One thing to remember: your checklist doesn’t have to take the form of a list. One checklist I use every day is my Daily bookmark folder. It’s a bookmark folder in my browser (I use Firefox) that contain the sites I want to visit daily. Every day, all I need to do is opening the bookmark folder and it will automatically open all the sites I want. Simply by opening it I can be sure that I won’t miss anything.
3. Decide if you need a “communication” checklist. Most checklists are likely procedural (they lay out things you need to do), but some tasks or projects are so complex that communicating with others becomes vital to managing all the moving pieces. In such a case, create a dedicated communication checklist and make sure it includes who needs to talk to whom, by when, and about what.
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.
Accepting the fallibility of our memories and the overwhelming amount of information we need to manage and apply in our jobs is an important first step. Realize, as Gawande wrote, that "Knowledge has both saved us and burdened us," and recognize that the checklist can make sure your brain doesn't fail you—ever. Then, you'll be ready to create and rely on a checklist, one that that will help you perform better, and more consistently.
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’.
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:
Introduction of a new tool without full consideration of its purpose, benefits and limitations may actually increase risk to patients, providers and the system as a whole. Overimplementation of checklists may erode respect for long-standing healthcare cognitive aids that are effective, have been iteratively improved, and are well suited to specific purposes. Overreliance on checklists as a safety net can lead to omission of other safety practices that may better support safety through reliability and resilience. Checklists are excellent ‘aides memoire’ and directives to correct procedures, but they are not a panacea.
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