How checklists can save your life

Dr Atul Gawande is currently in London, touring the radio stations to promote his book “The Checklist Manifesto“. Dr Gawande is a surgeon in Boston Mass., who has been looking at how to deal with complexity in surgery and elsewhere.

He has discovered that complex systems work, mostly through people using checklists. Furthermore, no matter how expert you were, well-designed checklists could improve outcomes. So, with some assistance from Boeing, he developed a 90 second checklist (download it here)  that reduced surgical deaths and complications in eight hospitals around the world by more than 30%.

In the book, he shows how low-cost checklists actually work, why some make matters worse and why others make matters better. 

According to The Guardian, Dr Gawande argues that the right kind of checklist liberates rather than stifles professional intuition. A ­concise sumary of what might go wrong, and what to do if it does, galvanises groups of professionals into tighter teams. Indeed, one of the key factors, included in the checklist, was to introduce everyone in surgical team to each other: it leads to people having the confidence to speak up.

Michael Scriven, at Western Michigan University, author of a paper called The Logic and Methodology of Checklists commented,

Checklists have long been regarded as beneath the level of serious consideration by methodologists and others interested in the logic of the disciplines. But they are more sophisticated than they appear–and are perhaps the key methodology of those disciplines that really treat theory and practice as equals, e.g., surgery, engineering, neural and public economics, program and product evaluation.

For more on checklists, see:

Guidelines for Checklist Development and Assessment by Daniel Stufflebeam

The Ten Commandments, Constitutional Amendments, and Other Evaluation Checklists by Daniel Stufflebeam

Useability Evaluation Report for the Evaluation Checklist Project Web Site by Barbara Bichelmeyer

The Evaluation Checklist Project: The Inside Scoop on Content, Process, Policies, Impact, and Challenges by Lori Wingate

3 thoughts on “How checklists can save your life

  1. Pilots and submariners have used checklists for years. Are they any less professional? No, but they and their passengers are less dead.

    Hopefully surgeons will get over themselves soon.

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  3. A well-designed checklist can serve several important purposes in many types of jobs: Hardware or software installation and configuration, quality control verifications, etc. If the checklist has initial and date fields for key steps, it provides a record of work completed, with a clear indication of where the procedure was stopped. In 24/7 production or health care environments when jobs are passed on to the next shift, key steps will not be skipped because of poor communication of where the previous worker left off. In our litigious society, archived checklists could provide the essential record that a job was completed properly.

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