Pilots have known for a long time the importance of checklists to avoid error. My father was a pilot and having flown with him many times, I still remember his check list for take-off: Trim, Temperature, Fuel, Flaps, Gills ….. Ok I don’t remember it all but he always said it before take-off and it was for a good reason. We humans forget little details when we do not have a check-list.
Creating simple checklists can deliver a consistent process with fewer errors. The key is creating checklists that are in fact simple and then getting everyone to buy into the checklists. Atul Gawande in his book “The Checklist Manifesto” examines a series of examples where simple checklists have added tremendous value in complex environments. One example he gives is that of a Critical Care Unit at John Hopkins in 2001. The problem was 4% – 11% of IV lines become infected and 10% of these lead to death. This is a very serious problem. The solution was a 5 step checklist: 1. Wash your hands with soap 2. Clean patients skin with chlorhexideine antiseptic 3. Put sterile drapes over entire body 4. Wear a mask, hat, sterile gown and gloves 5. Put sterile dressing over insertion site once line is in. The result was that the infection rate dropped to almost zero. Over the next 15 months only two patients were infected. The checklist is estimated to have prevented 43 infections, 8 deaths and 2 million dollars. There is tremendous power in a simple checklist especially if you are one of those eight who will never know it!
“The Checklist Manifesto” by Atul Gawande: