Healthcare safety activists have looked to checklists to solve a myriad of problems, particularly with the current iteration of checklists that have been imported from aviation. Large-scale implementations with conflicting outcomes suggest that these tools are not as simple or effective as hoped. Scholars debating the efficacy of checklist implementation in healthcare have identified important reasons for varying results: that success requires complex, cultural and organisational change efforts, not just the checklist itself2; that results may be confounded by a mix of the technical and socioadaptive elements,3 and that local contexts may either augment or undermine the implementation's outcomes.4
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.
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.
Modern construction is a perfect example of how checklists can help us manage the complexity of modern life. In today’s complex and interdependent world, failure to communicate is the cause of most of our ineptitude. Different people or teams have different bits of knowledge to complete a project, but failure to communicate that information between the various groups and individuals can cause big-time breakdowns that lead to setbacks, or abject failure.
Aviation checklists are designed for modern aircraft that are complicated, not complex; it is usually possible to define a single process path that offers optimum performance for each flight condition. These process paths are flight tested, endorsed (with minor modifications) by airlines when they purchase a new aircraft type, and published in procedural manuals and checklists. There are two categories of checklist used in the cockpit: normal and non-normal (or emergency) procedures.
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.
Every construction job begins with a massive checklist of tasks that have to get done and each task has an accompanying deadline. While that to-do list plays an important role in ensuring stuff gets done, an equally valuable checklist is also used. Called a “submittal schedule,” it centers on communication. The submittal schedule details which project managers need to talk to which project managers during a specific phase and about a specific process. The submittal schedule’s purpose is to get teams that are working on different yet co-dependent projects to regularly connect so they can discuss any potential sticking points. For example, there might be an item on the checklist for carpenters and plumbers to meet up at a specific time to discuss their progress on their respective tasks. Maybe a problem has come up with the pipes that affects when the carpenters can get started on their work, but perhaps there’s something the carpenters can do to help the plumbers. The trick is to keep each other in the loop so each respective team can take care of these “known unknowns” as quickly and as effectively as they can. Once the teams talk, they check the communication task as complete, and move on with their work.
Mental checklists to improve thinking. Berkshire Hathaway vice-chairman Charlie Munger uses a mental checklist of biases and cognitive flaws that he reviews before making any big decision to ensure he’s thinking clearly about it. He’ll go down the list and ask himself if any of these biases are clouding his thinking and what he can do to mitigate it. Ever since I’ve learned about that, I’ve tried using something similar in my life. Crafting this list is still a work in progress for me, but here’s what I have so far:
Checkbox Form Object - Use the checkbox form field only if you are wanting to add interactivity to your checklist. The checkbox form field, found in the Forms toolbar, can link to a cell in the spreadsheet without requiring any Visual Basic programming. The linked cell will be a boolean value TRUE or FALSE. Like the drawing objects, working with a large number of checkboxes can get messy.
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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