In healthcare, this technique is used in resuscitation procedures. Healthcare workers are trained and recertified, in low and high fidelity simulators, to commence procedures such as Advanced Cardiac Life Support without referring to a checklist. When the patient is not readily revived or responding as expected, the team will refer to their checklists or algorithms to make sure the steps have been executed properly, and that they have not forgotten anything. For this reason, healthcare workers often keep a cognitive aid (a ‘checklist’ of sorts) posted on emergency carts, tucked into pockets or loaded onto mobile devices. ‘Boldface’ checklists can be effective whenever there is a critical sequence to be completed but time is short, or the situation does not enable a physical list to be immediately accessed and used.
2. Focus only on the “stupid” essential stuff that’s frequently overlooked or skipped. You don’t need a checklist that lists every single step on how to complete a task. That renders a checklist useless. Instead, just focus on putting down the “stupid” but essential stuff that you frequently miss. Your checklist should have no more than 9 items on it. The shorter the better.
Being a professional implies constant education. Even top-notch experts have to nurture their domain knowledge to maintain their background. At the same time, can we claim that a high level of expertise guarantees lack of errors? The question is especially acute in software development where each error results in an increase in time and cost. Therefore, regardless of the chosen methodology - Agile, Lean, Rapid, Feature Driven, or others - striving to organize software development processes should be a top priority for project managers and other leaders. In that context, similar to the unsung hero, whose is not noticed by the public but crucial for the history, checklists come to center stage.
First, the structure varies from the design of aviation checklists, in that it combines procedures with formal team discussion; these processes are not mixed in the cockpit but remain distinct because they serve different purposes. The WHO checklist consists of a checklist (Sign In), a briefing (Time Out) and a checklist with a short briefing at the end (Sign Out). Checklists are suited to verification of procedures for linear processes; whereas briefings are suited to support execution of complex processes that may require appropriate adaptation and variation. Briefings are important because surgical outcomes are complex and emergent, and optimal performance of surgical procedures may require flexibility to accommodate the unexpected, however briefings should be instituted separately from the checklist. If briefings are too closely coupled to checklist completion, teams may miss the cognitive shift required to move from linear or procedural work to complex or adaptive work.
Travel checklist. I also have a checklist that I use before I leave on an extended trip. It’s kind of a combo of a to-do list and a routine list. It’s stuff I need to get done, but I use the same list every time. And it’s a DO-CONFIRM checklist: I do my prep from memory but then check the list before I leave to verify that I took care of everything essential. These are the things that I’ve had the most trouble remembering in the past, so they’re on my list:
Clinicians have long relied on an analogous form of decision support such as lists or algorithms for differential diagnosis. When a patient presentation is unusual (non-normal but not emergent), differential diagnosis lists (whether in old-fashioned textbooks or new-fashioned handhelds) support clinical performance by serving as a cognitive aid. The practice of reviewing a complete differential helps overcome anchoring and confirmation biases and can be a forcing function to ensure that every critical, and treatable aetiology is ‘ruled out’. Unlike non-normal checklists that are built into cockpit workflow, differential lists are often not well-integrated into clinical workflow and this may undermine their use.12
Sophisticated areas of focus like medicine, software development, numerous sorts of manufacturing, and others abound with complicated pipeline steps. Teams and departments interact to either complement or proceed with the production process in stages that require proper coordination. At first glance, the checklist's role is not remarkable. However, a deeper analysis shows that this tool stores trivial and easy-to-forget tasks outside your brimming-with-tons-of-data brain.
Boldface items are for immediate action, when the aircraft may be lost if the items are not completed quickly and in the correct order. Correct and rapid execution of these steps is so critical and essential, that pilots must complete them from memory. Through training and repetition, the paired cognitive and motor activities required to perform the checklist are stored by the pilot as procedural memory (or ‘motor skills’).10 Despite notable exceptions (such as ‘choking’ under pressure), procedural memory retrieval is less affected by stress than declarative or episodic memory retrieval.11 For this reason, aircrew practice time critical emergency procedures regularly to aid in forming the correct ‘habits’. However, as soon as time permits, the checklist is used to confirm that the steps were executed as required.8
You can leverage checklists in various areas of life. Are you going to get married? There is a wedding checklist. Is a business trip coming up? A travel checklist will help. Other options include inspection, security, packing, invitation, moving, shopping, etc. Most things are like that, your next or current project will definitely benefit from using this sort of process management tool.
Pre-flight checklists are a good example. A regular pilot is aware of the importance of checking a list of tasks to prepare an airplane for takeoff. These include checking the operation of the altimeter, fuel gauges, flight controls, magnetos, engine idle, and other system parameters. Besides, preflight checklists are usually segmented in a way that the accomplishment of final items (status of doors/windows, mixture, lights, camera, and action) is completed after the set of initial tasks. The same thing is with the before-landing checklist. According to the FAA's practical test standards, these sets of tasks must be in a written form for pilots’ use.
The crux of this problem is while the world around us is becoming more and more complex, we’re still stuck with a brain that hasn’t changed much in 100,000 years. Sure, we’ve figured out ways to off-load memory storage to books and computers so we can know more; we just haven’t figured out a good way to overcome our evolved biases, cognitive flaws, and intrinsic forgetfulness. And so, despite owning a brain brimming with ever more knowledge, we continue to make stupid mistakes.
Checklists let you put tasks in order so you can accomplish the most important things first. Once you have put things in writing though, you might feel pressured to complete the tasks in order. This can slow you down. Some people work better when they can jump from task to task and let their emotions guide them. A checklist might impede their emotion. However, if you truly need to finish certain tasks before moving to new ones, a checklist will keep you focused and on-track.
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.
6. Saving lives: Checklists can literally save lives. When the U.S. Army Air Corps introduced the B-17 bomber during WWII an experienced aviator crashed the plane during its second demonstration flight. After this tragedy the Army required that pilots use a checklist before taking off. This is the same type of checklist we see pilots use today that helps to avoid crashes.
Agile software development leverages a technique called the user story to get enough information for implementing software features from an end-user perspective. Shaping acceptance criteria is an integral part of this process that can be improved with a checklist's help. You can create a special format containing categories, point assessments, labels, names, etc. For example, a Definition of Ready can be transformed in Definition of Done category after changing the story specification. On the picture below, you can see an implementation plan, which is, in fact, a ToDo list containing guidance on how to handle the user story written in the description section.
Thanks for this great post. I was very skeptical about the idea for being an automaton by following a checklist or a schedule of all day, day or mounth. And then my life was a real impasse. I ignore what great things I did it and so for. Afte that I decided to get a plan of my live. I decided to savor my live by listing waht I did and what I want to do.
We may not like to admit it, but many of us can describe a time when we’ve made a mistake during the progress of a study. These mistakes can range from mixing up wires or forgetting to turn on an amplifier to forgetting to collect an essential piece of information that either requires additional processing time or prevents you from analyzing a certain variable altogether. Increased computing power and technological advancements have also made it easier than ever to collect data. We can collect five measures simultaneously in one study and hundreds of trials in no time at all. But where does this leave us now? We must set up all of this equipment and make sure it works together, monitor it as well as our participant or specimen, and somehow sift through all the data post hoc. Even with a detailed lab notebook, its no wonder problems can arise. Even just writing this makes me feel…exposed, as if I’m the only one who struggles with this. It seems so simple, how can I not get it perfect every time? I always thought that I just had to work harder to not miss small steps, but maybe I just needed a different, yet structured, perspective on how to manage such a high volume of complex information.
NO, I don’t. I call them “to do” lists. LOL! They’re very helpful, they keep me sane and keep stress away. For many years now, I keep a daily list prepped the night before; and a weekly list that’s prepped every Sunday. Keeps things smooth-sailing all the time. So at the end of the day, if all items are crashed-out (as in “done”!), I feel so good about myself. :)