In healthcare, we need to get back to the basics with checklists and reserve the tool for processes that are simple, easy to follow, standardised and (perhaps) time critical. Expanding the term to cover briefings and other tools more suited to complex and variable processes is confusing, and may require communication and advanced team skills to implement and sustain. It is appealing to embrace a single tool to improve safety, and checklists have been found to be effective in some settings.16 However, the complexity of quality and safety improvement in healthcare guarantees that solutions will never be singular, straightforward or simple to sustain.
Being a professional implies constant education. Even top-notch experts have to nurture their domain knowledge to maintain their background. At the same time, can we claim that a high level of expertise guarantees lack of errors? The question is especially acute in software development where each error results in an increase in time and cost. Therefore, regardless of the chosen methodology - Agile, Lean, Rapid, Feature Driven, or others - striving to organize software development processes should be a top priority for project managers and other leaders. In that context, similar to the unsung hero, whose is not noticed by the public but crucial for the history, checklists come to center stage.

In healthcare, this type of operational check of equipment has evolved along with advanced medical technology. Since 1993, Anaesthesia Apparatus Checkout Recommendations have targeted the proper configuration of anaesthesia gas delivery systems.9 These recommendations are intended to be peer-reviewed, modified and updated for each specific type of manufactured anaesthesia equipment. Thus, prechecks are incorporated into manufacturing and inservicing of equipment and iteratively updated by the professionals using them. Operating room and anaesthesia workflows accommodate these prechecks.
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.
Thanks for this great post. I was very skeptical about the idea for being an automaton by following a checklist or a schedule of all day, day or mounth. And then my life was a real impasse. I ignore what great things I did it and so for. Afte that I decided to get a plan of my live. I decided to savor my live by listing waht I did and what I want to do.
What these stubborn surgeons fail to see is that checklists provide them more freedom to exercise their professional judgment. They don’t have to think about remembering to do the stupid simple stuff because there’s a checklist for that. Offloading the need to remember basic tasks frees up the brain to concentrate on the important stuff. For surgeons, this means they’re left with more mental RAM to focus on handling unforeseen problems that often come up when you’re slicing someone open.
The crux of this problem is while the world around us is becoming more and more complex, we’re still stuck with a brain that hasn’t changed much in 100,000 years. Sure, we’ve figured out ways to off-load memory storage to books and computers so we can know more; we just haven’t figured out a good way to overcome our evolved biases, cognitive flaws, and intrinsic forgetfulness. And so, despite owning a brain brimming with ever more knowledge, we continue to make stupid mistakes.

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 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.
We may not like to admit it, but many of us can describe a time when we’ve made a mistake during the progress of a study. These mistakes can range from mixing up wires or forgetting to turn on an amplifier to forgetting to collect an essential piece of information that either requires additional processing time or prevents you from analyzing a certain variable altogether. Increased computing power and technological advancements have also made it easier than ever to collect data.
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 let you put tasks in order so you can accomplish the most important things first. Once you have put things in writing though, you might feel pressured to complete the tasks in order. This can slow you down. Some people work better when they can jump from task to task and let their emotions guide them. A checklist might impede their emotion. However, if you truly need to finish certain tasks before moving to new ones, a checklist will keep you focused and on-track.


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