Atul Gawande proposes a solution for all sorts of endeavors in his book The Checklist Manifesto: How to Get Things Right. It’s a short, engaging read, and I recommend it for anyone who has to apply knowledge to complete a task. That’s most of us.

We use checklists and recipes in some of our software development processes, and I’m in the process of applying what I’ve learned to improve them. I hope to share some of the results here in coming months — supposing that the final product isn’t too site-specific — but in the meantime, here are my more-or-less raw notes from Gawande’s book, which isn’t specific to any particular industry, although it was written from a surgeon’s perspective.

• Checklists are all about managing complexity, providing a “cognitive net” against “flaws of memory and attention and thoroughness.” They are “forcing functions . . . straightforward solutions that force the necessary behavior.” A good checklist should help its users “get the stupid stuff right.”
• The project plan is a kind of checklist. And the communication (submittal) schedule is a complexity manager. The idea is to communicate what needs to happen when in a complicated process (like building a skyscraper, writing software, or operating on a patient) and having a process in place to ensure that all of the parties in the project have shared all of the information about changing requirements and problems available at specific times.
• It’s possible/advisable to use tools to manage complexity, conflicts, and information integration. Sometimes the result of using the tool looks like a checklist, but not always. Sometimes it’s a Gantt chart or a cook’s recipe.
• The checklist steward: Anybody can change a checklist, but it has an owner who feeds and waters it.
• Complex situations don’t (usually) require detailed instruction. They do require high-level goals and lots of communication. (Gawande gives the fascinating case study of Wal-Mart’s response to hurricane Katrina in 2005.) Solutions should be simple, measurable, transmissible. They should encourage team interaction and engagement. Project owners should facilitate communication for complex tasks.
• The team huddle helps coordination, and it can help with keeping commitments. It’s important to communicate risks and issues early and often.
• Communication should happen (at the very minimum) during specified “pause points” between transitions in the process. In the operating room, these points might be just before administering the anesthesia, before closing up the patient, etc. In an airplane cockpit, they are before starting the engines, before leaving the gate, before take-off, before landing, and so on. (Figuring out what these are in a software development process is something I’ve already started considering.)
• Aviation uses lots of small checklists. A “normal situation” checklist should be very short. An exceptional situation should be very brief, readable, and actionable, too.
• Good checklists are made by practitioners, usable, available, put into use, about 5-9 items long, tested, and completable in about 60-90 seconds (or less).
• Bad checklists are long, imprecise, vague, hard-to-use, or impractical.
• Cockpit crew have created two categories of checklists: DO-CONFIRM and READ-DO. “With a DO-CONFIRM checklist . . . team members perform their jobs from memory and experience, often separately. But then they stop. They pause to run the checklist and confirm that everything that was supposed to be done was done. With a READ-DO checklist, on the other hand, people carry out the tasks as they check them off — it’s more like a recipe.”
• Things that are “never” forgotten by a normal practitioner don’t need to be on a list.
• After they’re put into use, checklists need continuous improvement. They must be revisited and refined. It’s a good idea to put a publication date on them.
• Most people — doctors, financiers, software engineers, etc. — don’t like to use checklists. They consider them neither fun nor in keeping with the “heroic” nature of their role. They feel checklists are “beneath them.”
• Ideally they should be usable and helpful for both novices and old-hands.
• Checklists should not be rigid, creativity- or team-killing exercises. They’re designed to “get the dumb stuff out of the way” and provide the leeway to be creative on the hard/sexy stuff. They’re frameworks for self-discipline and productivity.

Other people’s notes about the book:

• How to write a checklist (What Consumes Me)
• A checklist for your checklists (The Clutter Diet Blog)
• Checklist Manifesto (Lumber Tribe)
• Official book website (Atul Gawande)
• Checking — 1, 2, 3 (Health Man Blog)
• Charlie Rose interview

Do you use checklists? How well do they work for you? What do you like and dislike about them? Feel free to leave your feedback in the comments.

About six weeks ago we bought our tickets to Sydney after devising a rough, month-long plan. And then we didn’t do much until a few days ago.

Well, that’s not exactly true. We did get our tourist visas online. I’m a little sad that we won’t get full page documents pasted into our passports like when we went to India, but it was a lot less expensive and much more convenient than sending away our passports to the Australian consulate. In fact, the whole process took less than five minutes for the both of us.

We also debated whether to get an RV for our trip through the Northern Territory or to hop between towns with a rental car. In the end, we decided to go half/half: We’ll carry our home with us on our backs as go from Darwin to Alice Springs; and then we’ll drive point-to-point hitting up the desert parks in the “Red Centre.” I have grand visions for this part of the adventure, at the same time that I’m a bit intimidated that the first vehicle I’ll be driving in Australia (on the left side of the road) will be a 22-foot, manual-transmission RV.

And it took us a while to figure out which part of the reef we wanted to visit. I had great hopes that we’d be able to spend a few days on a resort island on the reef itself. But, even though we’ve been saving for a couple years, neither of us could justify spending the same amount for one night on the island as for a full-week rental of a condo 20 yards from the beach. Especially, when you consider that there’s a two night minimum.

But we eventually got the big things figured out. So we bought all of our domestic airline tickets and booked all of our hotels over the last few days. I discovered that the Australian version of Expedia had the same airline tickets at half the price of the US site, even with our credit card’s “foreign transaction fee” and the currently poor exchange rate. Bonus! Of course, this did end up triggering the credit card company’s fraud protection system, and I had to contact about it  . . . twice. But it was so worth it. (Update: Also consider Wotflight.)

I’m glad all most of those decisions are made. Picking hotels is hard. Picking the right RV or rental car is hard. Finding the right flights is hard. I get wicked buyers’ remorse on almost everything I do online. In the back of my mind, I’m sure that I spent too much for not enough. I’m slowly getting over that . . . slowly.

So what’s left?

Well, I still have to rent a car or two and an RV. And I need to make sure that our health insurance will travel with us.

And I want to learn a little bit about Australia. Just enough so that I have completely the wrong idea about the place. So I think I’ll start with some fiction. My friend recommended Peter Carey, Tim Winton, and Sally Morgan (especially her autobiography My Place, which probably isn’t fiction).

Better add another book to my never-ending list.

In December 2006, the Keystone Initiative [which used checklists in the ICU and integrated executives to help remove roadblocks] published its findings in a landmark article in the New England Journal of Medicine. Within the first three months of the project, the central line infection rate in Michigan’s ICUs decreased by 66 percent. Most ICUs — including the ones at [Detroit's troubled] Sinai-Grace Hospital — cut their quarterly infection rate to zero. Michigan’s infection rates fell so low that its average ICU outperformed 90 percent of ICUs nationwide. In the Keystone Initiative’s first eighteen months, the hospitals saved an estimated $175 million in costs and more than fifteen hundred lives. The successes have been sustained for several years now — all because of a stupid little checklist.

This is the kind of thing that has to happen in every department of every hospital if we’re going to have affordable, first-class healthcare everywhere in the US. Unlike some other changes this one is relatively easy to implement and costs very little, with almost immediate payback.

But our checklists have gotten a little long and messy, which raises the risk that people won’t use them at all. Part of my job is to improve our team best practices and checklists, so I’m working out how to make all of those checklist-bound countermeasures fresher and more accessible.

So I’m very hopeful that Atul Gawande’s The Checklist Manifesto: How to Get Things Right, which arrived on my desk today, will give me some in-the-trenches perspective. I’ll keep y’all posted on what I learn.

While working away the afternoon at home, I started reading Mary and Tom Poppendieck’s Implementing Lean Software Development. I guess “rereading” would be more accurate, this time with an eye toward actually implementing the ideas. Here are my notes from the first few chapters.

What is Lean Production?

• Use just-in-time (JIT) flow of work products.
• Stop the line to fix problems as soon as they are discovered.
• Eliminate stockpiles of in-process inventory. Create small batches.
• Make mistakes impossible from the beginning.

Product development is knowledge creation via exploration of designs, experimentation with prototypes, and integration meetings that evaluate designs and make decisions.

Schedules have synchronization points, but let expert workers function autonomously between them.

Explore multiple options and make competing prototypes. Defer the decision about which to actually build until the right time (usually later than you think).

Software should be easy to change. Employ all of those high-quality best practices and metrics during construction.

The Toyota Product Development System — upon which the Poppendiecks base their book — is very empirical. The final idea/design/product emerges during development. At the outset, define the goals to meet, not the technology or architecture you’re going to use to satisfy it.

1: Eliminate Waste — Minimize the time from request to fulfillment

• Waste is everything that doesn’t actually add value to a customer feature. Focus on value.
• Reduce the amount of partially done work (inventory). [Basically, don't work on what you haven't been asked for, and complete what you start. Get it written, tested, checked-in, and reviewed.]
• Reduce the time between requirements, coding and testing. This helps reduce requirements churn. Use test-driven development (TDD). Shun “big bang” integration.
• Avoid extra features and scope bloat.

2: Build Quality In

• Control the conditions for creating quality components, preventing defects.
• Write tests first. Use TDD.
• Continuously integrate. Integrate code and tests together.
• Write less code. Keep it clean and simple. Don’t duplicate. Refactor.

3: Create Knowledge

• Go from a sketch to detailed design during construction.
• Release a minimal set of functionality to customer for feedback.
• Create daily builds and get feedback (knowledge) from integration tests.
• Have an experienced team. Pour learning back into the team.
• Build a modular architecture that supports adding/changing features as you learn more.
• Generate new knowledge through disciplined experimentation. Codify that knowledge and make it available to the larger organization. Build a knowledge base. Encourage long-term thinking.
• Continuously improve processes.

4: Defer Commitment

• Try to make most design decisions reversible/undoable/nonbinding.
• Schedule irreversible decisions for the last possible responsible moment.
• Always move toward the concrete, and identify where change is likely to occur.
• Experimentation reduces the risk of making the wrong decision.
• Planning is an exercise, but plans are overrated. Avoid “plan-driven methods.”

5: Deliver Fast — Compete on time

• Be faster than your customers’ ability to change their minds.
• Requires low defect rates, high quality processes, good understanding of the customer.

6: Respect People

• Favor ownership at the worker level, not top-down.
• An entrepreneurial leader should own the product and foster engagement.
• Develop and nurture technical expertise as a competitive advantage.
• Give general plans with reasonable goals. Then let the group self-organize to meet them.
• There is no “one best way.” There is continuous improvement, though.

7: Optimize the Whole

• Optimize the whole value stream, that is, not just local processes.
• Pay particular attention to where products,code and processes transition between departments, teams, organizations or physical locations.

The product development timeline:

• Concept — What’s the unmet customer need or desire?
• Feasibility — Test feasibility by experimentation. Build stuff. Ship betas. Design systems. Investigate the major features of the business process, key hardware modules, interfaces, boundary behaviors, software architecture and constraints. Can the product really be built? Will it work?
• Pilot — Work with your customers. Show off the product; collect data; iterate. Let people choose from multiple options by playing and “voting with their attention.” Run multiple pilots to refine the design.

You have to go way beyond meeting basic expectations, even beyond adding new features or improving performance. You have to identify needs customers don’t know they have and then delight them by meeting those needs. This requires developing a deep understanding of the customers’ world.

That’s all for now. I’ll post more as I continue my way through the book — perhaps the next time it “snows.”

I was a bit nervous about today’s journey. Casper was forecast to have two inches of snow, starting right around the time this morning that we were to leave. And somehow I got us a the Casper to Denver to Chicago to Boston itinerary with tight layovers of less than an hour at each stop. But after the frustrating travel experiences we had last month on our way to and from Kansas, we had good travel karma today. We even walked out the door at baggage claim just as the Logan Express to Framingham rounded the corner. That never happens.

We very much enjoyed spending time with my mom and seeing friends in Wyoming, but it’s nice to be home. Nice to be back to sea level. To be back to my pile of reading.

While my two shelves of books will persist into the new year, my periodicals stack won’t. At the beginning of the year I set myself a goal of cleaning up the big shipping box full of various magazines and issues of the New York Times Book Review that I had amassed over the two and a half years that I was in grad school. What I haven’t finished at the end of the year goes into the recycling. “Out with the old” and all that.

Sadly, I haven’t made much progress throughout the year. But I did manage to read a bunch of magazines on the flights last Sunday and today, so maybe there’s hope after all. The Runner’s World article on 1980’s hurdling phenom Danny Harris, who destroyed his career with cocaine, and the National Geographic Adventure feature on a new hiking trail across Nepal were my favorites. The Scientific American article from last year about how the Large Hadron Collider will likely reshape physics reminded me that when I was younger I wanted to be a particle physicist. Oh well, something more to read about next year.

I rearranged my reading list this morning, finally acknowledging the fact that it had spilled over onto another shelf and that it wasn’t shrinking nearly as quickly as I had hoped.

Fifty-five books. (Click for larger. . .)

There would be fifty-six, but this afternoon I finished a short book on the life and works of Gustave Courbet, the nineteenth century Romantic/Realist French painter, bad boy, and Communard. This continues a trend of reading about notable French painters: Eugène Delacroix, Jean-Auguste-Dominique Ingres, and Édouard Manet. If you look closely, you can see Ross King’s The Judgement of Paris there on the shelf. I’ve read about a third of the interesting — if somewhat passion-free — book about Meissonier, Manet, Monet, the revolution in French painting, and the birth of Modernism and Impressionism.

The truly sad thing is that shortly after I finished reading the aforementioned book about Courbet, instead of picking up The Judgement of Paris, I went to Amazon to see what books I could find about Jacques-Louis David. This, if nothing else, demonstrates that I’m a depth-first learner. When I get interested in something — 19th century French painting, for example — I tend to get really into it. But as you can see from my reading list that spans two freakin’ shelves, I get distracted (or maybe “burned out” is a better phrase) and move on to something else.

(Fortunately, there really are very few books available about just J-L David. So one day I’ll get myself over to the Newton Free Library and settle in for an evening of reading about a truly revolutionary figure.)

I’ve been thinking about this aspect of my personality recently. I don’t have this “problem” of amassing too many books and then losing interest in subjects at work. Well, not anymore. Ever since I switched over to a leaner, “just in time” learning mindset a few years ago, I’ve been doing much better. So why can’t I do that away from the office? Why doesn’t that whole Getting Things Done ™ mindset carry over at home? Who knows?

Anyway, I feel like I should do something about my reading list — short of just shelving the books elsewhere in the library. I don’t read quickly enough to read a book a day. Reading one a week might be pushing it, but it seems like a worthy goal.

Ask me after Christmas how I’m doing.

But before that, here’s a simple request. Currently I’m between books and having a hard time figuring out what to read next. Classes don’t start for another three weeks, and I have the ambition to read something on the longer side. So maybe I should read that book that Leslie suggested: Michael Chabon’s The Amazing Adventures of Kavalier & Clay. Then again, I still have The Plot Against America from the last time I went to the bookstore; and I’m trying to do better about reading what I buy.

What do you think? What should I read next?

Okay, here are my recommendations. Just be aware: I’m rubbish at giving short synopses that don’t totally suck the life out of whatever I’m recommending.

Apex Hides the Hurt by Colson Whitehead. An enjoyable novella about names, branding, growth, change, race, and (ultimately) ourselves. Tantalasia: “An emotional state, that muted area between desire and consummation.”

Willing by Scott Spencer. You might think I’d be apprehensive about recommending a novel about a down-on-his-luck author who goes undercover to take a high-priced sex tour, since it makes me sound a bit bawdy and the description will likely drive all sorts of unexpected traffic to my site. But I’m a sucker for a well-told, ambiguous morality tale that attempts to divine what our morals are in the Internet age. (p.s. – What’s up with not using quotation marks in fiction these days?)

Harry Potter and the Deathly Hallows by J.K. Rowling. I have to admit that I like Harry Potter. I came to the party late — mostly because Lisa wanted to talk to me about book #5 — but I was very anxious for its release last year. If I remember right, I read the whole thing in, like, 20 minutes.

The Worst Hard Time: The Untold Story of Those Who Survived the Great American Dust Bowl. Timothy Egan wrote an amazing book about the plow that literally broke the prairie and the folks on the southern Great Plains who toughed out the Dust Bowl. That period of American history is far, far worse than I had fathomed.

China Road: A Journey into the Future of a Rising Power. Rob Gifford is my everyday hero: smart, self-deprecating, ruggedly handsome. All of these fine attributes come through in the travelogue of his cross-China trip. Along the way he talks to politicians, dissidents, students, farmers, hermits, truckers, hookers, entrepreneurs, . . . everybody. And as NPR’s long-time China correspondent, he draws from a deep, deep well of knowledge and cultural sensitivity.

Terra Nullius: A Journey Through No One’s Land by Sven Lindqvist. Perhaps there’s something that gets lost in the translation of this book; yet despite its imperfect execution, it is a very thought-provoking treatise on collective guilt, reparations, and the legal fictions Europeans used to justify taking other people’s land. I was amazed to learn that Australians are just like Americans, only more so.

Foto: Modernity in Central Europe, 1918-1945. It would have been hard for this thick catalogue from a really wonderful exhibit at the National Gallery of Art to disappoint. But strange things happen in the world of art catalogues. Sometimes the images from the exhibit aren’t in the books. Or there’s no text. Or the text that does appear is hopeless art speak. This book has none of those problems. It’s as fresh as the Central European photographs it covers.

I like photobooks. Monographs, surveys, collections, criticism . . . it doesn’t matter.

I like reading and discussing books. The latter usually happens with Lisa and our friends via book club. But photobooks aren’t really what they’re into. (I can understand.)

Books of photography can be pretty expensive, and I try to respect copyrights. So scanning large portions of books just to discuss them isn’t something I would really do. Aggregating from the Internet is possibly a different matter.

Any suggestions about how to start (and sustain) a photobook club? Either virtual or in-person.

At the recent medical imaging symposium I bought myself a copy of Daniel Malacara’s Color Vision and Colorimetry: Theory and Applications from the SPIE Press. I managed to read the short monograph on the five hours of flights from sunny, warm San Diego to freezing New England.

It’s not exactly an elementary book, but it covers the mathematical basis of colorimetry. Unlike my article on color vision, Malacara draws upon a lot of research and presents the essential equations of color science — at least those that relate to color measurement.

This is one of the rare books on color vision that leaves the human visual system to the end. In fact, the cone response functions are among the last topics discussed. Instead, this short work of about 150 pages takes a more or less chronological approach to colorimetry, starting with a few fundamentals on colorful light, progressing through basic trichromatic systems (like RGB, XYZ, and xyY) and uniform color systems (such as Munsell, CIELUV, and CIELAB) before ending at color mixing and measurement.

It’s quite a good book for those needing concise definitions and equations. Many diagrams and full-color images complement tables for color matching functions and color transformation equations. In a few places the text is overly terse, and my only wish is that Malacara would have provided a bit more context around some of the equations explaining where some “magical” values come from.

But, all things considered, it’s a work that belongs on the bookshelf of anyone who works with color as numbers.