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.
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Donald, I like the article man. One way that I’ve utilized checklists in my life is by utilizing Nozbe. It’s both an app for browser on computer as well as iPhone and Android compatible. Essentially it is an electronic checklist for helping with daily tasks as well as for projects involving multiple people. Check it out, it’s saved me a bunch of time!
Introduction of a new tool without full consideration of its purpose, benefits and limitations may actually increase risk to patients, providers and the system as a whole. Overimplementation of checklists may erode respect for long-standing healthcare cognitive aids that are effective, have been iteratively improved, and are well suited to specific purposes. Overreliance on checklists as a safety net can lead to omission of other safety practices that may better support safety through reliability and resilience. Checklists are excellent ‘aides memoire’ and directives to correct procedures, but they are not a panacea.
In healthcare, we need to get back to the basics with checklists and reserve the tool for processes that are simple, easy to follow, standardised and (perhaps) time critical. Expanding the term to cover briefings and other tools more suited to complex and variable processes is confusing, and may require communication and advanced team skills to implement and sustain. It is appealing to embrace a single tool to improve safety, and checklists have been found to be effective in some settings.16 However, the complexity of quality and safety improvement in healthcare guarantees that solutions will never be singular, straightforward or simple to sustain.
An example from my own work is the process of creating a new blog post. Although I usually remember the steps of creating the content because it's part of my writing process—writing an outline, doing the research, drafting, and editing—there are plenty of other steps that I can easily forget. Adding images, working through multiple headline options to find the best one, and making sure image credits are correct are all standard tasks that are easy to overlook.
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.
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