The Power of Checklists

A New York City surgeon had a significant problem. He saw some of his patients had complications that weren't attributed to the procedure. He was so frustrated by the rate of infection that he set out to detail the steps that went into the care of each patient. In doing so, he realized there was a lack of consistency in the care protocols. Everyone assumed what had to be done, but no one followed the same process each time. As a result, there was inconsistent care and missed steps. He worked with his surgical team to ensure that everyone followed the steps in the checklist. They would update the process if they uncovered a new issue that led to less than the desired outcomes. This led to a significant decline in complications, and eventually, Dr. Atul Gawande published his book "The Checklist Manifesto" as a way to share how checklists can literally save lives. Atul has taught this methodology for medical and non-medical processes, including helping America deal with significant medical challenges.?

If you have ever flown, gone on an amusement park ride, watched a live play, or had a medical procedure. Checklists are not the same thing as a "to-do" list. They are an organized progression of action steps that you can take to accomplish a larger goal. They provide oversight and direction for someone who may not know how to do a task and allow others to trust that the required steps were taken to ensure success.

Smart leaders know the value of a checklist, but many will assume that people already know how to do a task, and it's not worth the effort to put painstaking details on each of the processes their team handles daily. The result is more of a guideline vs a checklist progression of how to do a task.

If you think the details don't matter, watch this short clip of a father following his child's directions on how to make a peanut butter and jelly sandwich.?

Peanut Butter & Jelly Sandwiches Directions

Is it an exaggeration? Sure, but note the frustration on the kids' faces as the father attempts to make the sandwich and fails. How often have you felt the same way with one of your team members who can't seem to accomplish the simplest of tasks without making multiple mistakes? Sure, we would prefer to have people figure things out on their own so we don't have to oversee them, and they figure it out on their own. We know from Situational Leadership that everyone starts at the point of being an enthusiastic beginner. They need specific and detailed directions. They need a checklist.

Checklist for creating a checklist:

1. When you build out your checklist for the first time, be so explicit with your directions that anyone, and I mean anyone, can follow them. You can't have enough detail in the first draft.
2. Have someone try it without your supervision or comment. A well-written checklist will leave little to no room for error. More likely than not, you will quickly discover that your first draft must be more precise and cover any missing steps.?
3. Sit with the individual and have them go through the checklist, explaining what they think are the directions. Make a note of the differences and amend the checklist.?
4. Have someone else attempt to follow the checklist. Make sure the new person was not involved in the first attempt. Review their effort and adjust as needed.?
5. Repeat the process as many times as needed. The goal is to get the documentation to the point where anyone can follow the steps every time.?
6. Consider visual or multimedia guides to help others complete the checklist.?
7. Identify the critical steps in the process and highlight them so they know if they hit the milestones along in the progress.

The power move is to put an expiration date on all of your checklists. If it's a newer process, the expiration date may only be a few days or weeks. Keep the checklist fresh by reviewing the process frequently.

What steps have you found to be useful when making a checklist? What steps did I miss or could be made better? Feel free to add your own below.