Why We Need Checklists

Everyone has a list of items that they need to accomplish on a day-to-day basis in order to be successful. This can be as trivial as making sure to brush your teeth or attend a meeting, but other times, these simple tasks, such as a surgeon washing their hands before surgery, could have huge effects if not followed. Amidst the complexity of our lives, we need checklists to help get the easy things right.

Atuwal Gawande highlights this in his book - “Checklist Manifesto” - here Dr. Gawande was tasked with trying to deduce why patients that had surgeries performed, were returning, weeks after the completion of the procedure, with infections and in need of another surgery.  

His analysis pointed out that the current paradigm, in which the nurses rely on the surgeon’s sign off as the end-all and be-all authority, was not effective for managing pre-operation and post-operation procedures. As a result, if the surgeon missed something on his mental checklist, mistakes occurred that could have huge implications. In some extreme cases, this dismissal of awareness from the staff even left some patients with syringes accidentally left in the body of the patient! Surgeons and nurses made assumptions that processes were being followed appropriately, but there was no accountability on either side to make sure that the all steps were followed accordingly.

Dr. Gawande implemented a pre-operation and a post-operation checklist which led to a massive drop in the number of patients returning with infections or other complications that arose as a result of their last surgery. The New York Times noted that “when it was later tested in I.C.U.’s in Michigan, the checklist decreased infections by 66 percent within three months and probably saved more than 1,500 lives within a year and a half.” (http://www.nytimes.com/2010/01/24/books/review/Jauhar-t.html?_r=1)

Check lists are employed across multiple industries and disciplines to help ensure proper planning and preparation before execution. Tracking accountability and equipment quality is immensely important for first responders where every second counts after the alarm sounds. Subscribe to the blog as we dive more into what checklists mean to both first responders as well as other professions.