Though Gawande admits he didn't expect to see the checklist make much difference in his own surgeries, he followed it to avoid hypocrisy and was surprised by the results. The checklist saved a life in at least one case, where a mistake by Gawande led to a critical need for blood while the mistake was corrected. Thanks to the checklist, extra blood had been prepared ahead of time, despite Gawande's confidence in performing a surgery he'd done successfully many times before.
3. Checklists instill discipline. Checklists continue to play a vital role in aviation. Every time pilots and co-pilots take off and land, they verbally go through a checklist. A lot of what they review is of course the stupid simple stuff, but it’s important stupid simple stuff. When you’re responsible for the lives of 120 passengers, you have to have the discipline to make sure you do even the small things right. If there’s ever an incident in air, investigators will go back to see if the pilot and co-pilot went through the checklist. There’s no fudging with it. You either did it or you didn’t.
Checklist makes it easy to get started using checklists, with a built-in repository of checklists submitted by users that you can browse and use. You can find lists for almost anything here, from SEO to property inspections to camping. Add the lists you need to your account, or build your own checklists from scratch, and you can get started organizing your workflows without much hassle.
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
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.
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