The Checklist Manifesto: How to Get Things Right

In Chapter 7, Gawande lists these two types of checklists. When adhering to Do-Confirm checklists, people “perform their jobs from memory and experience […] They [then] pause to run the checklist and confirm that everything that was supposed to be done was done” (122). When adhering to Read-Do checklists, “people carry out the tasks as they check them off—it’s more like a recipe” (122).

The “master builder” represents a top-down model in which one leader is charged with almost all aspects of a project. In Chapter 3, Gawande introduces the term by mentioning historic buildings such as St. Peter’s Basilica and the US Capitol building. He suggests the “master builder” model is losing its relevance in an age where technological advancements create a growing need for super-specialization; establishing one point person is no longer the go-to model of efficiency.

In Chapter 5, Gawande learns about pause points as he studies the aviation industry’s construction of flight checklists. He defines pause points as “points at which the team must stop to run through a set of checks before proceeding” (111). When Gawande works with the World Health Organization (WHO) to develop safe surgery checklists, he borrows this principle—establishing pause points before the application of anesthesia, before incision, and following the operation but prior to the patient being removed from the operating room.