Let’s take a simple example. When you get in a car, you can’t just drive because there is a set of specific operations to be done. These include fastening your seat belt, removing the handbrake, putting a transmission gear lever into neutral position, starting the engine, checking the indicators, etc. After you have checked and accomplished all these routine tasks, you can press the accelerator pedal and drive. Every driver has this checklist in his/her memory because of its regular use. If your set of tasks is bigger or varies frequently, it’s challenging to keep it memorized all the time.
Reinforcement and sanctions surrounding tasks may distract performance from the intent of the checklist. In healthcare, there is often a need to adapt the procedure to the patient or the context. Recent findings show that the WHO checklist, for example, is often implemented differently within single organisations, depending on context. Clinicians may be discouraged from acting in a manner that is best for the patient if they perceive that they may be censured for not following the procedure ‘to the letter’.

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