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.
It’s likely that the bulk of the audience doesn’t need any explanation of what a checklist is. In a nutshell, it is a list of questions or bullet points that characterize the status/progress of a certain activity or process. The list may contain any essential data regarding your accomplishments or plans. Due to their versatility, checklists can be leveraged in any industry regardless of the business focus. But what is the purpose and benefit of using this process organization tool?
After impressive reductions of catheter-related blood stream infections (CLABSIs) were achieved with the implementation of a checklist bundle, checklists were promoted as evidence medicine should look to this safety solution.19 However, successful reduction of CLABSIs was not due to the checklist alone: multiple interventions addressing ICU safety were implemented at the same time, and it remains unclear what role the checklist specifically played in infection reduction.2 For example, the CLABSI checklist relies on nurse oversight. The changes in nursing behaviour can improve physician performance of line insertion in ways that are unrelated to the checklist: through the ‘Hawthorne’ effect, because the physician knows they are being watched; through empowering nurses and levelling the power gradient between physician and nurse and improving the safety culture; or, through formation of best practice as a habit as physicians insert lines the same way each time.
1. Checklists verify that the necessary minimum gets done. With increasing complexity comes the temptation to skip over the stupid simple stuff and instead focus on the “sexy” parts of one’s work and life. Because the stupid simple stuff is so stupid and simple, we often fool ourselves that it’s not important in the grand scheme of things. But as we’ve seen, it’s often our most basic tasks that can spell the difference between success and disaster.
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!
IM Checklist program has been created by Kevin Fahey. Kevin Fahey is a very successful internet entrepreneur. He is also a well-known business coach. He had originally created the checklists to guide his students in the course of internet marketing and to educate them with various marketing ideas and strategies. However, recently Kevin Fahey has made up his mind to introduce these checklists for internet marketing strategies to the general public for the sake of educating them to become as successful in this field as he is.