Make Better Decisions: Use a Surgeon's Checklist

Last Updated Mar 16, 2010 2:11 PM EDT

I'm a list keeper. I have a daily to-do, of course. And after each major project, I pull out my after-action review checklist. Now I'm happily proceeding down my vacation list for an upcoming family vacation to London.

That's just me. Some people would find my list fetish too formal. To me, a checklist is just a lot of things I don't have to cram into memory -- I just have to remember where the list is! But I believe everyone can benefit by selective list keeping. Just look at the popularity of The Checklist Manifesto, by Atul Gawande, a surgeon and writer. In his 2007 New Yorker article "The Checklist," he argued that checklists lead to better decision making, setting off the current fascination with the subject.

Harvard Business Review's Justin Bell likes lists as well, and provides a handy way to think about the different ways lists can be used in his blog post, What Sort of Checklist Should You be Using?

His "checklist taxonomy" breaks down this way:


  1. To-Do List. Unique among all the lists, the To-Do is uniquely personal. The list-of-all-lists helps you plan and prioritize your day, your week, your year.
  2. Task List. Step-by-step procedure for getting something done, such as starting a chainsaw or finding contact notes in a CRM system. "Task lists are best suited for technical endeavors that involve too many details to remember, but not a lot of judgment," Bell writes.
  3. Troubleshooting List. Methodically determines what went wrong and how to fix it.
  4. Coordination List. A very complicated project, such as building a home or an airliner, requires a coordination list so all participants are in contact with each other when they need to be.
  5. Discipline List. A standard set of procedures or considerations that are evaluated before investing time or resources. A venture capitalist's due diligence process is a discipline list.

I'll add another useful list: the Criteria of Merit list. When Olympics judges awarded American figure skater Evan Lysacek a gold medal over peeved Russian competitor Yevgeny Plushenko, they were using a COM List to apply agreed-upon criteria to the performances. You might use a similar list as you evaluate job candidates ("He was strong on verbal but his Half Pipe aerials were weak"), project requests or vendor selection.

The key question for individuals or businesses using lists is when to formalize them, says Bell:


"Over the past half-century, medicine has gone from a profession built mostly around individual doctors making judgment calls to one in which there is now far too much specialized knowledge and expertise for a single doctor to do all the work or make all the calls. Hence the need for task lists and coordination lists and troubleshooting lists ... that might not have served much purpose 50 years ago."

If South Africa kept a list of presents given to heads of state, President Jacob Zuma yesterday could have avoid the embarrassment of giving the Queen of England the same exact chess set presented her royal highness 14 years earlier by Nelson Mandela. "Oh, another set," Zuma said, spying it across the room.

Tell us how you and your company use checklists and I'll report back with a summary.

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(Checklist image by Xtreme Xhibits, CC 2.0)

  • Sean Silverthorne

    Sean Silverthorne is the editor of HBS Working Knowledge, which provides a first look at the research and ideas of Harvard Business School faculty. Working Knowledge, which won a Webby award in 2007, currently records 4 million unique visitors a year. He has been with HBS since 2001.

    Silverthorne has 28 years experience in print and online journalism. Before arriving at HBS, he was a senior editor at CNET and executive editor of ZDNET News. While at At Ziff-Davis, Silverthorne also worked on the daily technology TV show The Site, and was a senior editor at PC Week Inside, which chronicled the business of the technology industry. He has held several reporting and editing roles on a variety of newspapers, and was Investor Business Daily's first journalist based in Silicon Valley.