Checklists organize what needs to be accomplished so nothing is forgotten. If you're a detail-oriented person, then creating a checklist in the morning gives your day a definite path and direction. However, organizing a checklist might be too time-consuming. Some people get caught up in the details of the list when they should have been focused on actual work. If you find yourself too focused on list-making, try accomplishing a few of the tasks and then return to creating the list.
Concerns have recently been fuelled by the disappointing results after implementation of the checklist in Michigan17 and large-scale mandated implementation in Ontario Canada.5 Interpretations of results are also complicated by reported differences between perceived and actual application of the checklist. In a recent US study, hospital documentation indicated 100% compliance with checklists, but observers found that on average only 4 of 13 checklist items were actually completed.18 Even strong advocates for checklists admit that full implementation of the WHO checklist is difficult and that improvements require more than the checklist, including strong institutional leadership, data collection, and monitoring, and training in teamwork.4 ,14
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Construction. Take a moment to think about the complexity of building a towering commercial skyscraper. Teams of contractors and subcontractors work on different parts of the building at different times and hundreds of specialists are needed to get the job done: engineers of all kinds, electricians, plumbers, carpenters, elevator installers, excavators, window installers, environmental experts, security experts, geologists, cement pourers, steel manufacturers – the list goes on.
It’s likely that the bulk of the audience doesn’t need any explanation of what a checklist is. In a nutshell, it is a list of questions or bullet points that characterize the status/progress of a certain activity or process. The list may contain any essential data regarding your accomplishments or plans. Due to their versatility, checklists can be leveraged in any industry regardless of the business focus. But what is the purpose and benefit of using this process organization tool?
B-17 Bombers. You’re likely familiar with the iconic B-17 “Flying Fortress” Bomber. But did you know if it weren’t for a simple checklist, it never would have gained its renown in WWII? In the 1930s, the U.S. Army Air Corps held a competition for airplane manufacturers vying to secure a contract to build the military’s next long-range bomber. Boeing produced a plane that could carry five times as many bombs as the army requested, and flew faster and further than previous bombers. On the day Boeing demonstrated its Flying Fortress, the plane lifted off the tarmac, stalled at 300 feet, and then crashed in a fiery explosion.
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As you can see, the power of checklists is not an illusory phenomenon. A famous surgeon, Atul Gawande, even wrote a book dedicated to this topic. Despite their simplicity, checklists give an extraordinary boost to organizing things in the most effective manner. Though, maybe their very simplicity underlies their power? Anyhow, you should try a few out. That is the only way to realize why you need checklists.
What these stubborn surgeons fail to see is that checklists provide them more freedom to exercise their professional judgment. They don’t have to think about remembering to do the stupid simple stuff because there’s a checklist for that. Offloading the need to remember basic tasks frees up the brain to concentrate on the important stuff. For surgeons, this means they’re left with more mental RAM to focus on handling unforeseen problems that often come up when you’re slicing someone open.
Though Gawande admits he didn't expect to see the checklist make much difference in his own surgeries, he followed it to avoid hypocrisy and was surprised by the results. The checklist saved a life in at least one case, where a mistake by Gawande led to a critical need for blood while the mistake was corrected. Thanks to the checklist, extra blood had been prepared ahead of time, despite Gawande's confidence in performing a surgery he'd done successfully many times before.
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This isn’t a problem unique to medicine, of course. It exists across almost every domain of life, be it business or science or even just getting things done around the house or on your car. More and more of our work requires coordinating different teams to get a task done. If you work for a big corporation, you’re likely collaborating with a whole host of people to complete a project. And just as in medicine, you’ve likely seen projects delayed or even fail not because of lack of know-how, but due to head-scratching ineptitude.
When ideas are translated from one industry to another, the assumptions underlying the original concepts may be lost or diluted. As checklists are increasingly imposed through a variety of professional and regulatory mandates in North America,5 Europe6 and elsewhere,7 perhaps it is time to review the fundamental principles of checklist use, including why they might work and how we can implement them better.
We’ve mentioned debugging as a component of the deployment process. However, a process of removing existing and potential errors in the code can be optimized with checklists describing the most important steps for both novice and experienced team members. With that in mind, you will turn the never-ending process of fixing errors into an organized and tailored activity for product optimization.
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