Atul Gawande a Harvard Medical School professor, surgeon at Brigham and Women’s Hospital, and New Yorker staff writer, investigated excellent performance across disciplines in search of ways to improve global medical care.
His findings suggest simple behavior changes, such as following a structured checklist, can avert poor performance and related negative outcomes.

In a recent talk at Harvard, he said, “people that were focused on achieving something more than competence…weren’t smarter than anybody else, they weren’t geniuses…Instead they seemed to …come to grips with their inherent fallibility—fallibility in the systems that they work in, and with what it took to overcome that fallibility.”

Gawande discusses three elements of better performance in Better: A Surgeon’s Notes on Performance

• Diligence – Attending to details, to avoid errors and overcome obstacles.
  Gawande offers a rationale for checklists and principles for their optimal structuring in his The Checklist Manifesto: How to Get Things Right
• Doing Right –Ensuring that skill and will and incentives are aligned to drive excellent performance
• Ingenuity – Deliberate, mindful monitoring of potential and actual failures, continuously seeking innovative ways to improve performance and solutions

All of these elements can be improved with attentive coaching observation and feedback

Gawande distinguishes making mistakes because we don’t:

• Know enough (ignorance)
• Make proper use of what we do already know (ineptitude)

He notes that because we have extensive access to information, ignorance occurs less frequently than ineptitude.
In addition, he argues that both can be improved by systematic analysis through tools such as checklists to detect, avert, and remedy failures.

The application of systematic checklist-based analysis was linked to Internal Rate of Return (IRR) in Geoffrey Smart’s study of investments by Venture Capital (VC) firms,  The Art and Science of Human Capital Valuation

He described the VC firm’s approach to assessing the “human capital” that would lead new ventures in seven categories:

• The Art Critic – The most frequently-used approach in which the VC assesses leadership talent at a glance, intuitively, based on extensive experience.
• The Sponge – Conducts extensive due diligence, researching and assimilating information, then decides based on intuition
• The Prosecutor – Interrogates the candidate, tests with challenging questions and hypothetical situations
• The Suitor – Woos the candidate to accept the leadership role instead of analyzing capabilities and fit
• The Terminator – Eliminates the evaluation because the venture is funded for the best ideas, not the originators, who are replaced
• The Infiltrator – Becomes a “participant-observer” in an immersive, time-consuming experientially-based assessment
• The Airline Captain – Uses a formal checklist to diligently study past mistakes, which rendered the top average Internal Rate of Return (IRR), 80%, in contrast to all others, which were 35% or less for all of the other types.
  This approach had 10% likelihood of later having to fire senior management, whereas the others had at least 50% likelihood.

Smart said that Venture Capitalists said that two of their most important mistakes are:

• Rushing to close a deal and investing insufficient time in analysis of the talent and the deal
• Being influence by “halo effect”

Both Gawande and Smart present evidence for the value of systematic reminders to execute all elements required for expert performance, to prevent failure and alert to potential failure points.

-*How do you improve performance?
-*What value do you find in expert coaching?

See related posts on Performance Improvement:

Geoff Colvin’s Talent is Overrated and

Anders Ericcson’s Making of an Expert in The How and Who of Innovation 

Task structuring tools:

• David Allen’s classic, Getting Things Done: The Art of Stress-Free Productivity 
• Six Apps to Increase Your Productivity

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Related Post:
Developing a SMARTER Mindset for Resilience, Emotional Intelligence – Part 2