try to picture yourself doing it, you see it just not happening, for some reason or another, and you judge your hypothetical self. This is a symptom of depression. All you can think of are the times you failed in the past, not the times you succeeded - in getting through high school, in getting through college, in getting into med school, in meeting your SO and maintaining a relationship with them (That's hard for people with ADHD).
Because you know that you didn't fail because you just aren't smart enough or clever enough, that means there was just something wrong with your approach. Try looking at one of your recent mis-steps from a detached, analytical point of view. Instead of treating it like evidence of some weakness of character, treat it like a symptom, because that's what it is. Put on your medical professional hat and scientifically examine what went wrong, as if it's someone else's experience.
Imagine a person recently diagnosed with diabetes. Maybe a kid with type 1, or an adult with type 2. They try to keep in mind their disease, but sometimes they get caught up in the moment, maybe at a restaurant with their friends, or too absorbed in their work or school, and they crash or spike. It's not that they're stupid, and it's not that they lacked the willpower to constantly mind their levels. It just happens sometimes, because people tend to assume they're normal, and it's easy to forget when everyone else can do something "the normal way" that you can't. The wrong approach is to tell that diabetic person that they can never participate in "normal person" things, that they must always eat at home from carefully prepared special boring meals and must choose a job, a life that makes it easy to manage their diabetes. No. You work with that person to help them come up with strategies that let them live life by dealing with their illness as just another part of life. It's just a slightly different way of doing things. Maybe they carry a little finger-pricker thing and some emergency glucose in their purse or manly man bag when they're out with friends, and they set up subtle reminders on their phone to check themselves every so often at work or at school. With the right support system, they can get used to it and live life with relatively little overhead.
Like that diabetic person, you can't pretend you can approach life exactly the same way someone without ADHD can. Someone else can say, "Oh, I'll remember that," and have a chance of actually remembering. Us, not so much. But that doesn't mean you're doomed to a life of forgetting important things and your license expiring or your rent being late. It means every time you get a bill, you ALWAYS put 5 different reminders in your phone to beep at you before it's due. It means when you get some important paperwork, you leave it paperclipped to your keys, or taped to your bathroom mirror, somewhere you CANNOT miss it. It means when a patient mentions a symptom, you write it down, and when your boss verbally asks you to do something, you ask them to please send you an email and then you write that shit down in two different places right then and there because you carry at least 3 moleskines or folded-up pieces of loose leaf or just ANY paper you can write on, and at least 5 pens with ink on your person AT ALL TIMES, and then you put a reminder in your phone or your Outlook or both to remind yourself to do that thing. It means that you take the Checklist Manifesto to the n^th degree. It also means you plan every day, and schedule time to plan every day, and set multiple reminders that hey, it's planning time for the next 15 minutes and hey, that's enough planning for today, you're getting bogged down in details.
There are so many of these little coping mechanisms mentioned in various books and various threads in this subreddit that it seems overwhelming. But once you have one in place, it melts into the background, and it's just there helping you, and if it doesn't work, you're not a failure, it's just not for you, and you try another, because it's worth it to have a life that's not consumed by your ADHD. You can be in crisis mode, or you can be in management mode, and once you can get into management mode, it just gets easier and easier. You don't remove the structure you created for yourself any more than a diabetic person would stop checking themselves and assume they know what low or high feels like; you just optimize your systems for your life.
The book The Checklist Manifesto talks about how the air travel industry overhauled itself after some high-profile, avoidable disasters. It's fascinating, as is the rest of the book.
On the whole the book basically asks "How do normal people, who make normal mistakes, manage to do incredibly complex things, nearly perfectly, nearly every time?"
I probably have 50 or 60 books in the queue, i'm a bit behind!
I finally finished Zero to One by Peter Thiel. It's not a long read, but I've barely had time to read.
Here are some of the books:
I can't even remember what else I have. What do you enjoy reading?
The surgical industry got the idea of using checklists from the construction industry, which actually has a really good track record historically (there have been a lot more botched surgeries than buildings that fall apart). Source
Here's an amazing read on checklists: "The Checklist Manifesto"
I just use Excel, the world's most flexible tiny database management system. Work item, due date, assigned to, done date. If the checklist needs other columns, like checked by, it's easy to add them.
Have you read The Checklist Manifesto, by Atul Gawande?
nothing you said seemed like a big deal.
i mean, maybe you're a flake, idk. you sound pretty normal to me.
if you want to change it, then start making a list. use a list app like "any do" or something. and just write down what you want to do so you don't forget. get in a habit of doing the list.
read "checklist manifesto" by Atul Gawande
I just finished reading The Checklist Manifesto (Fantastic, I highly recommend it.) One section details the Miracle on the Hudson and credits it to a synchronized effort of a Team sticking to their checklists. Apparently when Sully and the co-pilot deboarded they looked at each other and said, "Well, that wasn't that bad." The author makes the point that we tend to celebrate lone heroes. The myth of the "master builder." One man has all the information and experience in his head to accomplish a complicated task. When the truth (and more importantly, saving lives) is about teamwork, management, and following a checklist.
I mostly do this in my head, but yeah sometimes I make real lists. It's a huge help. Real LPT material. Lists are incredibly useful both in professional life and personal life.
Also, be sure to adapt this idea for your personal style of thinking. You can see in these replies that people have different methods for breaking down large goals into simpler tasks. Figure out what works for you.
Further reading: The Checklist Manifesto
Or listening: NPR interview about The Checklist Manifesto
interesting as hell read
Depends on how old you are.
I always sucked at my job.I hate routine and get distracted easily!
Here i am replying to stuff on reddit and facebooking :(
So i very often make stupid mistakes because i dont prepare for tasks so my evaluation reports always suck
on the bright side im good with out-of-the box stuff and making stuff work so that sort of makes up for my failings in other departments up to a point i'm sort of the only person who can get stuff done quickly
anyway ive been using time management and task management tools on the web to keep tabs on what im supposed to do and its been helping quite a lot
check out trello.com
Read "The Checklist Manifesto" it briefly covers how feats like this are accomplished.