Take This Checklist and Shove It

By Koko Wadeson

Not so fast. Checklists save lives. And limbs—literally. The next time you are laying on an operating table, you should hope your doctor doesn’t have the same bad attitude toward checklists you had before reading this post because studies show that when surgical teams use checklists, deaths decrease by 40% and complications decrease by more than 30%. Those impressive numbers are the reason you should learn to love checklists regardless of your vocation.

I know, checklists are boring. They may be the nerdiest way to increase your efficiency and reduce costly and time-consuming errors. A sexy robot would so much cooler, but a checklist is way easier to produce. Trust me. But before the how, let’s take a look at the why, which is dead simple: No matter how good you are at what you do, a checklist will improve your outcomes. Checklists serve to document essential processes. They ensure consistency and promote accountability. Even the act of creating checklists can be beneficial, leading to the improvement of policies and procedures and encouraging collaborative dialogue among team members.

I’ve been a hard-core list maker for a long time, but I’m a recent checklist maker. A while back I was browbeaten into creating a checklist for a complex business process. I thought a checklist was unnecessary. More to the point, I was pretty sure nobody in their right mind would want to use the 11-page end result. I had better uses for my time than creating a tool that could only expect to suffer the humiliation of being ignored, like the spork. But the checklist was effective. People appreciated having a roadmap to their final destination, and they actually liked using it. So I became a convert.

Checklists, like so many things in life, can be absurdly simple or exhaustively detailed. The most successful checklists are written and mandatorily implemented. (Even if that means self-imposed.) But mental checklists can work for simpler tasks, especially when they have a catchy rhythm or rhyme. I once had a roommate who never left the house without running down his checklist of essential items: money, keys, herb. To this day that checklist pops to mind as I walk out the door—not because I am using it, but because it’s ingrained. And I never forget my keys. That’s the power of a good checklist.

Give checklists a try. They work. Just ask your doctor.

For more information about research on the effectiveness of checklists see the article “A Simple Checklist That Saves Lives” published in the Harvard School of Public Health News (http://www.hsph.harvard.edu/news/magazine/fall08checklist/); see also the bestselling book The Checklist Manifesto by Atul Gawande.