A Checklist for Your Checklists

I just read The Checklist Manifesto: How to Get Things Right by Atul Gawande, mainly because one of my favorite writers, Malcolm Gladwell, so heartily endorsed it. (book photo from author's site)

You may know how I am always going on about capturing information… a checklist is one great way to capture important information and make it able to be replicated by others. I love using checklists for office procedures, for example, and recipes are actually checklists too. Everyone knows how to make simple packing lists and the like, but here are some things from this book that I never thought about with regard to writing good checklists– a checklist for checklists, if you will:

• What is the "pause point" at which the checklist is supposed to be used? This pause point should be specified.
• Do you want a "Do-Confirm" checklist, or a "Read-Do" checklist? A Do-Confirm is used when people perform the job separately and use the checklist afterward to confirm that the job was done correctly. A Read-Do checklist is used when people are to check off the tasks as they are completed.
• Is your checklist too lengthy? A rule of thumb is between 5-9 items on only one page.
• Have you focused on the steps that are the most crucial and left out anything that would be distracting?
• Is your wording simple and exact, using familiar language to the end-user?

This book's author, Atul Gawande, was compelled to write this book based on his experiences trying to write and implement checklists for hospital staff and surgeons. He knew there were over 100,000 deaths due to surgery complications each year, and that many of those deaths could be avoided. He worked with the World Health Organization and key hospitals to create checklists for reducing infections and standardizing surgery precautions.

Using a simple 2-minute checklist in ICUs in Michigan, a Johns Hopkins researcher reduced infections by 2/3 in the state and saved 1500 lives in the first year.

For surgery, the checklist cut deaths by over 1/3 in the first 8 hospitals that adopted it.

The surgeons were often reluctant and even offended to be asked to use the checklist, but after using it for 3 months, 80% of them liked using it and saw it catch errors. The most telling question, "If you were having surgery, would you want the checklist used?" had 93% of the doctors saying YES.

Checklists are simple solutions that solve so many problems– and in this case save lives. Click here to watch Atul Gawande interviewed on The Daily Show talking about the book.

Quote from the book:

"Faulty memory and distraction are a particular danger in what engineers call all-or-none processes: whether running to the store to buy ingredients for a cake, preparing an airplane for takeoff, or evaluating a sick person in the hospital, if you miss just one key thing, you might as well not have made the effort at all."

How have checklists positively affected your life? Share in the comments!

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