It’s an older book. It’s written by a medical doctor. But if you haven’t read it, it’s a “must read” for printing industry leadership. It’s called The Checklist Manifesto: How to Get Things Right, and its premise is so simple that you almost can’t believe the author stretched it into 142 pages. But it’s precisely because it’s so simple that a full book was required.

Written by surgeon and best-selling author Atul Gawande, the conclusion is that checklists reduce mistakes—a lot. People, especially Type A personalities like us, often don’t want to accept that we could be vulnerable to overlooking simple things we’ve done a thousand times, so it took a full-sized book to prove to us that we can. The conclusions apply to any industry that relies on repetitive tasks. Surgery, for example. Aviation, construction…printing.

Gawande opens the book with a story from a friend’s career as a surgeon. A patient lay on the table, a routine operation, and his heart stopped. The surgical team raced through the possibilities—major blood loss? Lack of oxygen? Collapsed lung? It turned out, someone had simply forgotten to doublecheck the patient’s potassium levels. Too much potassium stops the heart. This after all, Gawande writes, is how they execute prisoners. (In this case, the patient’s potassium levels were fixed and he recovered.)

More Prone Than We Think

Life—and manufacturing processes—are filled with complexity. When things are complex, with lots of steps from Point A to Point Z, it’s easy to miss things. As professionals, we think we’re immune, but we’re not. In fact, the more often we’ve done something, Gawande points out, the more likely it is that we will miss something. The consequences can be catastrophic:

Fifteen years ago, Israeli scientists published a study in which engineers observed patient care in ICUs for twenty-four hour stretches. They found that the average patient required 178 individual actions per day, ranging from administering a drug to suctioning the lungs, and every one of them posed risks. Remarkably, the nurses and doctors were observed to make an error in just 1% of these actions, but that still amounted to an average of two errors a day with every patient.

Compare this to the printing process. How many steps in taking an order? Prepress? Production? Binding and finishing? Invoicing? We all know the potential consequences, large and small, of a printing error. Hence why vendors have automated as many processes as possible. One of the ways automation improves profitability is by reducing the potential for human error.

It Can’t Be Just Any Type of Checklist

But it can’t be just any type of checklist. Gawande’s years of research found that it has to be a specific type of checklist:

• It must be concise.
• It must be specific.
• It must be boiled down to the key elements.

Best if it fits on an index card.

When it works, it really works. Gawande tells the story of a Boeing Model 299 military test plane. On its maiden voyage, the plane taxied down the runway—all 103 feet of its wingspan—and burst into flames, killing two of the five crew, including the pilot. Study of the crash showed that nothing mechanical had gone wrong. So the U.S. Army did something unusual. Instead of abandoning the plane or requiring pilots to get more training, they created a checklist. The plane, renamed the B2 Bomber, went on to fly 1.8 million flights without an accident.

Another example comes from the world of medicine, where one hospital implemented a checklist as a test for the pre-surgical procedure of inserting IV lines. “The results were so dramatic that they weren’t sure whether to believe them.” The 10-day line infection rate dropped from 11% to zero.

The Untold Story of Sullenberger and the Checklist

The Checklist Manifesto is filled with stats like these. But it’s the stories that stick with you, including a very familiar one: The Miracle on the Hudson, in which Captain Chelsey Sullenberger III miraculously landed US Airways Flight 1549 in the Hudson River after it ran into a flock of geese that knocked out both engines. But long after the hero fanfare ended, Sullenberger insisted that he, himself, hadn’t done anything extraordinary. It was a team effort, he said, and that team included a short emergency procedures checklist that was followed with exactness. Despite his years of military training, Sullenberger didn’t rely on his instincts. He trusted the checklist and followed procedure. So the hero that day wasn’t Sullenberger or his crew. It was the emergency checklist that the team chose to follow. So maybe that does make them heroes. They didn’t have to follow the checklist, but they did.

In the printing industry, automation solves many of the problems associated with human error, but not all of them. Even those it does, not every printer has made the investment. So maybe it’s worth considering a checklist, even if you think you don’t need one.