Second, the roles of the team members in completing the checklist are not clear. Who will read the checklist? Who will verify that the actions have been completed? Each clinician's role in the checklist should be formalised for the surgical setting, so that when tempo is high, steps are not missed. Third, compliance requires that boxes be ticked. This means that at least one team member will be occupied with completing the checklist and thereby not be available for other tasks. Boxes are more suited to a shopping list format, where items must be completed but order is unimportant, rather than an aviation-style checklist. Problems arising from combining a memory support tool with an audit device are discussed below.
Lastly, the checklist involves a Time Out: this requires that everything stops and no one interrupts. In an emergency, or under extreme time pressure, it is difficult to get everyone on the team to stop what they are doing and attend completely. The loss of team discussion under time pressure has been described by some centres implementing the Safe Surgery checklist.6 ,13 These are the times when mistakes are most likely to occur, yet paradoxically also when the Time Out portion of the checklist (the briefing to support complex work) is least likely to be performed as intended.

Checklists make it easy to delegate tasks if someone offers to help you. If you are lucky enough to have assistance, you can refer to your list and know what to ask them to do right away. You can even share your list with them and let them pick what appeals to them. The disadvantage to delegating in this way is losing control when other people choose what they want to do. If you are concerned about giving away easy tasks and getting stuck with the challenges, keep your list to yourself.
When it comes to checklist implementation, it is important to recognise that aviation checklists are integral to the normal workflow. The aircraft does not stop while the checklist is completed, and the timing of checklist completion is arranged so that it does not conflict with other essential flight activities. To that end, the checklist does not impose an additional burden or workload, but is actually perceived by aircrew as something that makes the flight easier. In contrast, the Time Out is performed before the case can begin, so essentially stands independently of the workflow. To that end, the Time Out is likely to be seen as something additional, and, unless it results in obvious time-saving downstream, will be perceived as an increase in workload. This mixture of purpose between checklist and briefing, in combination with implementation issues, may explain the range of outcomes as well as the range of enthusiastic to skeptical opinions about the mandated use of checklists in surgery.14–16
6. Saving lives: Checklists can literally save lives. When the U.S. Army Air Corps introduced the B-17 bomber during WWII an experienced aviator crashed the plane during its second demonstration flight. After this tragedy the Army required that pilots use a checklist before taking off. This is the same type of checklist we see pilots use today that helps to avoid crashes.
Google Sheets beat Microsoft to the punch and introduced a Checkbox as one of the Data Validation options. You can go to Insert > Checkbox to quickly create one, and you can customize it by going to Data > Data Validation. I've updated most of the Google Sheets versions of my checklists to use that feature. I hope Excel gets smart and introduces a similar feature some day.
 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.
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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.
You might have heard a lot about Internet Marketing especially if you want to start an online venture. But oftentimes, you lack the knowledge on how to start and may get confused about different platforms you want to use to begin your online marketing journey. But a successful marketer, Kevin Fahey has created the IM Checklist, designed to make your marketing easier and more profitable.
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