How to Get Things Right
The sub-title of Atul Gawande’s book, The Checklist Manifesto (Metropolitan Books, 2009) is How to Get Things Right. Atul Gawande is a surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston, Massachusetts. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School. He was recently tapped by President Biden to be a member of his Covid-19 Advisory Task Force. He is a brilliant man, a superb speaker and an expansive thinker. “How to Get Things Right” is a bold subtitle for anyone, for a surgeon it is certainly a comforting thought; and for those of us currently leading and working during a pandemic, getting things right seems all but impossible, but of course extremely important as a goal.
One of Gawande’s maxims is: there’s always a better way. This doesn't mean that the way in which we are currently operating is wrong; it’s just that we always want to consider how we might make it better. (See Gawande’s equally helpful book, Better, for more on this theme.) Many organizations follow this very maxim and create environments where everyone in the team is encouraged to come up with new ideas, seek new approaches, always looking for what might be better. Creating a culture of shared ideas that emanate from all quarters is a failsafe way not only to encourage innovation and improvement and build ownership, but also to make better sense of the depth and breadth of information coming in.
In The Checklist Manifesto, Gawande describes many kinds of simple systems—sometimes lists, sometimes articulated approaches, all agreed upon ahead of time and all derived from a huge amount of underlying complexity. In his particular field these systems create change that actually saves lives, via surgery. The basic idea of the checklist, however, comes from the checklists that airline pilots use before take-off and landing. He focuses on the concept that we are all exposed to an enormous amount of information and it is the ways in which we synthesize and make sense of this data that are important. By telling powerful stories through clear examples that illustrate his points, he leads us to understand the ways we might do the same for our particular field of work. As I look to what school principals, leaders and managers in all sectors are doing now, during the pandemic, I am in awe thinking of the depth and magnitude of data coming at them. What might checklists and rubrics offer to them as vehicles for synthesis of data and clarity of purpose?
Gawande talks a lot about working in teams and how teams working together can create checklists that emphasis their common approach to problem-solving. He argues that, in any given situation, you are a team leader or a teammate, and you need to be really good at both. He believes that teamwork is an “unspoken but critical component of success.” For example, he describes one emergency surgery where he was the “team leader” (chief surgeon), working with a group of people he had not worked with before. Because that hospital used the checklist idea, the team automatically followed the pre-determined protocols. He recounts the good outcome of the surgery and how each team member anticipated the needs of the other – how everything automatically worked for the well-being and good health of that patient. In this anecdote, Gawande describes the essential value of working together, of understanding each other, and, in any given moment, knowing what your role is and what it requires. It is a powerful picture of how to “get things right,” a picture of a community of professionals working seamlessly together – an image all leaders, and team members, would take great pride in.
So how do we “get it right” when the rules keep changing and the ground shifts beneath our feet? Based on what Gawande outlines, you create a checklist, a check list based on what you have learned about success through common goals, a common language and a common understanding. You apply your core values, tested over time, to each situation and you check things off. Getting things right is about believing in your approach and trusting your team—and yourself.
In a January 2010 letter to The New York Times, written to answer a few points that had been made by a criticism of his book published in the newspaper, Gawande wrote: “Under conditions of increasing complexity, in medicine and elsewhere, experts require a different set of values than we’ve had. We require greater humility about our abilities, greater self-discipline and the prizing of teamwork over individual prowess. And those are precisely the values contained in the willingness to design and use checklists for what we do.” His definition of “getting things right” is broad and iterative and yet constant. Humility, self-discipline and the prizing of teamwork are his guiding principles. Principles that will certainly stand the test of time, over the long haul, and the test during current times, during the pandemic. Building and nurturing strong, committed teams and ensuring that we have approaches that allow us to cope with huge amounts of complex and ever-changing data are vital to the work of a successful organization. Gawande’s ideas and constructs offer us the right assistance, right now, and, let’s hope, for the foreseeable future.