Saturday, February 6, 2010

The Checklist Manifesto

I just finished reading "The Checklist Manifesto" by Atul Gawande, a very interesting book.

Gawande, a surgeon, essentially makes the following point. Given the incredible amount of knowledge we have accumulated in some professions, the complexity of certain tasks could be incredibly overwhelming to professionals (e.g., surgeons, airline pilots). Since in many situations these professionals work under pressure, they often forget some very simple yet important steps that later create unforseen problems (e.g., making sure the antibiotics are applied at a particular time before the incision is made into the patient).

Hence, he argues for simple checklists that teams should go through to ensure that important details are not glossed over. In the airline industry, checklists are used religiously. At every step of the flight, or whenever anything goes wrong, there is a checklist for the flight crew to follow. Gawande's main argument is that this principle should be applied in other professions as well, and in particular, in medicine. He describes his experiences launching such a checklist program with the World Health Organization and the impact that it had on reducing complications following surgery.

There are two main challenges this strategy. First, the checklist needs to be short as to not to completely slow down work. Hence, choosing and phrasing the items on the checklist requires significant thought. The second challenge is putting ego aside. For example, surgeons are used to being the kings of the operating room, and do not lightly take comments from nurses or other staff. Well, pilots have gotten over it, and they're not slackers in the ego department.

Gawande also gives examples from the construction industry and from restaurants, where constructing a high-rise or making sure that everything comes together at the right time on a customer's plate can be rather challenging. One main observation he makes from all of these examples is the importance of communication among the team members, in addition to the checklist. It is crucial for members of the team to communicate well with each other and building communication into the workflow is key. In that way, it's less likely that things fall between the cracks leading to additional problems.

To me the book was interesting because it points out that even if we build a huge body of knowledge in a particular domain, applying this knowledge in practice can be equally challenging.

A Trip to Australia

I recently returned from a trip to Australia, where I gave a keynote at the Australasian Computer Science Week, the annual gathering of computer scientists from Australia and New Zealand. You can see a journalist's account of what I talked about here.

There is a small but very strong database community in Australia, and I encourage anyone who has a chance to go down under and visit. The strength of the community was apparent when two of the three major annual awards were given for database work. Heng Tao Shen from the University of Queensland received the Chris Wallace Award. This is the top prize given for technical achievements across all fields of computer science (full professors are not eligible for this prize). Heng Tao made his mark spanning the fields of databases and multi-media.

The second award was the Ph.D Thesis Award that went to Michael Cahill who received his Ph.D from the University of Sydney under the guidance of my friend (and excellent cook!) Alan Fekete. Michael and Alan also received the Best Paper Award at SIGMOD 2008 for this work on serializable isolation for snapshot databases.

I was very fortunate to spend time with these winners. Heng Tao was my wonderful host in Brisbane and helped make a long-time dream come true -- sitting on a sunny beach in the middle of January (in Gold Coast). When I went to Sydney, Alan took me to an espresso machine making factory, where I got to see up close how these machines are made!

The coffee in Australia is amazing, and will be the subject of a different post. But if you're going to Australia and need coffee, check out my list of favorite cafes and you'll be happy.