Atul Gawande, the surgeon and author, discovered something surprising in his research on medical errors: the majority of surgical complications weren't caused by a lack of knowledge. They were caused by a failure to consistently apply knowledge that surgeons already had. The solution wasn't more training. It was a checklist. The WHO Surgical Safety Checklist reduced major surgical complications by 36% and deaths by 47% in hospitals that adopted it (Haynes et al., 2009, New England Journal of Medicine). Not because surgeons learned anything new — but because a simple tool ensured they consistently did what they already knew to do. The same principle applies to decisions in business, productivity, and daily life. Most bad decisions aren't caused by ignorance. They're caused by inconsistency — forgetting to consider factors you already know matter. A decision checklist fixes this. Research in behavioral economics identifies several systematic failures in human decision-making: Recency bias: Overweighting information you encountered most recently. (Tversky & Kahneman, 1974) Anchoring: Letting the first piece of information you receive dominate your evaluation. Omission under stress: Under time pressure, people skip steps they would normally complete. This is the exact failure mode that surgical checklists address. Decision fatigue: After making many decisions, the quality of subsequent decisions degrades (Baumeister et al., 2008). A checklist counteracts all four. It ensures you consider the same factors every time, regardless of what's top of mind, what you saw first, how stressed you are, or how many decisions you've already made today. Here's a practical framework for building decision checklists that improve both speed and quality. Not every decision needs a checklist. Focus on decisions that are: Recurring: You make them regularly (hiring, product prioritization, technology selection, resource allocation) Consequential: They affect outcomes for weeks or months Mult