In the middle of the night, somewhere off the Horn of Africa, a team of Navy SEALs leapt out of a helicopter, headed straight for the Indian Ocean. The mission: rescue two international aid workers being held captive by Somali pirates.

The mission was time-sensitive, especially since one of the captives was incredibly sick, though they didn't know what from. Because they didn't know how ill she was, they had to prepare for all kinds of outcomes. What if she was too delicate to move? What if she wasn't on board? What if she had already died?

Most of all, what if someone made a mistake under pressure?

We venerate the U.S. Navy SEALs for their ability to execute even the most complicated of missions and strategy. The elite special ops team is widely known for its strength, agility, and tactical brilliance. But no matter how superhuman they seem, the way SEALs navigate these tricky situations is actually very human and understandable.

While they can't control the other variables--all those unknowns when entering combat--SEALs can control one thing: human error. But in order to do so, they have a system in place to catch human error in all SEAL combat missions.

This is especially important for ensuring that the Navy incentivizes excellence, not competence. And it's how they rescued the aid workers from Somali pirates despite all those unknowns.

As it turns out, this strategy system is their most important weapon of all: the checklist.

How checklists save lives.

And it's not just the Navy. Surgeon Atul Gawande was witnessing a similar human error problem in his hospital: doctors and nurses weren't washing their hands.

OK, so they washed their hands most of the time. But there were a few instances when they forgot, or decided they didn't have the time, or didn't do a thorough job. And in an operating room, that can make all the difference. No matter how much high-tech equipment and software the hospital used, they were still failing to avoid really basic mistakes that could result in infection or even death.

But checklists have a surprising ability to prevent these mistakes and human error. Gawande documents the implementation of checklists in his bookThe Checklist Manifesto: How to Get Things Right. At first, people were resistant, in part because it seemed just too easy, or like an oversimplification:

"It is far from obvious that something as simple as a checklist could be of substantial help. We may admit that errors and oversights occur--even devastating ones. But we believe our jobs are too complicated to reduce to a checklist."

But they aren't. Checklists reduce human error in hospitals, airports, and investment banks--all very complicated systems.

Checklists make their mark

Doctors, nurses, and administrators now agree with Gawande--checklists are an incredibly efficient way to minimize human error. A lot of them use templates for their checklists from other hospitals or sources, but many tailor them to their own institutions.

Tech entrepreneur Vinay Patankar was so impressed with the efficiency of Gawande's findings, he molded his startup, Process Street, into the Checklist Manifesto software. It helps people in all different professions develop checklists that they can then run multiple times as processes, ensuring that everyone sticks to a system.

The goal is to take Gawande's book and make it really actionable.

To do so, Process Street helps people create recurring checklists for their business, team, family or even themselves. As The Checklist Manifesto shows, whether you're rescuing captives, running a hospital, or onboarding engineers at your startup, we can all benefit from a checklist to minimize human error.

A Navy SEAL's 10-Step Combat Checklist

Just like operating surgeons have to be prepared to handle all kinds of injuries, Navy SEALs have to be prepared to attack all kinds of scenarios, in all kinds of terrains. Even in the middle of the Indian Ocean, conditions unknown.

How do you even begin to approach that?

As Gawande writes in Checklist Manifesto, these kinds of unstable conditions--especially when there's sensory overload or a lot on people's plates--can be easily solved by implementing a checklist. It should be no surprise to him then, that Navy SEALs turn to checklists in the most dangerous of combat missions.

Former Navy SEAL leaders Jocko Willink and Leif Babin lay out their pre-combat checklist in their best selling book Extreme Ownership: How U.S. Navy SEALS Lead and Win. Like the reminder to wash your hands in an emergency room, each step prompts you to think about something you might have forgotten.

It's a quick and easy way for SEALs to ask questions that might have been otherwise overlooked.

1. Analyze the mission

2. Identify personal assets, resources, and time available

3. Decentralize the planning process

4. Determine a specific course of action

5. Plan for likely contingencies through each phase of the operation

6. Mitigate risks that can be controlled as much as possible

7. Delegate portions of the plan and brief to key junior leaders

8. Continually check and question the plan against emerging information

9. Brief the plan to all participants

10. Conduct post-operational debrief

Babin argues that this checklist is incredibly adaptable, for all kinds of combat missions but also for other goals. In fact, it's what he uses with top executives in his leadership consulting firm that he and Willink have worked for since returning from duty.

How Checklists Save Companies

Sure, rescuing captives from Somali pirates isn't exactly the same as closing your next deal.

But this kind of military-precision checklist thinking is actually pretty natural. When researching Checklist Manifesto, Gawande found all kinds of examples in the business world where people employ checklists to do the heavy lifting.

In fact, one of the investors Gawande interviewed believed that implementing checklists would have prevented the Enron debacle. The anonymous investor argues that when making investments, even the most seasoned. "This is basic basic basic," he said. "People could have figured out it was a disaster entirely from the financial statements."

But they got so excited, they let that "basic basic basic" step slide--something that, like washing your hands, seems obvious, but if you forget to do, can kill you.

Checklists kill your "cocaine brain"

As it turns out, it's really easy to let those basic steps slide, especially if you're overexcited about something. One of the investors Gawande interviewed dubbed this "cocaine brain"--and no, it doesn't actually involve doing any drugs.

In his words, dealing with high-stakes deals gets people hyped up on adrenaline. "You go into greed mode,"--the same primitive dopamine reward circuits that control your desire for more, more, more of whatever it is that's making you happy. It's scientifically proven, in fact. Money and cocaine light up the same centers of your brain--turns out that investor wasn't so far off.

This, the investor argues, is what happened with Enron. Everyone was so excited about the prospect of making buckets of money that they failed to check to make sure the numbers were straight. That's because when you're overexcited or overwhelmed--whether it's in a conference room or a combat mission--it's hard to see clearly.

It's hard to make the right decisions. It's hard to remember the little steps of a process.

Checklists can help mitigate those effects. It's a strategy Warren Buffet uses before making any huge decisions--you can check out his investment checklist on the Process Street blog. He relies on it to prevents getting seduced by tempting deals, or starting to cut corners.

Because whether you're a veteran Navy SEAL or a surgeon with 30 years of experience, there's always room for human error. And while you can't always control the other variables in your life, that's something you can definitely control to avoid disaster.

Published on: Jan 14, 2016
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