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.
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.
Reinforcement and sanctions surrounding tasks may distract performance from the intent of the checklist. In healthcare, there is often a need to adapt the procedure to the patient or the context. Recent findings show that the WHO checklist, for example, is often implemented differently within single organisations, depending on context. Clinicians may be discouraged from acting in a manner that is best for the patient if they perceive that they may be censured for not following the procedure ‘to the letter’.
Gawande in 2009 introduced a hospital surgery checklist for doctors and nurses as part of a program developed with the World Health Organization. The checklist was designed to ensure basic checks were always completed before surgery. Run through the list, and you'll make sure everyone in on the same page about the surgery to be conducted, aware of who else was on the surgical team, and knows their role in the procedure.
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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.
2. Checklists free up mental RAM. People often bristle at using a checklist because it feels constraining. They want to be flexible and creative, and the checklist seems to take away their autonomy. For this reason, implementing checklists among surgeons has proven difficult, even though studies show checklists dramatically reduce the number of preventable, life-threatening errors. Surgeons feel that their work requires an intuitive judgment that’s born from years of training and experience and can’t be reduced to a simple checklist.
If you're a fan of writing in Markdown and using keyboard shortcuts, Checkvist is made for you. It's a web app that lets you create checklists that you can print or share with others, and even set up daily reports. If you need collaborative checklist management, or you want a checklist that integrates with your favorite services like Evernote, try Checkvist.
That brings us to the last point about checklists - they DO NOT replace knowledge. An investor interviewed for the book said it best when describing that the checklist is “not a fail safe thing…you still need expertise and insight into the process to be able to ultimately perform each step correctly”. These checklists wouldn’t help me if I didn’t know what I was doing to begin with. Rather than being a “Step by Step to Collecting Data”, people can perform a task however they want and the checklist makes sure that in the end that task was performed correctly.
And the tragic thing is it’s often the “stupid” simple stuff that gets people killed or keeps them in the hospital for longer than they needed to be. I have an acquaintance who ended up in the hospital for two weeks because he got the wrong heart medicine. The problem was ultimately one of miscommunication — a basic thing you think would be a given, seeing as how hospitals can transplant human faces and whatnot.
Your job desperately needs to be structured with a checklist, but if your first checklist doesn't survive, don't despair. Just like best laid plans, checklists—at least first drafts—will often go awry in the real world. Even aviation and surgical checklists are constantly being modified to be easier to use, clearer, and more useful in real-world situations.
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:
This week I made my first checklist for setting up one of my thesis data collections. I listed specific essential tasks and supplemented them with common errors I had either made or had encountered in the past. After making this specific checklist, I decided to see if I could make a general list that could be applied to all studies. Surprisingly, it was easier to do than I thought, although I’m sure it isn’t perfect. I was able to group many of my tasks together under one common point. What is not easy so far is trusting and not deviating from the checklist. It’s been easy to throw the checklist to the side when I get frustrated. In more stressful situations or even when things are running smoothly, I may forget that I’ve come up with a structured way to make sure I’m managing my data collection in the best way possible.
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