Atul Gawande:
The Checklist Manifesto: How to Get Things Right
Transcript
Show 183
[00:00:00] Mike Parsons: Hello, and welcome to dementia moonshots podcast. It's episode 183. I'm your co-host Mike Parsons. And as always, I'm joined by mark checklist. Pearson Freeland. Good morning, mark.
[00:00:13] Mark Pearson Freeland: Hey, good morning, Mike. Get things done, Parsons. This is a big show within our productivity series.
[00:00:21] Mike Parsons: It certainly is. And if you thought we had exhausted all matter of productivity listeners, you're totally wrong.
[00:00:29] We have so much more productivity to give you. And it starts right now. Doesn't emote.
[00:00:34] Mark Pearson Freeland: Yeah. It starts with today's show episode 183 with a tool called one days, the checklist manifesto, how to get things right. Mike at all is a pretty spectacular individual. I won't be able to list all of his accomplishments and achievements here because we're probably near the entire show.
[00:00:54] But just to give you a quick snapshot, ease of renounced surgeon writer, public health leader, he was a [00:01:00] longtime writer for the new Yorker and he's written for four New York times bestsellers, including today's topic, which is the checklist manifesto, which fits in perfectly into that series
[00:01:10] Mike Parsons: of. It does, you could have given us a an executive summary mark, and just say until going day overachiever.
[00:01:18] Mark Pearson Freeland: Yeah, exactly. Overachieve a bus. I think we know how he managed to be that overachiever, Mike and I think the secret is checklists.
[00:01:28] Mike Parsons: How cool is that? Though that somebody who has produced so much done so much from being a doctor from attending Harvard school of health and medicine to someone who's written best sellers, he's giving us the formula.
[00:01:48] This is so moonshots when we have the chance not just to go, wow, this is really cool. What he's done and he's working is wow. But to go deeper and say how did he do it? And here's the killer map [00:02:00] we today we'll ask ourselves, how do we. Do it too, if you want to be so prodigious like a, to go one day, then right here on this show, we will break down the secret sauce versus success habits that he followed our good is
[00:02:19] Mark Pearson Freeland: that, he, like you say, breaks it down from quite a medical background.
[00:02:25] He brings in stories around utilizing elements of the checklist and those type of tasks and behaviors in your daily and professional life. I think there's so much for us to learn within this show, Mike I and it's areas. Like I say, we can use when we're creating a show for moonshots, when we're getting ready for our days or our weeks ahead, it translates.
[00:02:50] All of those different elements of our lives. And I think we're basically getting from a tool, a bit of a cheat sheet on how to be that best version of ourselves
[00:02:59] Mike Parsons: we certainly [00:03:00] are. And I think what's ahead of us in this show, mark is we're going to get insanely practical on mastering the checklist, but we're also equally going to push a ride into, if the making of the checklist is the habit and the following the checklist, it's the daily habit, right?
[00:03:18] On the other side, there's the behavioral stuff, the psychology behind why we should use them and often why we don't. And what's really interesting. Mark is in exploring all of these masters of productivity. We are not just learning. About time management, task execution. We seem to be discovering some real truths about how we think and behave as human beings.
[00:03:47] Don't we mark? Yeah, I
[00:03:48] Mark Pearson Freeland: think you're spot on there. And particularly in today's show from a tool, he does break down the hurdles and the difficulties, perhaps on the challenges that we do run [00:04:00] into when we're trying to be that little bit more productive, because I think we're all hardwired into certain behaviors.
[00:04:06] We often take that path of less resistance. And what I found in the last couple of shows within our productivity series with David Allen, for example, is this permission, the permission to almost forgive yourself and say, okay, it's all right. If I haven't been that good, however, based on Chris Bailey's work with hyper-focus, I can take ownership and then become that little bit.
[00:04:30] Productive that a little bit more efficient, that a little bit more focus. And I think when you break down the key lessons aside from, the habit formations within some of these works, it is really just about getting that mindset. Getting yourself into a place where you want to go out and achieve and maybe take the path that's slightly less trodden.
[00:04:52] Mike Parsons: Yeah, absolutely. And when you hear checklist and manifesto, you think, oh, gee, that's like getting a bit overexcited about the humble checklist, [00:05:00] but mark. It really is so much more. I think our tool has a big story to tell he doesn't he? Yeah, he
[00:05:07] Mark Pearson Freeland: really does. So Mike, why don't we let a tool himself introduce us to the concept of checklists because they really can help us or get that little bit better.
[00:05:17] So let's now hear from Tuk one, they break down the value of checklists.
[00:05:23] Atul Gawande: I got interested in this. When the world health organization came to my team, asking if we could help with a project to reduce deaths in surgery, the volume of surgery had spread around the world, but the safety of surgery had not now our usual tactics for tackling problems.
[00:05:41] Like these are to do more training, give people more specialization or bring in more technology. In surgery, you couldn't have people who are more specialized and you couldn't have people who are better trained. And yet we see unconscionable levels of. [00:06:00] Death disability that could be avoided. And so we looked at what other high risk industries do?
[00:06:06] We looked at skyscraper construction. We looked at the aviation world and we found that they have technology, they have training and then they have one other thing. They have checklists. I did not expect to be spending a significant part of my time as a Harvard surgeon worrying about checklists. And yet what we found were that these were tools.
[00:06:36] To help make experts better. We got the lead safety engineer for Boeing to help us, could we design a checklist for surgery, not for the lowest people on the totem pole, but for the folks who were all the way around the chain, the entire team, including the surgeons and what they taught us was that designing a checklist to help people handle complexity actually involves [00:07:00] more difficulty than I'd understood.
[00:07:02] You have to think about things like pause points. You need to identify the moments in a process when you can actually catch a problem before it's a danger and do something about it. You have to identify that this is a before take off checklist, and then you need to focus on the killer items and aviation checklist like this one for a single engine plane.
[00:07:25] Isn't a recipe for how to fly a plane. It's a reminder of the key things that get forgotten. Or missed if they're not checked. So we did this, we created a 19 item, two minute checklist for surgical teams. We had the pause points immediately before anesthesia is given immediately before the knife hits the skin immediately before the patient leaves the room.
[00:07:52] And we had a mix of dumb stuff on there, making sure an antibiotic is given in the right timeframe because that cuts the infection rate by [00:08:00] half and then interesting stuff, because you can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected.
[00:08:09] And we had items like making sure everyone in the room had introduced themselves by name at the start of the day, because you had half a dozen people or more who are sometimes coming together as a team for the very first time. That day that you're coming in, we implemented this checklist in eight hospitals around the world.
[00:08:29] Deliberately in places from rural Tanzania to the university of Washington in Seattle, we found that after they adopted it, the complication rates fell 35%. It fell in every hospital. It went into the death rates fell 47%,
[00:08:48] Mike Parsons: 47% reduction in fatalities, mark. I think he just made the best case possible for the checklist.
[00:08:57] Don't
[00:08:57] Mark Pearson Freeland: you? Exactly. Not only [00:09:00] are you hearing from a tool around the value of doing it pre takeoff, which I think is a great little term about what might get missed. He then goes on to say the proof is in. We said that rates were cut by nearly 50% in a for example center. So I think he's really, yeah, he's made the case for the value of checklists right there.
[00:09:22] And we've only just had
[00:09:23] Mike Parsons: one clip mark and just think about it. I think if I reflect on my own behavior, like I know that if I have a big event, a big deliverable, I'm probably inclined to go grab write up a checklist. Thanks to the show. What's been interesting for me is. I've discovered, listening to a tool there and listening to other experts is I don't think I use it nearly enough.
[00:09:55] Like I almost dismiss the need for a checklist of, for more [00:10:00] menial things for more daily things. But what's really interesting is that tools like, Hey, the checklist, it ain't some silly trite little thing, actually. It's the core of a language and a practice between not only one or two experts, but an entire team.
[00:10:21] It can be big. It can such a simple thing can become like the unifying force. It's it's like the constitution by which a team again, to work together.
[00:10:29] Mark Pearson Freeland: Isn't it? Yeah, I totally agree. And as we hear from a tool during the rest of the show, he is going to highlight this collaboration and teamwork piece and to build on what you were just saying.
[00:10:41] And the way that I use to do lists is definitely quite functional, but actually what I am already learning from a tool is to insert checklists around the process I go on in order to complete some of those items on the [00:11:00] checklist. So what I mean by that is instead of saying today I need to do the pre-production of our show.
[00:11:06] That's one big item, but the truth is there's going to be a number of steps within that item on there. And through preparation, I can be a little bit more efficient if I know the steps that then go into building or pre producing that show. And I think what he's already revealing for us here is if you do that, if you're with a team, you can.
[00:11:29] Get over those inefficiencies very early. Sometimes even before you start because you and all your team are already anticipating the things that you're going to have to do. And when you know where you're going, it does feel that little bit easier.
[00:11:44] Mike Parsons: Doesn't it? Yeah. And so I think it's the case he made, said differently is look, take a checklist because we do have the habit of just having a bit of a brain fog.
[00:11:56] And just forgetting something that we've always remembered. We just forget. So a [00:12:00] checklist or back you up there. But I think importantly, what he's saying is that when a team has a great checklist, there's less uncertainty. To worry about there's lesson knowns. And if something unexpected happens, because everything is in order, you can always go back to the checklist and find your way out.
[00:12:23] So I think I am totally on board. And I think that the exciting thing about what we've got ahead on this show is we're going to dig into the work of our, to go on date. We're going to understand why we perhaps don't always reach for a checklist. We're going to hear some amazing, some huge epic stories of how checklists have made a difference, but.
[00:12:50] We're going to break down the art of making a great checklist. And we're going to understand that this is far from something that is trivial, [00:13:00] but something so simple and elegant can be the key to high performance. Mark, we have so much ahead and I have a question for you. Can you think of one task to put on your checklist as you listen to the moonshot show, perhaps you get a cup of coffee, put in the headphones, you open up your phone, you press play on the podcast.
[00:13:26] I'm trying to think. Is there something else that we could add to that checklist bar that would be a really vital activity? I think
[00:13:35] Mark Pearson Freeland: for me, Mike, that vital activity would be to navigate one step further and start to become what we like to call our moonshots members. And Mike, those moonshot members are not only getting a shout out each week, but they're really making a fundamental difference to the moonshot show.
[00:13:57] Mike Parsons: Aren't they? They are, they really are that they're [00:14:00] joining in the conversation. They are supporting us as we pulled together this huge production that gets distributed all around for the four corners of the globe. But more importantly, it's an exchange of value, Work really hard, both ourselves and our research and production team.
[00:14:19] We incur all sorts of costs to make this show and we give it away because we want to learn out loud together. We want to be the best version of ourselves. We love your feedback and so forth, but if you really are enjoying it it's so vital. For us at the show that you become a member and the people that we want to acknowledge in a moment where you are so grateful to you for your contribution for your small contribution.
[00:14:50] You are not only helping us pay the bills, but you are actually part of something really special, a place where we come together, where we can say, let's get over all of our [00:15:00] insecurities. Let's get over the uncertainty and let's shoot for the moon. Let's be the best version of ourselves. So mark, I think get the trumpets, get the drum roll.
[00:15:09] Ready. Let's go. Tip the hat to our members. That's right,
[00:15:14] Mark Pearson Freeland: please. Welcome. Bob Niles, John Terry Nial, modulating candy yet mark, Tom mark Masha and Connor, Rodrigo and Yasmeen Liza said Mr. Bonn, ju Maria, Paul Berg and Kalman David, Joe, crystal Evo, Christian hurricane brain, somewhere like Kelly, Barbara and Bob Andrei and Matthew Eric and our brand new members, Abby, Josie, and Joshua.
[00:15:40] Thank you all for joining us today as moonshots members.
[00:15:46] Mike Parsons: And if you are tuning in and you're enjoying the productivity series, if you're dying to know what the ultimate checklist should look for. Sure. It's all ahead of you on this show and we would love it. If you [00:16:00] became a member to support us on this journey of building something special together, and we want your feedback, your suggestions, many of the shows that we have the authors or the experts that we focus on are suggested by you.
[00:16:15] And you can do that as, so go to moonshots.io. And if you go there, you can become a member. You can support us. And mark, you also get access to the moonshots master series, which is an entire second podcast that we do exclusively for our members, right? Yeah, that's right.
[00:16:33] Mark Pearson Freeland: The master series are fundamental de.
[00:16:37] Dives comprehensive breakdowns of topics that we might occasionally run into on the moonshot show. These are topics such as motivation, teamwork and collaboration, as well as, real thinking models like second order thinking and what you and I do. And the moonshots team, Mike, we really break down those fundamental frameworks and constructs don't we, [00:17:00] and try to identify how we can make them part of our daily habits.
[00:17:04] So members, they are the only ones who can get access to this version. So if that sounds a little bit tempting, pop along to moonshots.io, hit the big button at the top, become a member and join the moonshots family.
[00:17:19] Mike Parsons: Yep. And if you need any further encouragement, I'll do both the carrot and the stick Hema.
[00:17:24] The carrot is once we hit 50 members, we're at 37 guys. So we can do this. When we hit 50, we will roll out our moonshots, teas, posters and all that good stuff. And I think perhaps next week we might start sharing the designs with our members so they can vote for which ones they would like us to make.
[00:17:47] So we need 13 more members and then we can release the merchant. They're going to be some really nice t-shirts posters, tote bags, all that kind of good stuff that could be great for a gift or [00:18:00] something for yourself. And we've really tried to design them as for example, t-shirts that we'd wear or posters we'd have in our office or our studies.
[00:18:08] So we'd really encourage you. So we need 13 more marks. So we'll put out the designs next week. We'll get some feedback from our. But on the other hand, we really would ask you to contribute to the show. We only ask the price of one cup of coffee per month to support the show that helps us pay all our bills.
[00:18:28] And we are well over 50,000 listeners a month now, and we have just 37 members. So there's gotta be a few more of you listening to this show who are thinking, I really look forward to when the moonshots podcast comes out every single week, every single holiday, we still ship a show for you so you can learn out loud.
[00:18:47] And if you're into that, if you want to put something on your checklist, become a member@moonshots.io. So mark, now that we've added something to the checklist, I think it's the perfect [00:19:00] moment where we need to understand why sometimes folks don't always want to use their checklist.
[00:19:07] Mark Pearson Freeland: Yeah, that's right.
[00:19:08] And as we were saying, it's all about the value of maybe getting over that path less trodden. And there's always going to be times in our lives where we feel that little bit resistant to something that's brand new to us. So let's hear from a tour now tell us. Why we think that there is such a resistance towards checklists.
[00:19:29] Atul Gawande: There's a deep resistance because using these tools forces us to confront that we're not a system forces us to behave with a different set of values. Just using a checklist, requires you to embrace different values from ones we've had like humility, discipline, teamwork. This is the opposite of what we were built on independence.
[00:19:56] Self-sufficiency autonomy. [00:20:00] I met an actual cowboy, by the way, I asked him, what was it like to actually herd a thousand cattle across hundreds of miles? How did you do that? And he said, We have the Cowboys stationed at distinct places all around. They communicate electronically constantly, and they have protocols and checklists for how they handle everything from bad weather to emergencies or inoculations for the cattle.
[00:20:27] Even the Cowboys are pit crews now, and it seemed like time that we become that way. Ourselves making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work, whether in healthcare education, climate change, making a pathway out of poverty is the great task of our generation.
[00:20:53] As a whole, in every field, knowledge has exploded, but it has brought [00:21:00] complexity. It has brought specialization and we've come to a place where we have no choice, but to recognize as individualistic as we want to be complexity requires group success. We all need to be pit crews now.
[00:21:20] Mike Parsons: Oh, the pate craze analogy is so good to what is required here, but there's so much from what he just said, and this is something it's a thing.
[00:21:31] That has come up a lot on the show. Something that I really identify with, which is that we are surrounded by complexity. So therefore, if we're in complexity, we need two things. According to a tool he's saying we need a checklist, right? And we need to work as a team. And the reason I really relate to that is the amount of information notifications and the speed [00:22:00] at which we work means that we are processing so much information.
[00:22:06] I think about at the start of my career and mark a minute, share out how old I am here. We used to send in the morning I would go into the office when I was 20 and we would send faxes out to our clients in the morning. Here's all the news that came in on the wire. Here's what's happening. We'd send out the faxes and then we would ring around and say, okay, what did you see on the newsfeed?
[00:22:32] That was interesting. And therefore the day's work would be created. It was so inefficient and slow compared to how we work now, because that would have happened as an automated service. And perhaps. Th their response may have been automated. My point being is things happen at Lightspeed. We work at a speed in a density now that even in my early career, 27 years ago, we would [00:23:00] never, we would have been shocked that we were working at that speed, that philosophy, that volume.
[00:23:06] So in a funny way, as sophisticated and hyper speed is our way of working is the more we need to grab onto these human simple truths, have a list work as a team because that's the only way to counterbalance the speed, the complexity and the sheer data that we're processing as human beings.
[00:23:28] Mark Pearson Freeland: Yeah. I believe it's really calling.
[00:23:32] References and similarities to count. Newport's work with digital minimalism and deep work and his latest book on emails as well as last week show with Chris Bailey on hyper-focus, even though we are in a world where you don't have to send faxes anymore, instead you get it all streamed into your emails, social media, and so on.
[00:23:53] That's too much information, isn't it. It's very complex to compartmentalize and understand and [00:24:00] draw insights from that level of information. And I think you're right, calling out what a tool is calling out is putting in that system, making it work, whether it's in medicine or marketing or any other industry education, it's going to help those individuals who are absorbing that information because otherwise it's just over whelming.
[00:24:24] Isn't it?
[00:24:25] Mike Parsons: Think about it like this. We love and personally, one of my favorite, most used features on the iPhone is, do not disturb. Like you're literally saying I've got this like rocket ship of a device, but please neutralize its functionality. Cause it's just too much. It's preventing me from getting my job done.
[00:24:51] So I think that tells us everything our need to go onto do not disturb our need to go on a digital [00:25:00] detox tells us, makes the case for the complexity that we live in. If you acknowledge that and say okay. Okay. Okay. All right. Some basic things let's work as a team, let's have a checklist.
[00:25:10] Let's make it real simple because when facing complexity, the art is making things simple. That's the own leeway. So hopefully now what we've done. As we've rebranded checklists, we've made them the thing of the moment, mark. They are no longer considered second class citizens, but they are our number one tool in a moonshot.
[00:25:33] But I feel like what we need now, mark is we need a story. We need a tool to share with us some moments where following the checklist and working like a pit crew has really delivered just to make sure that we're all really committed to this idea of checklists. So why don't we jump in and listen to a tour?
[00:25:57] Accounting. It's a [00:26:00] story of a girl and a frozen girl, and how the power of a checklist and working like a pit crew. The unthinkable and it brought her back to life. I
[00:26:14] Atul Gawande: want to start by telling you about a case that got me thinking about what we're really trying to pull off in many lines of work. But if this is a medical case and I read about it when it came out in a journal about a decade ago, outlining how we take care of people who've drowned and what we should do to try to revive them.
[00:26:34] It described the case of a three-year-old girl who had fallen into an icy fish pond with her family while out on a picnic in Austria, in the Alps. And the girl it's one of those nightmare moments was simply lost beneath the water. The parents saw her dive in and couldn't get her. It was at least 30 minutes until they were able to find her [00:27:00] at the pond bottom Fisher out, get her to the surface and then to the shore, she wasn't breathing.
[00:27:07] They called the emergency services line. The operator gave instructions on how to do CPR. About eight minutes later was when the first emergency services team arrived on the scene and they got the first vital signs. Her temperature was 66 degrees, more than 30 degrees below normal. Her pulse was
[00:27:33] Mike Parsons: absent.
[00:27:34] She wasn't breathing.
[00:27:36] Atul Gawande: And most ominously of all her pupils were dilated and didn't react to light, meaning that the brain is gone, but you don't give up on little girl. They took over taking care of the chest compressions. They got her in a helicopter and transported her to the nearest. There she was taken directly to the operating room [00:28:00] and bypass the emergency room.
[00:28:02] And that the article outlined what the team then went through as they walked through, what would you really do to be able to save, have a shot at saving a child in this kind of situation? What it involved was getting the child onto cardiopulmonary bypass, which is not a small matter. You have to cut down over the femoral artery and vein plugin, inflow and outflow lines to the cardio, pulmonary bypass machine prime, the pump and get it all going.
[00:28:30] So it was an hour and a half before you finally had circulation restored for her an hour and a half without oxygen and any sign of breathing or circulation, but they kept on going. They slowly warmed her body. And after two hours, her temperature reached 76 degrees. At 76 degrees, her heart started beating in a
[00:28:59] Mike Parsons: normal [00:29:00] rhythm
[00:29:01] Atul Gawande: for the next week.
[00:29:03] She was comatose and then slowly, she came back first, her pupils began to react to light, and then she began to breve voluntarily. And then one day she just woke up. She was there a week later, she went home. She was not done her right leg and right arm were paralyzed. Her speech was severely slurred. They had to do occupational and physical therapy along with neurological therapy intensively week after week.
[00:29:40] But two years later, she came back to the hospital and underwent neuropsychological testing and it showed that she was actually. Back to normal her right arm and right leg had equal strength to her left side. Her speech was no longer slurred [00:30:00] and her her psychological and mental skills were at her proper age.
[00:30:07] She was in other words, like any other little girl that you and I.
[00:30:12] Mark Pearson Freeland: My, this story is accordingly attributes to the inspiration of the book, the man of the checklist manifesto by a took one day, apparently he heard and read that journal and instantly believed that there was something there.
[00:30:28] And I think for me, what stands out in that story is where it starts. It's an insurmountable challenge. To go on the water, icy water for half an hour. No way of bringing her back gradually through the use of following items, step-by-step warming and heart and brain through the use of step-by-step as well as teamwork, they were able to essentially achieve the impossible, which is [00:31:00] bringing somebody back
[00:31:01] Mike Parsons: after the water story.
[00:31:02] This has to be up there with our old time clips like this one to me is not only did they work as a team, not only did they follow the checklist they did. So for many. Days weeks, even years. And they brought a little girl back to life and remarkably, I don't even know scientifically how this happened without it seems hardly any side effects even got the movement back into her body.
[00:31:34] What what that closes the door checklists everywhere now. Yeah, exactly.
[00:31:40] Mark Pearson Freeland: You can only, I can only imagine the coordination of all of those moving parts, those different team members. There's different family members. There's different operational requirements inside the girl and warming Harper and so on and so forth.
[00:31:56] They will have to have it certain they will have to have happen [00:32:00] at certain moments. And if you step back for a second, anything, okay what am I going to do here? Do I need to write it out on a whiteboard? It's fundamentally this checklist, isn't it. In order to map where you're going to get. How are you going to treat this go?
[00:32:16] But also what's already happened. What have they tried? What didn't work. And I love this concept of the checklist somehow being used as like a test and learn situation, because then you can refer back to what's taking place. Was that process or system
[00:32:33] Mike Parsons: efficient? How can I improve it?
[00:32:34] It's a bit like a map, isn't it? Because you can say, oh, have we taken the wrong turn? Let's go back one step. You think about it. If you're, taking a lovely stroll in the mountains and you're like, oh, I think we've taken the wrong term. What would you do is you'd walk back to the previous 10 point.
[00:32:53] That's right. Yeah. That's cool. So if you've got a shared checklist with shared language and Hey, this project seems a bit [00:33:00] off track. Okay. Hang on. Let's just go back a step still not right. Okay. Let's go back a step further and then you get back into it. Okay. That step was right. So then it was the following step where we've misjudged something.
[00:33:10] Okay. And I think what is really powerful about this, not only does this relate to a lot of the productivity stories that we've heard so far in our series, but I'm going to make a little bit of a tangent or jump here. So buckle in Marky, mark. But the thing that I want to pitch you is this is also what we learnt in the E-Myth and the E-Myth essentially makes the case for the difference between working in the business and working on the business.
[00:33:42] And one of the real key points in the email is that you should have a manual. Said differently, a checklist for everything you do in the business so that you're not held hostage by one individual, oh mark. He's the only one who knows how to do that. And he's really [00:34:00] busy. So it can't happen unless he does it.
[00:34:02] That to me is where the business is very much people dependent, not process dependent. The checklist mark what's dawning on me as we go through this is that the checklist is the way to build systems in teams, whether they're sports teams, whether they're business teams or even at home with their family, friends, and partners.
[00:34:24] I think here, what we're discovering is that the checklist becomes the map, the guide, the shared language, it gets us aligned. And if we get off track, we can come back and then it becomes. Because if I know how to do a thing and I write it down as a checklist, what a great way to start teaching. Let's say, something really great.
[00:34:51] Let's say it's your checklist for writing a book. And I want to write a book. You can sit down with me and say, Mike, I've written a [00:35:00] extensive checklist of all the things you need to do. Step by step in sequence for writing a book, start with an outline, do some research, et cetera, et cetera. I don't be like, oh, okay.
[00:35:12] This takes this huge challenge of writing a book. Oh, okay. I see what I need to do next. And I think that's how we can unlock. So much of our potential is when we know where to start. And when we get lost, we know where to come back to, but we can also see guidance, mentorship. And then if you think about great teams, they're really great teams on the sports fields are the ones that there's something magical happening.
[00:35:44] They're all on the same page. They just get it done. And what you'll find is as a method and a practice behind it. And what we can learn today is that all starts with the steps we take. The actions we take [00:36:00] said differently, the checklist. Yeah.
[00:36:03] Mark Pearson Freeland: Remember the last, maybe really good sporting event team sport, when it's almost, as though they're all the players are of one mind, they are where they should be.
[00:36:15] Let's say it's soccer or football and the ball just lands exactly at the feet of another player. It's not because they're all being telekinetic and talking in their minds or they might it's because they've practiced, they've gone through a checklist of moves of coordinations, of reactions to certain events within the game.
[00:36:37] So they're prepared so differently. And I think you're quite right in all of our lives. Even for me, if I am trying to let's say, go for a run the next morning, or I need to go and be somewhere important. What I'll probably do is create a bit of a checklist on the things that I need to remember.
[00:36:57] Let's say it's a work. Mel or a family trip, [00:37:00] because say it's been awhile since we've all done business travel MC, but having a checklist just creates a sense of confidence and removes that anxiety over the level of preparation are my team prepared for this event? Good news is we have our playbooks or our checklists or our items and plays formations almost.
[00:37:25] So I feel confident that we're going to be able to achieve it. Likewise, with packing or preparing for a marathon. Maybe if you've got your process and system aligned and you know what you're going to do at what point let's say it's in your case, Mike, maybe you've probably got a bit of a checklist or process and system in place for your marathon of when to take certain gel packs.
[00:37:47] We'll have glasses of water and so on. I think it just comes through practice and a framework of. Creating the most efficient way of doing something. And again, that's [00:38:00] foundation is within
[00:38:01] Mike Parsons: this checklist, isn't it? Yeah. And I think the real liberation is there because to use the marathon running example is if you know that you're going to have a gel pack, every seven kilometers, if you know that you're going to eat a power bar at 21 kilometers, if you have all of these things on your checklist, do you have your bum bag?
[00:38:25] Do you have your hat? Do you have your sunglasses? Have you put your suntan lotion on? If you have all of this in a checklist, then there is this enormous sense of liberation that you don't have to spin your wheels thinking. Have I done everything? You just open up the list, even if you've looked at the list 10, 20, 30 times in your life, you can go back.
[00:38:49] To the list and you don't need to worry. And I think it's all that energy we spend going, oh, have I got everything right? If you have a list, you don't need to spend [00:39:00] energy worrying. You don't need to be anxious. You can then be like, I've got everything. So now I can transition from that anxiety or nervousness and transitioned to excitement.
[00:39:13] I'm going, I'm traveling. I'm going on a big run or I'm going to give a presentation. I've gone through the checklist. I'm good. Same way you can go with the team. Hey, we've done everything we've trained with prepared. Let's enjoy the game, it's when we're not prepared when we don't have the checklist out where Ooh, God have I have I'm not sure.
[00:39:33] Maybe feels like it may be not a hundred percent.
[00:39:35] Mark Pearson Freeland: It's exactly what David Allen was teaching us. Wasn't it? Yeah. We will have stuff on our mind. And when you have stuff on your mind, it means that you're not doing it, pop it down, write it down. Oh, great. Exactly. It's the tools saying, put it in a checklist.
[00:39:50] Be comfortable and confident. Mike, I think we're making the case for checklist, Sarah.
[00:39:54] Mike Parsons: Yeah, I know. I know. And don't forget that in a second. We're going to show you how to make a great one, you're talking about something that's [00:40:00] on my mind, mark. What is so on my mind is that right now there's a chance that 50,000 people are listening to us and they've got their mobile device could be Android, could be iPhone and maybe they're listening on Spotify or apple podcast, or maybe one of those other players.
[00:40:21] And they have. An opportunity to take something off on their checklist. Wouldn't you say
[00:40:27] Mark Pearson Freeland: that's right. That take could even become some stars because there's what we're pitching to you is to help us spread the moonshots message and get the show around the world, into the ears of like-minded individuals.
[00:40:43] And you can do that and you can help us by popping into your podcast app of choice, whether it's on mobile or desktop, or even your smart home speaker, you can leave us a rating or review via Spotify, apple podcasts, and all the others. And it really does make a difference. Does it [00:41:00] helps the algorithms figure out what shows people listening to and gets it into the ears of other like-minded individuals.
[00:41:08] And we can really see that is the case. Looking at where the listeners are around the world. We're really touching all four corners of the globe and that's to you listeners sharing the show and leaving ratings and reviews, and we really do appreciate
[00:41:23] Mike Parsons: it. Don't we, Mike? We do. And let's be honest.
[00:41:25] We really appreciate personally to see that feedback to see what people actually enjoy about the show, because you know what mark, we're in the business of inspiring and supporting and helping our listeners. So if we're doing something right, tell us, and we'll do more of it. If we need to improve something, please tell us.
[00:41:47] So that's the opportunity that you have in the Palm of your hands to give us a rating or a review. So jump into your app just while we're chatting now, just open. Give some stairs. If you [00:42:00] can leave a review, we see all the reviews. We really appreciate it. We're very grateful for it. It helps us grow the podcast.
[00:42:08] It's how we went from 500 to 50,000 listeners and there's still work to be done. I believe everybody on this planet needs to become the best version of themselves. And so until that job is done, we shall not rest him. Yeah, exactly.
[00:42:22] Mark Pearson Freeland: We shall not rest. That is our track list. And maybe that goal we'll just keep on working towards
[00:42:28] Mike Parsons: now.
[00:42:28] I'll tell you another guy that doesn't rest very much. And that's Brian from optimize one of our favorite YouTube channels. He decodes books and we love his work and rock coming up right now. We've got a clip from him and he's breaking down a tube. Checklist manifesto. And he's a recounting a story of how well the checklist can in the most surprising place lead to excellence, rewind time.
[00:42:57] Van Halen is the first [00:43:00] band to go into smaller markets with nine 18 wheelers. Usually it was like three 18 wheelers that would go into major markets, right? They'd come in with nine super high production value, ton of stuff going on, and they'd go into smaller markets. And these smaller markets, there's less, less sophistication in these markets, right?
[00:43:20] So they had this set of document. Their contract had a ton of different things that the individual who was putting on the event where they would perform, had to execute in order for them to go on stage and perform, so there's literally over a hundred different clauses that they had to get.
[00:43:37] When van Halen
[00:43:38] Atul Gawande: showed up to perform. Now
[00:43:40] Mike Parsons: in that super thick contract, they had article 126 was the no brown M and M's clause. So van Halen rolls up nine 18 wheelers. The team does their thing. They're getting ready to take this stage to do their rehearsal. And what they would do is they would look [00:44:00] at the bowl of M and M's.
[00:44:01] And if the bowl of M and M's had a brown eminent, it, they would cancel their show. One more specifically, they would do a walkthrough to make sure everything was done. Because if the group that was putting on the event, couldn't get the brown m&ms clause. Correct. They probably missed something else.
[00:44:19] So a tool tells this story and he's listening to a radio show about this. And he screams to himself, van Halen used a checklist. They had a checklist to make sure that the surgeons confirmed what side of the body the surgery was on. You'd be surprised, but that you can make that mistake when you're in the going for it.
[00:44:37] Oh, wait, was it on this end of this side? Very rare. But it's those rare opportunities for van Halen, where if someone couldn't get the brown M and M out, they did a walkthrough and they didn't get the weight right. On the support for the stage. And had they gone on stage, they might've literally been killed.
[00:44:54] So the brown M and M's are simultaneously super mundane and irrelevant [00:45:00] and absolutely essential. So we want to have clauses in our lives where we have the brown M and M's clause in the last P and T V. I talked about my one plus 10 plus 100 plus a thousand plus 10,000. That's my article 1 26. I do my sun salutations.
[00:45:17] My pull-ups, my burpees, my rowing, my, my steps. Do I really need to do that? No, I don't really need to do that, but if I can't get those basic fundamentals I probably didn't get other basic things, that are really important for me to create a great day. Therefore, I have a checklist and I crush those things on a consistent basis to make sure I do everything at a high level of excellence.
[00:45:39] And I don't fall into the ineptitude of why we are.
[00:45:44] Mark Pearson Freeland: My, this is something that I feel is spot on with the moonshots message we're trying to achieve that level of excellence, that level, that best version of ourselves. And I know you and I have obviously [00:46:00] spoken about the practices, the methods, the behaviors, and the habits that we do each and every day.
[00:46:07] Particularly in this series on productivity, the idea of journaling in the morning, getting some exercise, to be honest, mark I'm even remembering Robin Sharma and the 5:00 AM club, breaking down that first hour into a meditation. Excellent. Exactly. These little behaviors or habits or differently, I think is really what the tool is calling out in that story before we go much further.
[00:46:31] What a fun revealing story that was,
[00:46:33] Mike Parsons: right? Yeah. And from the most surprising place, and it shows you that. Really it is the, that saying that the devil is in the detail. It's so true because basically van Halen's just saying, look, if you can't get the brown M and M's out, then chances are the audio.
[00:46:55] Any other visual stuff, the stage set up rehearsal times VIP [00:47:00] lists back room, all of that stuff. That's much more complex than just separating M and M's. And it's a really it's a really neat way of sharing how, when you have a checklist, it can really help you perform better, deliver better outcomes.
[00:47:18] And in fact, what a tool reveals in his book is that, the start of building a great checklist is to start with those objectives and those outcomes. And I think that's a really good way to start. So maybe we should just like. Let's like, let's think what would it take? What would be the key things mark to build like a really effective checklist?
[00:47:41] I think number one, you'd start with a really clear sense of what's the outcome that you're aiming for. What does success look like, but what would you, what you've got that in your mind, but what do you do then?
[00:47:52] Mark Pearson Freeland: Yeah, I think for me after defining what that goal or objective is that you're trying to do, it's creating a [00:48:00] point where you can begin that checklist.
[00:48:03] So what I mean by that and what a tool means by that is rather than creating the list and thinking I've got to begin right now. Maybe you factor it in or schedule it in to a certain situation. Like the surgeon in the operating room, that's when that checklist begins. So it's having a really clear, not only definition of the end goal, the objective, but it's having a beginning point as well.
[00:48:27] Mike Parsons: Yeah. And then from there, I think the interesting thing he explores is he says, this is interesting that the best checklists are relatively short. They're only like five to nine items. Oh yeah. And that's, I think that's a bit of a forcing factor because then you really got to get okay, I better hit the, the eight main things.
[00:48:47] Cause you could get buried in the detail. But I think What his point is, if you have too much in your checklist, you're overwhelmed the don't you.
[00:48:56] Mark Pearson Freeland: I know I've certainly been guilty of that, Mike. And I [00:49:00] think the lesson that our tool really calls out is helping only add keeping that sh helping to keep that short is by focusing on the killer items, the items that you may well, you can have all the detail and all the information available, but maybe it's somewhere separate in a different document on your to-do list and checklist.
[00:49:19] It needs to be the key killer things that you have to hit. Otherwise they're going to cause critical issues if they aren't.
[00:49:26] Mike Parsons: And I think that okay, so we've got the outcome, we've got those key points of start and finish those little moments that are tools spoke about those review moments or those pores points where you can like, okay, before we go into the next step, have we got everything?
[00:49:42] You've got five to nine items. You've kept it really simple. I think the next thing you really need to do is to actually use the checklist. Review and discuss, did it work maybe even revise the checklist with [00:50:00] a partner in the process, right? Yeah. I
[00:50:02] Mark Pearson Freeland: think this is a real kicker that we can't overlook because for me, checklists feels very in the moment, but I think you're right.
[00:50:11] And it tool was corrected by revisiting and essentially doing a bit of a retrospective maybe with yourself, but also with the team who can give you that real world feedback. How did it feel when we were actually physically doing the item? Did we need more detail? Maybe we needed less detail. You can then revise it and bring it down and condense it maybe into something that's even more efficient so that by the time you have to do it again.
[00:50:35] Hey, good news. That path is a little bit more trodden and you feel a little bit more comfortable doing it.
[00:50:41] Mike Parsons: The the real twist here, though, mark is. As we've gone through that, and as you and I have built, that sounds pretty straightforward, but I reckon the real challenge with all of this is the rigor and the discipline [00:51:00] to apply it consistently.
[00:51:02] I think that's going to be like, it's like saying, Hey, I'm going to get 30 minutes of exercise every day. Come for a walk or a light jog. Hitting the gym once. Yeah. That's good. It's like when it's raining and you need to go and run, that's the real test,
[00:51:20] Mark Pearson Freeland: isn't it? Yeah. It's the discipline to stick to it.
[00:51:23] Isn't it? Because, and again, it calls back to Cal Newport and even Chris Bailey with hyper-focus, we can get distracted by those notifications, by a colleague coming to your desk or send you an email that then brings you away from that checklist. And suddenly you've got to start it again. I think you're right.
[00:51:44] It's that organization and checklist to define bright. I'm going to maybe time. And attack this problem, or I'm going to get in a room with my team, virtual real, and all of us are going to close. Our laptops are all going to work on this
[00:51:58] Mike Parsons: project [00:52:00]
[00:52:00] Mark Pearson Freeland: because otherwise you are, you're getting, you're going to step away and lose track of where you've gone.
[00:52:05] Yeah.
[00:52:06] Mike Parsons: We've built the list now it's about the discipline to make it happen and something that you might face as you go to implement your checklist every single day with all of those really crucial, critical primary activities, ones that you don't want to get wrong, then you need to accept that.
[00:52:30] Maybe you're not perfect and that when you think you got it, there's absolutely nothing wrong with saying to yourself, but first I'll check that. List. So let's hear for the last time in this show from a to go one day and he's going to be sharing his thoughts on us, accepting our own fallibility. I think there's
[00:52:54] Atul Gawande: a deeper idea here about why we're resistant to.
[00:52:59] [00:53:00] Taking the kind of standardized, same way, every time approach of making sure you run through checks before you take on something of great complexity or risk. And that's that we believe the joy of work, especially as experts comes from autonomy, from the freedom to decide whatever it is that you is, that you find is the best way to do things you've trained for many years, you have great experience, you know what you're doing, and yet we find we can make experts better.
[00:53:34] The reason I think is. We haven't quite embraced the notion that we are fallible, that the complexity of the world at this point exceeds our capabilities of our brains to hold it all in. And it leads us to have to almost have a different way of thinking of ourselves. As people setting out to accomplish things in the world, we have to rethink what it means to be great, [00:54:00] which is not just about having that flash moment when you can save the day.
[00:54:07] Just by intuition or gut instinct. It is about being prepared for the unexpected. It's about the discipline to make sure that you're ready for whatever may come. The checklist then is a tool and something, I go into great length about how they work and how you can make them better for what you need.
[00:54:30] But there's something deeper than I'm trying to get at and writing about something like this, which
[00:54:35] Mike Parsons: is about
[00:54:37] Atul Gawande: where we are as a culture in society, trying to grapple with the complexity of the world. And as we turn to something like a checklist, what we see is something that is lowly and humble and overlooked,
[00:54:52] Mike Parsons: and I think has the,
[00:54:54] Atul Gawande: and misunderstood.
[00:54:55] But when we pay attention to. To where our weaknesses [00:55:00] are and then pay attention to how something like a checklist works to supplement the failings of our brains and the difficulties teams have in making things come together. What you realize is that an idea like this can be transformative under conditions of complexity.
[00:55:21] Our brains are not enough. We will fail. Knowledge has exceeded our capabilities, but with groups of people who can work together and take advantage of multiple brains preparing, being disciplined, we can do great and ambitious things.
[00:55:44] Mike Parsons: Our
[00:55:44] Mark Pearson Freeland: brains are north enough. This is so in line with getting things done by David Allen.
[00:55:52] Mike Parsons: Isn't it. And who would have thought that in exploring a tool and [00:56:00] David's work that we would discover, there are much bigger things of energy, focus and humility are really at the heart of being productive.
[00:56:10] Mark Pearson Freeland: That's an interesting interesting. Reveal, Mike, the idea that your ego and your desire for autonomy as a tool calls out, it is something that we take pride in, but when you then appreciate it and realize, what, I'm, I could be better with others and the help of input from real world situations.
[00:56:32] Maybe it's users, maybe it's my colleagues and bringing in disciplines systems and processes to help me be that better version. It's quite a reveal. Isn't it? This step back from your ego and be that better version of
[00:56:44] Mike Parsons: yourself, which tells you that's the curse of knowledge is the temptation to think you're a grand master and you got it.
[00:56:54] This intuitively and back to front, who the hell needs a checklist.
[00:56:59] Mark Pearson Freeland: [00:57:00] Exactly.
[00:57:00] Mike Parsons: So from all of these things that we've talked about, all of these lessons that we've gleaned from our tool going day, which one is which one's going to get a little bit of extra homework from you? I
[00:57:14] Mark Pearson Freeland: think the most surprising or chuckle worthy one is the brown m&ms with van Halen.
[00:57:21] I think that's a nice little Brexit, but I think the true value really comes through in that last clip. Actually, the accepting your fallibility, you could be better with others. And I think that's the kicker here. To do lists and checklists and get other people to review them and maybe even follow them that I think is the core message.
[00:57:42] What about you?
[00:57:43] Mike Parsons: Listen, I think I'm just going to be like turning everything into a checklist that's really important because I feel like in doing that, I'm going to learn so much more I'll review it more and get better. And I think I have been, I've had a little too much hubris with somethings.
[00:57:58] For example, all of the[00:58:00] the things that kind of. All of the activities that come with us producing the show, some of those things I just do intuitively and I don't write them down. So maybe I'll start them up.
[00:58:10] Mark Pearson Freeland: Yeah, me too. Me too. I was thinking the exact same thing, simple little processes that I'll follow.
[00:58:15] I can again, test to see if it can be done maybe more efficiently. And then refine the gray
[00:58:23] Mike Parsons: lesson. Yeah totally. Mark, thank you to you for joining me on this absolute adventure and really, this one had some surprising turns in it. This journey show 183, our tool going day, the checklist manifesto, how to get things right?
[00:58:41] And thank you to you, our listeners and our members who are on their way to getting things right to an hour journey today started with the value of checklists. They make experts better. They bring teams closer. And the reason that we need [00:59:00] something so simple, like a checklist is we face so much complexity and we're a little bit resistant to them.
[00:59:06] We think we got it, but we need to take. Those checklists, if we want to be better experts and better teams. And we heard a very inspiring story of the frozen girl, we even heard about brown m&ms and rock and roll baby. That's what it takes. If you want to take things a level higher. And if those are the practices, the checklists, the rigor and the discipline, there is a mindset where you have to be a little bit more humble, except your fallibility, and know that you need a checklist just like van Halen.
[00:59:38] And if you do that, you'll get better every day. If you do that, you can learn out loud with others and doing all of those things will help you become the best version of yourself. And that is absolutely what we're all about here on the moon child's podcast. That's a wrap.