Gawande explains that we are up against two things when performing either a high volume of simple tasks or a variety of complex tasks. The first is that human memory and attention can fail you, especially when a bigger issue arises. This could be your participant being late and your data collection program freezing, making it easy to forget that you haven’t performed a baseline test. The second thing is that we skip tasks even when we remember them because nine times out of ten that step doesn’t matter. Never check to make sure your wires are plugged in correctly? If you’re the only one working in the lab maybe it doesn’t matter, but if multiple lab mates are cycling through the lab, this could be a bigger issue.
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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