
The Simple Genius of Checklists - zzaner
https://blog.nuclino.com/the-simple-genius-of-checklists-from-b-17-to-the-apollo-missions
======
euler_angles
I have been a flight test and rocket test engineer. Checklists were life,
especially in the rocket world. The fantastic thing about checklists is that
they both keep you accountable and free your mental resources so that when
something happens that one of your checklists don't cover, you know you've at
least tried all the sane/expected things. I personally found that backstop
freeing and allowed me to use my creativity when it was demanded by things
going wrong.

~~~
ncmncm
It took three generations of flight training for checklists to become an
essential part of aviation.

Note that a flight-training generation is less than a human reproductive
generation; it's the time from first lesson taken to first lesson taught (plus
some). It had to wait for the older instructors to retire.

We are still in transition, in medicine. Many physicians have not yet cottoned
to hand-washing, yet.

~~~
ls612
I don’t know about that last part. My dad is a fairly old physician and the
way he tells it hand washing has been mandated by the feds for decades and the
last cohort of old docs who refused to change in that respect retired circa
1990. But the culture may be different in other parts of the US or world.

~~~
JBlue42
Currently work at a hospital.

\- The CEO's semi-monthly emails have either contained a) reminders to get the
flu shot in flu season and b) statements about washing hands.

\- Thirty minutes of your new employee orientation is used to discuss
handwashing with some funny stories about diarrhea and they go around to every
single person to make sure they're washing them correctly.

\- Upon entering a patient room, anyone entering is supposed to wash their
hands

\- Anyone can call out a doctor and ask if they've washed their hands and
there are signs to make patients comfortable asking them to do so as well.

So yeah, 2019 and people still need all that as reminders.

~~~
BrandonMarc
I liked how in Freakonomics (I think), they interviewed someone who worked at
a hospital, and would regularly and randomly take culture samples of nurses'
and doctors' and administrators' hands. The results of the culture were shown
on a screensaver.

This feedback and public transparency was both amusing, and enforcing of the
necessary handwashing.

------
RedNifre
Can anybody recommend a good checklist app for Android? When I search for
"checklist" I only find ToDo-List apps that call themselves "checklist" app.

What I'd like is something where you can set a per-checklist timeout after
which the list resets everything to unchecked and maybe allow two different
ways to view each checklist (or modes): 1. All at once with little check marks
that you can check in any order 2. Strictly ordered checklists where you only
see the current task and check it to get to the next, ideally with a "3/14"
indicator or progress bar to know how far you've got through the checklist.

Which apps can you recommend?

~~~
Waterluvian
This sounds like a fun afternoon project for a web or mobile dev.

If nobody replies with a quality app that does this, I'm going to make it for
myself and share it here.

~~~
OedipusRex
This is my weekend project this week, ha. I'm reading Checklist Manifesto and
decided there wasn't any good app for it. I'll post back here when it's done.

~~~
justnotworthit
Advice (or warning?): I use Checklist Wrangler for iOS.

Checklist templates that repeat based on day of week; auto-archive after X
days. Tools for organization into groups, subgroups, etc. A way to view
completion over time.

I use it for daily things (daily autocreate, daily autoarchive), weekly
things, monthly things, and things I do in order but without a set time
(manual creation and... autocreation after completion? no i dont think that's
a feature).

Wonderful app for implementing checklists and it's a cornerstone is my toolbox
for making sure I'm living my life with intension.

Yet, it's long abandoned and I dont know if it's still for sale in the app
store. Probably made little money in a sea of Todo apps.

------
thomasfedb
Surgical Safety Checklists are crucial for preventing what used to be a really
shocking number of wrong-patient and wrong-side procedural errors.

Taking the good kidney out instead of the diseased one is practically murder.

[https://www.who.int/patientsafety/safesurgery/checklist/en/](https://www.who.int/patientsafety/safesurgery/checklist/en/)

~~~
hi41
That is a really nice check list. I think it is color coded as well to present
information clearly.

------
blunte
But where does one begin to identify the parts of life where a checklist would
reduce cognitive load?

In IT, some cases are obvious (such as deploying new releases). However, if a
process is so repeatable that you could have an accurate checklist, then you
could probably automate the process and eliminate the need for the checklist.

I would love to know what parts of my life I could relegate to checklists so I
could free my mind to focus on just the things that I excel at...

~~~
cco
Packing for a vacation or camping trip is a very good candidate. If you live
in a winter climate you can create a good winterizing checklist. Weekly home
upkeep is another.

~~~
deepspace
Yes! I used to forget _something_ every time I traveled. After reading
Gawande's book in 2010 I started making a checklist. It took about five trips
to converge on a stable list and these days travel is a breeze. Print out
checklist. Do stuff on checklist, in sequence. Enjoy stress-free travel.

------
wiscoDude
After my partner read The Checklist Manifesto by Atul Gawande, he set out to
help other organizations improve outcomes via the use of checklists. Together,
we built [https://www.manifest.ly](https://www.manifest.ly)

My main feedback from having witnessed thousands of organizations set up their
checklists is that they can be used to help teams succeed and they can be used
in an oppressive way to "ensure people do what they're supposed to do". Almost
always they contain too many steps compared to what they should have and that
is usually because the people creating/editing the checklists are often not
the users of the actual checklist. When the users and editors are the same
people, then the quality of the checklist goes up. We use our own tool on a
daily bases for processes that have high risks or for processes that we don't
do very often. They are great safety nets.

------
efa
I really enjoyed [http://atulgawande.com/book/the-checklist-
manifesto/](http://atulgawande.com/book/the-checklist-manifesto/). Very
interesting and at times frustrating. You ask yourself why more hospitals
can't implement success described in this book.

~~~
mgnn
I'm about 2/3 into the book, the idea is convincing, but did he put _any_
example checklist in the book? He referred to many extant checklists, but
there is no "Figure 1: a bad checklist" and "Figure 2: a good checklist,
improvement for the one in Figure 1".

~~~
ex3xu
They are at the end, in appendix format. The final checklist is a checklist
for checklists:

[http://www.projectcheck.org/uploads/1/0/9/0/1090835/checklis...](http://www.projectcheck.org/uploads/1/0/9/0/1090835/checklist_for_checklists_final_10.3.pdf)

~~~
mgnn
That's strange, my edition doesn't have appendices. Thanks for the page
though.

------
rb808
I hate checklists. I've just done an information security checklist at work,
200 questions, lots of them irrelevant, many are very vague, often require
evidence that is time consuming to put together. Next week I have a release
that I have to put a change ticket in for - another 50 boxes with questions
and combos. I'm ready to quit. Don't let checklists turn your company into a
bureaucratic hell hole.

~~~
epalm
So what you actually hate are "bad checklists".

~~~
ukj
Do you have a good checklist for writing good checklists?

~~~
mschnell
The Gawande book (Checklist Manifesto) contains one. A few points from my
notes:

\- distinguish Read-Do- \- Pause-Points \- Read-Do vs. Do-Confirm \- 5--9
items \- Only killer items \- No clutter and unnecessary colors \- Wording
simple and exact \- Use language of the profession \- Fit on one page \- Has
to be tested in the real world \- Also don’t forget Communication checks

------
JBlue42
Tom Limoncelli had a nice article about how documentation/checklists is the
beginning of automation in an IT setting.

Manual Work Is A Bug:
[https://queue.acm.org/detail.cfm?id=3197520](https://queue.acm.org/detail.cfm?id=3197520)

Makes a lot of sense and something I advocate for in my department.

------
aeturnum
Also worth mentioning the power of engaging our bodies physically and verbally
to ensure we're engaging with checklists:
[https://en.wikipedia.org/wiki/Pointing_and_calling](https://en.wikipedia.org/wiki/Pointing_and_calling)

------
runjake
Checklists were life in the USAF working on heavy bombers and the nuclear PRP
program.

I’ve done a procedure 100 or a 1000 times? Still going down the checklist in
the Tech Manual every single time.

Humans can’t multitask well and if you miss a step, people can die and planes
could crash.

------
vmurthy
Warren Buffett and Charlie Munger are big fans of checklists,too.[1]

Obviously, in a field like investing no checklist is perfect but at-least
it'll help you avoid _common_ pitfalls.

Source: Many of their shareholder's letters contain references to their
approach. I found another one online.

[1][https://hurricanecapital.wordpress.com/2016/08/12/the-
buffet...](https://hurricanecapital.wordpress.com/2016/08/12/the-
buffettmunger-investment-checklist/)

------
gargod
Reminds me of Chernobyl, where some steps within the safety system test
checklist had been crossed-out for an unexplained reason and they had to
essentially guess what to do. Not that a properly maintained checklist would
have necessarily prevented it.

~~~
zzaner
I actually don't know if that detail is true or if it was added for dramatic
effect in the HBO series. The official record seems to state that they simply
didn't follow the approved procedures for the test:
[https://en.wikipedia.org/wiki/Chernobyl_disaster](https://en.wikipedia.org/wiki/Chernobyl_disaster)

~~~
mjevans
There are all sorts of ways they messed up with that test, the design of the
system in general, etc.

A lot was learned, some of it costly stuff that we as a species really didn't
need to pay for again, and some things that were new and valuable as a result
of failure that ethnically could never be intentionally replicated.

One of the better lessons might be to avoid deviating from pre-planned test
procedures, and for every major step to have an 'abort' path (or two) for
safely entering either safety or normal operating procedures.

------
rmbryan
I've invested enough time in a personal checklist for a daily process to get
to the point where I feel like the checklist is "helpful", "minimal" and
"complete". If I had a printer, I would print out a stack of them and record
my compliance on paper. I don't have a printer, and I'm not buying one just
for this. What's the electronic equivalent for recording checklist compliance?

------
unethical_ban
What is the name of the font on that B-17 checklist? It is that mid-century
engineering font that I love so much.

------
hellosputnik
The article reminds me of Brendan Gregg's talk, "Performance Checklists for
SREs".

[https://www.youtube.com/watch?v=zxCWXNigDpA](https://www.youtube.com/watch?v=zxCWXNigDpA)

------
rkangel
I cannot recommend this book enough. It is a great read due to good writing
and interesting case studies, and the underlying message is immensely
valuable.

~~~
blunte
Would it help me identify when checklists would be effective, and then how to
build a useful checklist?

Or is it more about why checklists are good?

~~~
rkangel
Both are covered. It specifically talks about two categories of problems, for
which checklists are and aren't useful. Different sorts of checklists and what
should and shouldn't be on there is also covered.

------
qwerty456127
People share some IT-related checklists on GitHub already. It would be cool to
see more checklists on non-IT subjects.

------
randomdent
While I agree with the overall message, Boeing would not be my first choice
for best practices on safety

~~~
randomdent
Especially after reading this:
[https://news.ycombinator.com/item?id=20290449](https://news.ycombinator.com/item?id=20290449)

------
takanori
Has there ever been a platform for experts to build and share checklists and
for every/any task?

~~~
zzaner
Not that I know of but I came across this curated compilation of checklists:
[https://github.com/huyingjie/Checklist-
Checklist](https://github.com/huyingjie/Checklist-Checklist)

~~~
takanori
Any arguments why this would or wouldn’t work?

------
jowdones
I'm probably the smartest guy in Romania and can tell you I got my
certification that I can do 99% by making sure my usual cognitive load stays
at 1%.

I was also poor, which means there was no way to enforce my internal policy
which means today, 20 years later, I'm using 99% of my brain power to solve
issues a simple state/high-powered enforcement checklist would do.

At my 90%+ I still dreamed of a better future. Now I only wish my own death.
Tomorrow I hope and make sure you all die.

~~~
catacombs
> I'm probably the smartest guy in Romania

[citation needed]

