Checklist compliance is increasingly monitored in healthcare.5 Often, institutions conduct internal audits of checklist compliance in anticipation of regulatory inspections. Using ‘compliance with checklist’ audits as a measure of safety or quality, however, is problematic, as high checklist compliance is no guarantee that the task is well-executed,18 or that patient safety culture is high.20 In addition, some of the benefits that have been found to be associated with checklist usage, such as enhanced team building and nurses speaking up, are likely to be negated if compliance audits lead to sanctions.
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 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.

‘Non-boldface’ checklists form part of the normal framework of ‘job aids’, which might also include mnemonics and other rote learning tools, task visibility, context-sensitive help functions, decision support and instruction manuals. Mnemonics (such as ‘ABC’ for ‘Airway, Breathing, Circulation’ in resuscitation), for example, are sometimes used to retrieve procedural items where participants are likely to be subject to high cognitive load; however, mnemonics are more critical in situations where there is no later access to a physical checklist for confirmation.

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