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Improving Outcomes with Zero Increase in Skill

Yuri Arcurs/Alamy Stock Photo Construction worker reviews checklist on jobsite in high-visibility safety vest
Sound too good to be true? The Family Business Institute’s Wayne Rivers draws insights from famed author Atul Gawande on actions you can take at your construction company now to improve outcomes on jobsites and in business.

Is it possible for a contracting company to improve without anyone on the team becoming more skilled? The idea of enhancing outcomes without also having to improve skills came from a book called "The Checklist Manifesto" by Atul Gawande, who set out to improve healthcare worldwide through the simple—yet thorough and consistent—use of checklists. Did it work? I'll let you read the book to find out the details, but I wouldn't be writing about it if his efforts were a flop.

In the world of business, standardized checklists really gained traction thanks to Boeing in 1935. The company was rolling out a new aircraft for the U.S. Army, and they had big plans. But then the plane—one of the more complex of its time—took off, flew a bit, nosed in, crashed and burned. As a result, the Army took their business elsewhere, and the disaster almost broke Boeing.

But Boeing test pilots thought there must be a way to simplify operating this machine, which became the B-17 bomber—possibly the most successful bomber in military history. As part of the simplification process, the test pilots created and perfected the use of their checklists. Today, Boeing remains the premier source for checklists for any industry, whether medicine, aviation or others.  

Where contractors are concerned, what fascinated me about this book was when Gawande sought to learn how checklists work in real-time. While writing "The Checklist Manifesto," he served as a physician in an urban hospital in Boston. Leaving work one day, Gawande turned the corner and saw a vast construction project: 350,000 square feet, an entire city block, 11 stories above ground with three additional levels underground, 200 to 500 workers on the jobsite at any given time, almost 4,000 tons of steel, 13,000 yards of concrete, 64,000 feet of piping, 47 miles of conduit and 95 miles of wiring.

Gawande looked at this immense undertaking and thought, "How in the world does everybody know what they're doing?" So he located the jobsite supervisor and posed two questions:

  1. How could those working on the jobsite be sure they had the proper knowledge at hand?

  2. How could they be sure they were applying the knowledge correctly?

Throughout most of human history, large structures have been built by master builders—the great cathedrals of Europe, for example. The master builder served as the one person with immense knowledge in his head, and he was capable of running a complete, complex job. By the middle of the 20th century, however, master builders were no longer. Buildings were much too complex for any one person to have all the requisite knowledge.

So, what checklists did Gawande observe on this jobsite that helped compensate for the lack of master builders in today's world? In the job trailer, a large, printed schedule listed the various trades on the job in different colors and, of course, the critical path. On the other side of the trailer was a submittal schedule—it was this schedule that got his attention.

Believe it or not, what regularly happens in construction did not occur consistently in medicine. Gawande said the major innovation in the construction industry has been the continuous improvement of communication and tracking—the purpose of the submittal log. Applying improved communications in medicine via a process like a jobsite submittal log is one of the actions Gawande used to revolutionize medicine around the world.

He also wrote that the operating room is like a jobsite, but the doctors and staff he witnessed in Boston hospitals rarely even knew each other's names. They had their specialties and skills but didn't know each other as human beings. But Gawande wrote that when doctors and operating teams learned each other's names at the outset of a procedure, the quality of their communications and teamwork jumped, and the turnover rate for operating room nurses dropped by about two-thirds.

For Gawande, the idea originated thanks to a jobsite visit, but the construction trades today can take a page out of his book, too. It's time to revisit the checklists in use and determine how to take them further. Basic communication skills such as knowing colleagues' names, maintaining good eye contact, showing respect and shaking hands go a long way in improving jobsite culture.

In talking to my consultants—former contractors with as many as 300 employees in their companies—I learned that as CEOs, these leaders made an effort to learn every employee's name. Of course, they weren't always perfect, but the more names they knew and the more personal they could be with employees on jobsites, the better things worked.

In closing, here are two practices that you can take back to your construction company today:

1. Put names on hard hats at the jobsite.

My former contractors recommend putting the names on the front and back of hard hats and safety vests. That way, if somebody's bent over attending to a task and you can't see her face, you still know who she is. That makes a big communication difference.

2. Connect strong communication skills with effective jobsite safety.

Kevin Albanese, the former CEO of J.J. Albanese, said, "Safety is about courage and grace. Courage allows one to call out unsafe behavior. And grace allows others to receive that call out without judgment or anger."

John Woodcock, the former CEO of Balfour Beaty (East), offered a specific example. "It's a lot easier to walk past a guy doing something stupid and unsafe when you don't know his name," said Woodcock, "versus saying, 'Hey, Wayne, put your safety glasses on. I want you to be able to see your kids when you get home tonight.'" That is so much more personal and relevant.


Wayne Rivers is the co-founder and president of the Family Business Institute. He has authored four books about families in business and has appeared on multiple nationally televised programs.

He serves as an expert panelist for The Wall Street Journal and has been quoted by Forbes, Fortune, BusinessWeek, Entrepreneur, CFO, Family Business, The New York Times, The Washington Post and many other trade, local, regional and national publications. 

For over 15 years, Rivers has produced a blog and written hundreds of articles for various magazines and trade publications. He has held workshops and lectures for trade associations, prominent companies and well-respected universities. Along with being an Informa Markets Infrastructure & Construction contributor, he has also been honored as a Fellow of the Family Firm Institute.

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