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
Our checklists and checklist templates are licensed for personal use only. However, to avoid a bunch of emails, I will also say that I am okay with you doing almost anything with these checklists except posting the checklist (or anything you have created using the checklist template) on the internet or selling it. That includes permission to print and distribute as many paper copies of your checklist as you need. Don't remove the copyright or hyperlinks that I've included in the spreadsheet, though.
B-17 Bombers. You’re likely familiar with the iconic B-17 “Flying Fortress” Bomber. But did you know if it weren’t for a simple checklist, it never would have gained its renown in WWII? In the 1930s, the U.S. Army Air Corps held a competition for airplane manufacturers vying to secure a contract to build the military’s next long-range bomber. Boeing produced a plane that could carry five times as many bombs as the army requested, and flew faster and further than previous bombers. On the day Boeing demonstrated its Flying Fortress, the plane lifted off the tarmac, stalled at 300 feet, and then crashed in a fiery explosion.
I started to brain storm other areas that checklists could be beneficial. In the construction industry, Gawande explains that checklists are used so that key points are discussed between those in different aspects of the building process. For research, are there things that you always need to talk about with other experimenters or your supervisor when it comes to a study? Maybe a checklist can help there too. Also, when editing manuscripts or proofs, you could have a structured set of points to assess such as, “check to make sure data in tables/figures is correct” or “make sure reference list is up to date”. These all seem so basic, but if taking the time to go over them and know that once you’ve handed in the manuscript that these things have definitely been checked, it could prevent you from having to submit an erratum due to something like an improper figure.
Concerns have recently been fuelled by the disappointing results after implementation of the checklist in Michigan17 and large-scale mandated implementation in Ontario Canada.5 Interpretations of results are also complicated by reported differences between perceived and actual application of the checklist. In a recent US study, hospital documentation indicated 100% compliance with checklists, but observers found that on average only 4 of 13 checklist items were actually completed.18 Even strong advocates for checklists admit that full implementation of the WHO checklist is difficult and that improvements require more than the checklist, including strong institutional leadership, data collection, and monitoring, and training in teamwork.4 ,14
Your job desperately needs to be structured with a checklist, but if your first checklist doesn't survive, don't despair. Just like best laid plans, checklists—at least first drafts—will often go awry in the real world. Even aviation and surgical checklists are constantly being modified to be easier to use, clearer, and more useful in real-world situations.
Aviation checklists are designed for modern aircraft that are complicated, not complex; it is usually possible to define a single process path that offers optimum performance for each flight condition. These process paths are flight tested, endorsed (with minor modifications) by airlines when they purchase a new aircraft type, and published in procedural manuals and checklists. There are two categories of checklist used in the cockpit: normal and non-normal (or emergency) procedures.
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.
To-do lists are definitely awesome for getting things done, but there’s another kind of checklist as well – what I call the “routine checklist.” With a routine checklist, you write down all the steps/tasks needed to complete a certain project or process. The list of tasks never changes. You use the same checklist over and over again, every time you do that particular process/project.
That’s it for theory. In practice, you can take advantage of checklists in project management (PM) tools. This sort of software is leveraged to keep the workflow organized and provide the team with the ability to see other stuff circulating in the working environment. However, the market abounds with versatile PM solutions, which is not always a benefit to an inexperienced user. Therefore, you have two paths to choose from - either take a look at a comparison post like this one, or consider the following must-have features in your search:
Pre-flight checklists are a good example. A regular pilot is aware of the importance of checking a list of tasks to prepare an airplane for takeoff. These include checking the operation of the altimeter, fuel gauges, flight controls, magnetos, engine idle, and other system parameters. Besides, preflight checklists are usually segmented in a way that the accomplishment of final items (status of doors/windows, mixture, lights, camera, and action) is completed after the set of initial tasks. The same thing is with the before-landing checklist. According to the FAA's practical test standards, these sets of tasks must be in a written form for pilots’ use.
This isn’t a problem unique to medicine, of course. It exists across almost every domain of life, be it business or science or even just getting things done around the house or on your car. More and more of our work requires coordinating different teams to get a task done. If you work for a big corporation, you’re likely collaborating with a whole host of people to complete a project. And just as in medicine, you’ve likely seen projects delayed or even fail not because of lack of know-how, but due to head-scratching ineptitude.
So let's talk about and answer the question, why are checklists important? Checklists help you get all your daily, weekly, monthly and yearly tasks completed and done on time. Checklists allow you to focus and stay on track to keep deadlines on all your projects. If you have employees they set the perfect example and gives them a point of reference to start and to finish.
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.
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