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
In addition to the above examples, I’m trying to develop more checklists for my work and personal life. I’ve looked at some re-occurring sticking points that happen throughout the day and have been experimenting with whether a checklist can help with it. My challenge to you this week is to take a look at your own life and see if there are areas where a checklist would help out. It’s not a sexy tool, but it’s a powerful one!
Our checklists and checklist templates are licensed for personal use only. However, to avoid a bunch of emails, I will also say that I am okay with you doing almost anything with these checklists except posting the checklist (or anything you have created using the checklist template) on the internet or selling it. That includes permission to print and distribute as many paper copies of your checklist as you need. Don't remove the copyright or hyperlinks that I've included in the spreadsheet, though.
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.
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.
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
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.
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So let's talk about and answer the question, why are checklists important? Checklists help you get all your daily, weekly, monthly and yearly tasks completed and done on time. Checklists allow you to focus and stay on track to keep deadlines on all your projects. If you have employees they set the perfect example and gives them a point of reference to start and to finish.
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