Checklists, programs, and the nature of work

“We need a checklist,” my boss insisted. “So we don’t miss any steps.”

So I made a checklist of how to pay out physician incentives. Dozens of steps. I tried implementing it across the hundreds of instances over which incentives are paid. I still missed things.

“Why wasn’t that on the list?”

Checklists, surprisingly, are in vogue. I am nearly finished with Atul Gawande’s The Checklist Manifesto, which makes the case for checklists in healthcare. The book has been well-received in other industries, too. 

But a careful reading of Gawande tempers the need for the Mother of All Checklists — for one reason he brings up, and for another I would like to present. I will also present a corollary.

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