Attul Gawande is a general surgeon, MacArthur Fellow, contributing writer at the New Yorker and leads a WHO program. He has more degrees and letters after his name than this poor journalist will ever have.
In his latest book, “The Checklist Manifesto,” Gawande talks about how simple checklists have helped doctors in ICUs across the country reduce infection rates to statistically zero. They make sure doctors remember stuff like wash your hands before operating and cover the patient in sterile cloths before you cut him open. Not rocket science, but easy enough to overlook in a crowded operating room.
The checklist programs started with nurses, the people doing most of the hands-on work with patients day to day. They really caught on after hospital administrators gave nurses the power to call out doctors when they missed key steps on the list.
Gawande describes three types of problems these lists help solve: simple, complicated and complex. A simple problem is like replacing a light bulb. It has a few steps that anyone could accomplish, and repeat. A complicated problem is one that involves lots of people and decisions, but can be divided into many simple problems – like launching a rocket.
A complex problem is one that has hundreds or thousands of variables that require many decisions and experiences and specialized knowledge, but that aren’t easily predictable or repeatable. Like building a business.
This month, Allan Davis writes for us about the overwhelming mountain of tasks that every landscape contractor faces when he’s building his business.
Not what he has to do to run the business – schedule crews, buy equipment, pay people, sell – but what he has to do to build it. The stuff that’s so easy to push into tomorrow or next week, especially when you have all those fires to put out.
The key, as Allan explains, is not to try to do all of it at once. Pick one thing and do it, then do the next one. As long as you can articulate what the most important stuff is, and you work on the most important stuff, the most important stuff will get done.
It’s not a perfect system, and you won’t get everything accomplished overnight, but the only way to tackle a complex problem is to get started somewhere.
– Chuck Bowen