Positive deviants

Continuing this foray into blogging, using NaNoWriMo as the sword to push me off the plank, it seems this is taking me through the tools I have been using these past few years to bounce back from a bad mental state. This next tool is one of my favorites because of its simplicity: checklists. Checklists now rule my life, and actually help me be more creative by creating a stable platform from which to sprint into the unknown.

The Checklist Manifesto: How to Get Things Right by Dr. Atul Gawande helps me use the simple tool of a checklist to avoid two points of failure: ignorance and ineptitude. And, frankly, I have found the act of completing checklists to be fun and empowering, reminding me how many things I have done just this day to buoy me through the rest of the day. In a TED talk, he recounts how he first started studying the positive deviants, the ones who receive the best results of medicine for the lowest cost.

Accurately defining the work is half of the effort of actually doing the work. (I don’t have any source to back this up, just personal experience.) Checklists turn the brain on, rather than off.  They are concise reminders even the masters could miss. These are not comprehensive lists, but tools to buttress the expert skills of professionals. In a complex environment, experts are up against two difficulties: fallibility of human memory, and attention. Mundane steps are especially prone to have people lulled into safety to skip steps. Checklists remind us of the minimum necessary steps, and make them explicit, “improving outcomes with no increase in skill”.

There are two types of checklists:

  • Do-confirm
  • Read-do

Do-confirm checklists allow tasks to be done by experience, then at a pause point check the list to see of all steps are actually done, which give greater flexibility in how a job is done. Read-do checklists are like a recipe, and check off each task in the order it is done.

These lists need to be short. Past 60-90 seconds and the checklist is distracting from the task at hand: keep it to killer items. These lists should have no more than 5-9 tasks at a pause point, which is the limit of working memory. Also, first drafts always fall apart. Having a checklist is better than not having a checklist, and it will certainly be revised before it is in good efficient order. It can also be thought of as a living document, that it is subject to change as conditions change.

For example, aviation has checklists where minutes matter, much like surgeons. They may have three pages of daily checklists – such as before leaving gate, another after taxiing, another before flight – in addition to a volume of non-normal checklists for every conceivable emergency a pilot may run into. Some things weren’t on the checklist because studies showed the pilots didn’t forget them, which kept the list lean. Pilots are taught their memory and judgment are flawed, and need to recognize that fact.

I personally now have a do-confirm checklist to not forget anything (such as work clothes after the workout) for when I’m rushing around in the morning getting ready for work, with the pause point being before getting in the car to go to work. I also have one at night while I’m low energy, to make sure I take care of myself and reset the house just before I crawl into bed. Without these, my life was so much more chaotic, and I found myself spending a significant amount of time fixing things which should have been routine.


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