After some time, I decided to apply that same mentality to my own life. Both in private and work situations.
I get it now. Checklists reduce cognitive load tremendously well, even for basic tasks. As an example: I have a checklist for when I need to travel, it contains stuff like what to pack, asking someone to feed my cat, check windows are closed, dishwasher empty, heating turned down, etc. Before the checklist, I would always be worried I forgot something, now I can relax.
Also, checklists are a great way to improve processes. Basically a way to debug your life. For instance: I once forgot to empty the trash bin before a long trip, I added that to my checklist and haven't had a smelly surprise ever since ;)
I think they make sense for infrequently exercised routines of moderate complexity that are 100% execution. A complex but limited scope machine like a plane is really an ideal example. I guess preparing for a vacation could be another, although I get caught up because packing is totally different every time. I suppose I checklist myself when I rappel or go skiing ("Skins, skis, boots, ... working up the body")
Why do you say this?
Everytime you see a system flaw because of a missed step, you add to checklist. Everytime you have a process flaw because of a uselss step, you remove from the checklist. There's no problem here, checklist maintenance can be a step in the checklist.
> ("Skins, skis, boots, .
"Spectacles, testicles, wallet, and watch!"
Broken down a different way, you need two systems: an automatic system so you're not reconsidering decisions that have good outcome (a checklist), and a considerate system that decides what goes into or out of the automatic system.
If the considerate system is broken or just frozen, then you have a problem. How long it will take to manifest is a different question.
Removing an item from a checklist is done in response to a change in inputs. Sure, you may have automated release signing - but unless you are 100% confident that you are aware, and have mitigated 100% of the ways in which this can fail, you cannot, and should not remove the 'check that the release is signed' step.
Lost context has nothing to do with this. Unless you are an omniscient god, you probably cannot reason, with 100% certainty, that you have mitigated every possible input that produced a bad output.
So, check your outputs.
Having long checklists for comparatively simple tasks really hurts productivity, plus they're often used as an excuse to put automation in place, because 'the process is already defined' and 'people are already used to it'.
When designing a process, it is of utmost importance to keep checklist lengths minimal.
As the Boeing 737 Max 8 shows, adding new items (in this case a new design element) is also fraught with risks. You have to get the root analysis correct when adding or removing elements. Adding has risks of unknown (not accounted for) like removing has risks of unknown (accounting forgotten).
In the end, I guess I still believe the best strength is in good analysis at the consideration stage.
The asymmetry with checklists is that it's completely risk-free to add a new check, but it's risky to remove one. For example, someone might say "we're not totally sure that our system won't fail when we do X, so let's check that in QA, or at runtime, or at takeoff, or whatever." Now that the check is there, it protects you from failures when you do X. And now you're in a situation where you can't safely remove that from the checklist unless you can prove that your system won't fail when you do X. Adding requires only a suspicion, removing requires rigorous proof.
The case you describe with the 737 Max isn't the same at all. There's an actual risk when adding a new component to the system, but no risk when adding additional verification. That's not to say that there aren't other costs, but it can't directly make your system less reliable.
It's not a risk free check at all. It will likely increase the rate at which the drug is administered, with all types of plusses and minuses associated with adding a component to a system.
So disruption is taking a bulldozer, and driving right over them. The clearly usefull fences get erected quickly. The forgotten usefull ones are rediscovered after a while, maybe causing some minor damage in the process. But the grand majority turned out to be useless, and is now gone for good.
Of course, if there is a pack of nuclear civilization killing wolves out there, they better stay fenced off or else. The trick is identifying them. There might be a role for a regulator in there.
Check that the gas stove is off (important). Lights off. No running water (after a few, um, incidents). You didn't leave your phone, did you, and make sure the cat didn't run out (he'd always try).
I always wondered why "lights" were on the list, since nobody gave a damn about electricity bills.
Guess for the same reason that "testicles" are in the parent comment's list :)
Instead just put a sign up that says "Any unauthorized testicles entering the building will be donated to a good cause".
Yes. There have been several formal studies of this effect, e.g. . Checklists offset skill fade, which is in effect the 'forgetting curve'. Some skills (the classic riding a bike) last for ages, others (a good example being field fault diagnosis) are lost very quickly even with good initial training.
Incidentally, I once made a good camping packing checklist by making an inventory of the contents of my car as I unpacked it at the end of a holiday and the things I'd forgotten were still fresh in my mind.
This is a perfect example. I have a snowboarding checklist and it's reduced the cognitive load of packing tremendously.
Things to do the night before, stuff to wear for the drive, stuff to pack, what to include if I'm expecting extra cold weather, and a final checklist for things to do in the morning (e.g. get lunch out of the fridge).
For travel I have a checklist of things that I always need to take (toiletries, spare phone battery, Nalgene, pajamas) and then the stuff that varies is all I have to think about. Almost every time I travel there's something on my list of "stuff that always gets packed" which I would have forgotten.
I never forget socks but I've had to buy a few toothbrushes and deodorant...
Or maybe a checklist for refactoring all the checklists?
/this could get out of hand...
Suppose you have training material for new hires ("How we use git 101"). Do you hand them the same document from 10 years ago? Does it have accurate setup instructions (now you use Bitbucket and not Gitlab or vice versa, and it presents internally on a different domain).
All of these kinds of documents should be reviewed with some frequency (and ideally you should have a way to submit changes outside of the explicit review times, the explicit reviews are to catch things that weren't found earlier; wikis can help here). If you don't, then you do end up with the problem being discussed. You'll have a lot of checklists or procedures being done "because it says so" and not because they're needed.
I suspect that's part of the secret behind Netflix Chaos Monkey. Every single process gets run multiple times a month, and it's normalized enough that it's not a constant panic mode thing.
Don't you find that most trips have a ton of stuff in common though? Pajamas, contact case/solution, loofah, spare phone battery, ear plugs, phone charger & battery charger, reusable water bottle, etc. always go with me on every trip.
IMO the stuff that always goes is the stuff that I tend to forget, exactly because there's nothing unique about this trip that would make me remember it. If I'm going to the beach I know I need my swimsuit and beach shirts because I can walk through my activities and think about what I need for each one. But I'm likely to forget pajamas because I'm not thinking about "go to bed every night" as an activity to plan for.
Checklists FTW. Nobody above me has mentioned Atul Gawande’s book ‘The Checklist Manifesto’ so, just on the off-chance you’re not aware of it, there you go. I loved it. (Gawande is the doctor who implemented the checklist in this article.)
I have a packing crate for socks, one for underwear, one for causalwear and pants.
Then I just need to think how many nights I'll be gone to pick how much goes into each.
(Also reduces space in my carry on so I have room for conference schwag on the return leg)
The other thing is just bring less stuff. A lot of people are amazed by how little I carry and I don't consider myself extreme. Consider what you really need as opposed to want.
(Then again maybe I'm not travelling enough for your advice to apply...)
I agree on the bringing less stuff front. I've slowly pared down a lot of what I bring, and just stop in a drugstore to pick up if I forgot some minor thing.
I understand you're saying, but this statement exemplifies so well something I think I have gotten worse at since becoming a software engineer.
In my previous life, if I tried to apply checklists to my life, I would have taken a naive approach, applied my best effort, and that would be the end of it.
Now I would be much more likely to consider edge cases and counter-examples, compare my checklists to the "optimal checklist", and as a result I might fall into a checklist-design rabbit hole, or else constantly question the efficacy of my checklists in knowledge of the true complexity of the problem.
I don't think it's always beneficial to think in those terms.
If that bright soul also added a 'verify the signature' step to the build process, and the ability for the build system to know that signing failed, you've automated the entire thing and now your checklist is documentation for the build process.
Because of that book, I'm not surprised that the checklist reduced deaths, but its a bit shocking that its by a third. Then again, the base rate was very low to begin with, showing that surgery teams were already doing a seemingly good job:
"The death rate fell to 0.46 per 100 procedures between 2000 and 2014, analysis of 6.8m operations showed."
Still, over 6.8 million operations, is that 15,000 survivals? Wow.
Somebody sick dying in hospital, on the other hand, is just something that happens, and draws very little attention - even though way more people are affected than in plane crashes.
So, the clustering and visibility of plane crashes leads to excellent check list discipline and other best practices in aviation, by and large (CRM, Crew Resource Management, is another thing Atul Gawande brings up in The Checklist Manifesto, and also eminently transferable to surgery), while I suspect that in surgery it is easier to drift away from best practices again without anyone noticing.
That's why these large studies and the educational efforts of Dr Gawande and others are so important.
If we saw a midair collision of jumbo jets every day however the public would never accept it.
Same author as the book, but earlier. Contains all the meat, but none of the repetitions and the tenuous analogies.
Gawande had enough for a long-form article, but not for a book, and IMO it shows.
The book isn't bad. It's just that the essay is better.
On one hand, it's good to err on the side of too-long a book, as it's easier to skip fluff than to seek out more details, illustrations, and alternative phrasings that aren't in the book. On the other hand, it's annoying to have the extra weight in volume in one's book collection.
The worst is when the first three chapters are about how rich/smart/successful you'll become by reading this book! (Except for the first three chapters, of course, because those are just advertisements for the book you already acquired.)
The one that bothered me the most was the inclusion of the India soap program as support for checklists -- those are entirely different models.
The soap model involved researchers handing out free soap, and teaching people that they should wash with the soap in any of a set of specific circumstances:
- once a day (full body)
- before preparing food (hands)
- before eating (hands)
- before distributing food to anyone (hands)
- after defecating (hands)
- after wiping an infant (hands)
(Obviously, people can't handle the mental load of "before doing _anything_, check to see..." and instead would have added "wash your hands" to the appropriate five behavioral sequences. That reduces the mental load from (1) a constant mental drain on any activity of any kind to (2) learning five things. But if you make that switch, you stop having any relationship to the checklist concept at all.)
The article in The New Yorker is superb, you should really take a look. What could be missing there?
That said, "the medical community" is not a homogeneous monolith, and you can absolutely find regional variation in what checklists are used for, how detailed they are, how closely they're followed, how people are accountable for keeping to them, etc.
"The Checklist Manifesto" chose to overlook the studies about how transient the benefit of checklists is.
This 2014 review looked at 34 studies that looked at the effectiveness of safety checklists:
> The main findings were improved communication, reduced adverse events, better adherence to standard operating procedures, and reduced morbidity and mortality. None of the included studies reported decreased patient safety or quality after introducing safety checklists.
> Safety checklists appear to be effective tools for improving patient safety in various clinical settings by strengthening compliance with guidelines, improving human factors, reducing the incidence of adverse events, and decreasing mortality and morbidity. None of the included studies reported negative effects on safety.
So I'm going to ask for a citation on that claim.
The studies concerning long-term impact of surgical checklists I found all claim an improvement.
> Sustained use of the checklist was observed with continued improvements in process measures and reductions in 30-day surgical complications almost 2 years after a structured implementation effort that demonstrated marked, short-term reductions in harm. The sustained effect occurred despite the absence of continued oversight by the research team, indicating the important role that local leadership and local champions play in the success of quality improvement initiatives, especially in resource-limited settings.
>Only 3 of 22 operating stations (13.6%) had a functioning pulse oximeter prior to the intervention; accordingly, a pulse oximeter (model 7500; Nonin Medical Inc) was installed at each operating station as part of the implementation effort
The addition of essential medical equipment surely won't bias our results!
Interesting, that kind of surprises me. Without going to research it right now, I wonder how/if the efficacy is affected by things like going through them in tandem with a partner, or doing them out loud or with exaggerated physical acknowledgements (like the Japanese train drivers who point out signs/notices along their route as a way to maintain focus on those notices).
Over time people internalize the checklists because they unwittingly conclude the reason for the checklist is to learn a new procedure rather than foolproof their procedures and avoid errors. As a result, they start to skip the checklist or get sloppy with it.
There are a couple other points related to this that I believe Gawande does address in his book:
1. Doctors (more generally experts or egoists) will be resistant to checklists because they find them unnecessary (given their experience or expertise).
2. Checklists need to managed with regular review and updates.
You can boil Gawande's book down to: "Start using checklists because they're really effective." But his book goes deeper than that and addresses some of the underlying human factors involved in getting an organization to use checklists effectively.
At the end of Chapter 7 of Gawande's book (The Checklist Manifesto) is this revealing tale:
Nonetheless, some skepticism persisted. After all, 20 percent did not find it easy to use, thought it took too long, and felt it had not improved the safety of care.
Then we asked the staff one more question. “If you were having an operation,” we asked, “would you want the checklist to be used?”
A full 93 percent said yes.
But I agree with you wholeheartedly. I don't want my mind cluttered with stuff that can be handled by simple script.
It's been almost a year now since I read this but I'm fairly certain Atul touched on this, either in this book or in his book "Better", that after those implementing the changes left, the departments often fell back into old habits.
Could this be the case?
In order for the benefit to stick, you need to actually change the system. Otherwise, complacency or other things will return when the pressure and other early benefits wear off.
- [ ] not complete
- [x] completed
Other tools support additional per-task workflow states:
- [o] open
- [x (2019-04-17)] completed on date
I worked on a large hospital internal software project where the task was to build a system for reusable checklists editable through the web that prints them out in duplicate or triplicate at nearby printers. People really liked having the tangible paper copy.
"The Checklist Manifesto" by Atul Gawande was published while I worked there. TIL pilots have been using checklists for process control in order to reduce error for many years.
Evernote, RememberTheMilk, Google Tasks, and Google Keep all support checklists. Asana and Gitea and TaskWarrior support task dependencies.
A person could carry around a Hipster PDA with Bullet Journal style tasks lists with checkboxes; printed from a GTD service with an API and a @media print CSS stylesheet:
I'm not aware of very many tools that support authoring reusable checklists with structured data elements and data validation.
There are a number of configuration management systems like Puppet, Chef, Salt, and Ansible that build a graph of completable and verifiable tasks and then depth-first traverse said graph (either with hash randomization resulting in sometimes different traversals or with source order as an implicit ordering)
Resource scheduling systems like operating systems and conference room schedulers can take ~task priority into account when optimally ordering tasks given available resources; like triage.
TodoMVC catalogs Todo list implementations with very many MV* JS Frameworks: http://todomvc.com
GitHub and GitLab support (multiple) Issue and Pull Request templates:
Default: /.github/ISSUE_TEMPLATE.md || Configure in web interface
/.github/ISSUE_TEMPLATE/Name.md || /.gitlab/issue_templates/Name.md
Default: /.github/PULL_REQUEST_TEMPLATE.md || Configure in web interface
/.github/PULL_REQUEST_TEMPLATE/Name.md || /.gitlab/merge_request_templates/Name.md
There are template templates in awesome-github-templates  and checklist template templates in github-issue-templates .
I'll often be on call with customer and create a checklist on MacOS Notes on the fly. Then will copy paste that in slack or github for simple tracking.
You can post GitHub/GitLab project updates to a Slack/Mattermost channel with webhooks (and search for and display GH/GL issues with /slash commands); though issue edits and checkbox state changes aren't (yet?) included in the events that channels receive.
You'd need some system to mark when one list ends and the next begins, KanBan just treats them as individual tasks.
> even basic stuff like re-arranging your list.
All of them let you re-arrange your list. Is this a mobile specific issue?
You might notice that the book was written by Dr. Gawande, who implemented the checklist in the fine article!
'checklists are very very good. You should really use checklists'
Now if you require further info on why they are good, by all means read the book, i just found it was a blog-post, if not a tweet, expanded to a book, YMMV.
If you stop at that you miss a big part of the book where he describes that not all checklists are equal, what makes checklists useful (i.e. you should not state the obvious in a checklist and he goes at length to explain why), and how you spread the usage of checklists in an organization. That's a lot more important than "checklists are very very good".
The book, on the other hand, yes, expounds on the very same points again and again, with different examples, under different circumstances, highlighting different aspects, and then, having had the same message hammered home so many times, there's a faint chance that a month later you remember some of it.
(Great books change the way you view things forever, but that happens rarely, and never with business books, I'd say :-)
I get why they're in there, it's one of the few ways to argue the actual effectiveness of whatever advice the author is giving. It just seems excessive sometimes how much of the books are just 'I swear this works look at these important people it worked for.'
Or perhaps see if your local library has it.
I've reduced my book purchases, and generally only consider buying something nowadays if I still enjoy it after the second/third reading (from the library).
The only good thing is that they serve as visual reminders of the books that you've read; otherwise it's easy to forget the titles and authors.
I disagree. I write a lot on the margins of the books I own - notes, personal observations, questions, criticism. I highlight interesting passages. It helps me understand the book deeper and retain its ideas.
It doesn't need to be you who reads the book either, it could by your personal library and you lend it to friends interested in the same subject. Public libraries will get rid of unpopular books so having a personal library of obscure subjects you care about is useful. (The internet does not have everything)
It's possible to create an account on Good Reads or Library Thing to keep track. There's Delicious Library as well (for Mac?).
It's interesting to think how often dumb errors can be caught just by making sure everyone in the room is there for the same surgery (i.e., repairing a joint, not cutting off a limb). Correcting that confusion before cutting makes me feel better.
"And yet, most people think checklists are beneath them. They are insulted that someone with as much experience as they currently have would require a checklist."
We did something similar for example: left a tray of leftover food in the oven (turned off) just before a trip and came back to a pulsating surprise. I added "Check the oven is off and empty" to the list of things to do "Just before we leave" and it's never happened since.
That said, there are several hundred things on my generic version and it sometimes feels a bit daunting having to start afresh each time we travel but I think so far, it's been worth it.
I keep threatening to do a trip without it and see just how many things we forget, don't do and screw up. MAybe one day... :)
I just throw some stuff in a bag and worry less. Never fails. If I forget something it probably was not that important and I can just buy it at the airport / when I land.
I just fundamentally don't understand the statement, "If I forget something it probably was not that important". How does one follow from the other?
I still don't use a checklist for traveling, but I do use a to-do list religiously for...actual things to do. After this thread, I may just add a few more lists.
More seriously, when studying organization and lists in particular, I remember reading:
There are two types of list-makers - those who make them and use them, and those that make them and lose them.
If you're perpetually group #2, you're more likely to try it a few times then ditch the whole process.
It's been many years since I stopped worrying about it, and I've yet to have even a single instance come up where I forgot something important enough to be a real hassle.
Checklists are great for surgeons and pilots. The cost of missing something in those professions can literally be life or death. If I forget to pack something when I go on vacation, the most it could possibly cost me is money.
I was in an airline check-in queue behind some people who discovered they had left their passports at home. Cue near-coronary and marital strife. A relative had to break into their house and make a mad dash to the airport.
(I'm also a checklist person)
Then sections for hand carry, electronics bag, wash bag, suitcase and various subdivisions within each.
I found the best way to manage it is to make one giant list so it might have a kite and a bucket and spade in the "misc items" for example. When we're planning a trip, I copy that list to a new place, edit the title accordingly and remove all the items I'm sure we won't need. Like the aforementioned kite and bucket if it's not a beach trip. Or the car pack with chargers, suction cup for phone navigation etc. if we're not renting a car.
I agree that it'd probably be mostly okay if I went rogue and I can always buy stuff in the airport or at our destination. Notable exceptions being medications, passports, credit cards. I still garner some measure of comfort from knowing we have everything even if getting there can be a little stressful.
I don't have a checklist, and usually I'm fine. So, it's certainly possible :)
Also, I think if you have a list of over 100 items, maybe it's time to simplify it or break it up into sublists. That length itself probably produces more anxiety than saved by the list. It sounds like an over optimization
For background, I create todolists and checklists all the time in my life. Just so far, I haven't felt the need to make one for taking vacations.
Each kid has their own schedule, their own list of items they need that day, their own homework.
When you shop, you need to know what to get for everyone.
And there's the paperwork, you have to decide what to buy for major purchases and pay for them all, and you have to sign up to various things like voting registries and local tax.
Add to that your work, where you have a bunch of tasks to do as well, various projects, bugs, meetings, and so on.
I lived through the pre-mobile, pre-everyone-had-a-computer era, and I don't get how people did anything. Paper diaries? Rolodexes?
People certainly are busier now, but they seem to be a lot less focused on important things.
Kids playing used to be spontaneously organized by the kids, or even organized in advance by the kids. The amount of available greenspace in a neighborhood seems to be a lot less now, and play appears to be monetized and organized by adults and organizations.
Anyway, Pepys complains frequently that his day's work was lost because he was not able to meet with someone in the expected place at the anticipated time. That's just how things were then, you could neither phone to ask "where are you?" nor to say "change of plan I will now be at the old bridge until 4pm".
Perhaps more time to wonder, explore, and waste.
Perhaps less fulfilling and more difficult to achieve goals.
Carbon based one, ie brain.
I suspect there might be an opportunity for a "visual checklist" app that prompts you to take pictures of stuff....
NB I do use a paper checklist for remembering to take stuff when I go up mountains at the weekend - forgetting gloves when it is snowing is never a good idea.....
The classic example of this are train drivers: https://www.atlasobscura.com/articles/pointing-and-calling-j...
Quote from the article:
"Originally developed by the now-defunct Kobe Railroad Administration Bureau in the late Meiji Period (the early 20th century), pointing-and-calling is known to reduce workplace errors by up to 85 percent, according to one 1996 study."
It serves several purposes:
* it ensures that you actually look and check, not just say the magic incantation ("fuel selector valve: BOTH") out of habit, and
* for rarely used controls (such as the alternate static air source), it familiarises you with it once per flight, so you don't fumble around in case you need it.
Not all pilots do that. I wonder whether there are studies on whether this helps. Certainly, there are many cases of planes crashing because pilots forgot to do certain items, even though they were on the checklist and the pilots have gone through the checklist.
https://en.wikipedia.org/wiki/Lufthansa_Flight_540 ("The flight engineer was found to have failed to open the slat system bleed air valves as required on the pre-flight checklist.")
https://en.wikipedia.org/wiki/Helios_Airways_Flight_522 ("the flight crew overlooked the pressurisation system state on three separate occasions: during the pre-flight procedure, the after-start check, and the after take-off check. During these checks, no one in the flight crew noticed the incorrect setting."
This reminds me of https://en.wikipedia.org/wiki/Spanair_Flight_5022#Flaps_and_... ("In the Takeoff Imminent verification checklist the copilot had simply repeated the correct flap and slat position values without actually checking them")
There are for trains. Presumably, it generalizes for human behavior, even if it's a plane, not a train.
(New York City imported the practice from Japan)
I used to just group items by category (outerwear, electronics, etc), but now I've found it better to group items by where they're going to be packed (pockets, under-seat backpack vs carryon / checked bag).
Below that, I have short supplemental lists for things like camping, international, trips with swimming/beach, formal (wedding, etc), or trips longer than a week.
Also, a "Before You Go" list that's stuff to remember when literally walking out the door (take out the trash, shut down home theater computer, etc) that isn't realistic to pack or do in advance. Still a work in progress, but it really helps free up mental energy.
I am struggling with how to best organize the items within a section. You have given me some ideas. Thank you.
(Shameless plug from a happy user: I rely heavily on the Things app for Mac and iOS)
I wish I knew this when I was 30.
I get lots of credit for the former, but maybe one in five people see the latter as the bigger contribution.
We end up having to deal with things when we are tired. You have to make them so an idiot can do them, because some day you will be that idiot. All day exhausting meeting followed by a major emergency. Kid up half the night with a fever. New video game just came out. Bad dreams, whatever.
When I hit 50 I started making lists like a mofo, because I realized it would relieve my cognitive load. And it did, big time.
They are especially handy when on multi-stop travel where I'm spending all my time worrying about the logistics of the travel and meetings. It has definitely saved me from losing a number of phone chargers and razors over the years.
I've realized that there is quite a bit of overlap between some of my lists and have been thinking that I'd like it to be a modular system. A checklist consists of a any number of items and sublists so that one can quickly combine them.
For instance, travel might optionally include the sublist abroad and/or skiing or summer. A work-related trip might add another set of items etc.
I bet there are apps for this and I think I found a few when looking, but I'm afraid of the managing overhead and would like access to it on my phone and computers without cloud bloat. Maybe git + vim-wiki or something is good enough (would also work well enough on an android phone with termux).
I've found that using checklists helps tremendously when working on medium to large projects (things that take more than a weekend to complete).
For example, if I want to learn a new technology, maybe I'll get a book on python, add the list of chapters in my projects tracking document, and strike them off one by one.
That sense of steady progress helps tremendously.
Also checklists make it very easy to just get started.. just begin with the first task
And last but not least - I use checklists especially for things that I do NOT want to do at all (but I will have to do anyway). I am already annoyed (for whatever reason) by that task - so I want to minimize the amount of time I have to spend dealing with it. Therefore I use a checklist with the minimal amount of necessary steps to solve that problem or task, so I can get rid of it as fast as possible.
My messy stacks of papers made me look disorganized, but I could find anything important within ten minutes. In contrast, we routinely tore the house apart for an hour looking for something of my husband's.
He liked to organize and file and alphabetize. But the things he failed to organize often ended up in a heap on the floor. He did all that because he couldn't keep track of it mentally.
If your life works without checklists, don't worry about it. But if you find you start overlooking important details as you get older/busier/in a new and unfamiliar situation, you might revisit the idea.
Just don't rain on someone else's parade. Check lists work well for many situations and are especially valuable when lives are on the line for some reason (or similarly critical situations where mistakes often happen for various reasons).
I rely a lot on habits of that sort, which may be part of why I'm not big on lists for my own life.
Pretty much anything I have to do more than once, that involves more than a few steps, I make a checklist for. I take pictures sometimes, semi-professionally. I have a checklist for what to do before I take pictures (pack the bag, charge the batteries, clear the memory cards), and after (brighten teeth in pictures, remove lint/spots from clothes, pick photos to put in my portfolio). At work I have checklists for design tasks, some of which are things to do, some of which are things to consider (does this need a review from security? does this need additional monitoring?).
There are people that can keep all this stuff in their head. I’m not one of them and I know it. Having checklists reduces my anxiety levels by an order of magnitude.
- Shopping lists
- House errants (cleaning, maintenance)
- Recurring payments (tax, power, water)
- Car maintenance
- Reading lists
- Social (upcoming anniversaries, invitations, etc)
- Daily/weekly tasks
- Tax filing
- Server health checks
- Security checklists
In development, could be "pre-release/pre-push-to-production checks".
I've used them for video shoots too (e.g. pre-interview: "is camera charged? is extra battery on? are audio levels good? is frame ok? ND filter needed? took 10 second ambience audio sample? took b-roll?" etc.
Maybe for most things that you could use a checklist for, the effort just isn't worth it?
Writing down tasks saves you a lot of brain cycles and also removes worries, as otherwise you have to be constantly "refreshing cache" on pending tasks to not forget about them.
Things only stores checklists. Doesn’t share them.
First with a little training you can put mental reminders in your mind, trusting yourself that they will show up when needed. It also helps with keeping your brain and memory in good working condition, and force you to stay in mental clarity and not being so overworked and tired that you have to rely on external list.
Second it's not robust to rely 100% on a task list being completed, sometimes forgetting something means that it's not that important. It's more important to rely on situational awareness to know what's need to be done and in what priority. The logic behind is pick something from the hot mess and make the whole better.
Third we can automate and delegate more easily now, quite often if you need to use a checklist, a script would be even better.
It baffled me to learn that this is NOT the norm at hospitals. Due to the stress of a situation-gone-awry and inexperience, some horrific things can happen. In some situations you may only have a few minutes to enact corrective procedures. In any case without checklists (and without experience from running routine simulations) it's very easy to make mistakes or forget what to do.
I thought the checklists themselves were standard but it appears not...? The more I learn about hospitals' operating practice the more wary I become. I have no idea why hospitals aren't like the aviation industry and have checklists and expiring certifications. (Or maybe I heard wrong and I'm just completely wrong here.)
> Mead said the principal risk is a patient’s airway. He explained that a child’s breathing tube can collapse without warning under sedation.
> “It happens instantaneously,” he said. “You have maybe half a minute to make critical decisions about how you're going to manage that child's airway. You can't do that if you don't have somebody competent there helping you.”
Also, it wasn't a cost issue. The package was pretty cheap all told. The push back was in the "system getting in the way"...which was kind of the point unfortunately.
I have a private pilot license. This is not true at our level, and is very often not the case at the big companies. Everyone makes mistakes; firing all the mistake-makers would not end well.
One of the reasons aviation is so safe (excluding corporate coverups like what happened a couple of times with Boeing) is that there is an emphasis on learning and making sure that mistakes never happen again - to you or to other pilots.
I can't speak for professional aviation, but I would be very surprised if the safety ethos isn't similar. Ruining a career after a mistake only leads to covering up mistakes. Why the hell is this a systemic problem at all? It's obvious it won't work.
There is way too much litigation. Hospitals and staff are using defensive legal strategies-- obscuring docs, discouraging internal (written) investigation, delaying urgent treatment with unneeded consultation (to get more signatures on a decision).
IMO, there should be legal protection against malpractice lawsuits. Increasing the attack surface will not help with the core problem:
Doctors are over-worked, they are human and they make mistakes. The solution is to either enforce work conditions for doctors (and people die) or accept those mistakes (and people don't get money when they are on the wrong side of statistics)
What purpose does suing anyone for anything serve?
I don’t see too many doctors demanding to become employees (with far less personal liability) instead of independent contractors as they usually are. Getting the best of both worlds is asking for a lot.
It's also hard to insert checklists into established procedures. One thing you could do is attach them to important parts that are not allowed to be used until you read the checklist. For example, you could refuse to unwrap the main surgical pack until the pre-incision checklist is followed. Pharmacy could wrap the anesthetic induction drug in the first checklist. The surgeon could be responsible for signing the final checklist in order to get paid.
Keep checklists simple, use them every time. Put them in places where they have to be used.
Back when we used to burn "golden" CD-ROMs for releases: Our checklists were getting too unwieldy, we were still making mistakes.
So I started a Go/NoGo process, aka Roman Evaluation. Any one could stop the release for any reason. We'd fix the problem(s) identified, try again the next day.
(Of course, we fed each release's results back into process during the post mortems.)
These seem like very common-sense things to check - Is this the right patient? Are the instruments sterile? Have we counted all the surgical equipment after the procedure?
Maybe a shift-change caused the surgical team to be different from normal, so people aren't as comfortable with each other. There's social/professional pressure to fit within a hierarchy, especially with new people. Maybe a few people lower on the totem pole think something might be off, but don't want to say anything lest they risk appearing to undermine the surgeon.
So, at first it appears that a whole room of people would need to independently make the same mistake. But that's not so; only a few critical people need to make the mistake, and with enough ambiguity in the process (easily caused by anything happening 'out of the ordinary'), it won't be corrected some percentage of the time. Even seemingly trivial things.
The FAA found this occurring in the cockpit, especially from the '3rd seat'. A pilot and first officer may be 'in the weeds' dealing with the immediate threat of a situation, whereas others have the benefit of distance to reflect on a situation and observe more clearly. They don't get tunnel vision, and are in a better place to diagnose a tricky problem. However, they may not feel empowered to speak up, or feel they don't have the information the pilots do. Aviation has, broadly, sought to correct this and encourage anyone to speak up. Recently, this happened during the flight before the Indonesia 737 crash where similar AoA/MCAS issues occurred, but a 3rd pilot helped to address the situation.
[ ] Yes
[ ] Not available
[ ] Not applicable
2. If the document refers to a third party report, is it linked?
[ ] Yes
[ ] Not available online
[ ] Not applicable
3. Are background sources linked to high-quality, external sources?
[ ] At least 3 links present
[ ] We sat there for 1 minute and couldn't come up with anything that needs linking
4. Are needless generic internal links to category/tag pages etc. removed?
[ ] Yes
There seems to be a whole other list referenced: "Is the anaesthesia machine and medication check complete?"
Also the team are supposed to intro themselves along with their roles. I wonder if it often happens that someone is missing?
Surgeons don't need checklists because they don't make mistakes, unlike those filthy three dimensional bus and truck drivers. /s
Instead of adapting, they legislate.
And the fantasy that Physicians are unfailing experts leaves you after a you regularly interact with them.
Medical profession really comes across as arrogant and know-it-all, at least in my experience
Is that true of most professions? The difference being we only really care when lives or large quantities of money are at stake. Probably more the later and less the former unfortunately.
Cops and doctors (in that order) seem to be the biggest offenders when it comes to rejecting process improvements to the detriment of society but there's definitely others. It's not a binary value.
In the safest planes (commercial airliners), pilots have systems recording their control inputs, and these can be used to directly attribute damage to/loss of the airframe to pilot malfeasance; the shame of a clear screwup will be clearly documented and in most cases, divulged to the public.
Medical professionals, on the other hand, seem to face a lower standard of accountability simply because it's truly far more difficult (if not impossible in some cases) to monitor all the variables associated with treating a patient compared to monitoring human-designed systems. I have to wonder if this epistemic quagmire where cause and effect are not necessarily tracked (and in some cases, not even truly understood) leads to a mindset that is more willing to write off negative outcomes as the result of external factors (comorbidity, patient age, patient adherence to physician instructions, even pure luck/probability) than tackle the tough problem of correlating personal behaviors and actions to distinct outcomes.
That this also helps making doctor mistreatment claims hard to prove is hopefully an unintentional side effect. But you have to wonder...
I've advocated the use of checklists in software for decades. I wrote something 5 years ago and posted it here. The discussion was enlightening. Read the discussions, keeping in mind the comments here about the resistance encountered by people in the field.
Many of the points in the discussions are useful and can be used to create and adapt checklists, but no, they are being used to dismiss them out of hand.
Checklists? We don't need to stinkin' checklists.
I've given up and just use them in my companies.
I feel like I could use a checklist or two.
One of the others was testing furiously.
> The findings, reported in the April 17 British Journal of Surgery, are based on an analysis of 6.8 million operations performed between 2000 and 20014. The Surgical Safety Checklist was introduced in Scotland in 2008 as part of the Scottish Patient Safety Programme, and by 2014 the rate had decreased by 36.6 percent over six years to 0.46 deaths per 100 procedures. Researchers noted that this fall in death rates was not seen in patients who did not have surgery.
>I've been getting so upset at the medical community recently
Don't confuse media narratives with what's actually going on in the medical community. It's a sure-fire way to get (a) upset, and (b) entirely misled. Medical science has been a major target for media FUD for ages.