Checklists have been responsible for reducing infections in intensive care units by 66%. They took an aircraft type, which initially crashed on a demonstration flight, to operating over 1.8 million miles without incident. They rescue drowning victims, keep skyscrapers standing up, and are responsible for saving countless lives.
So how can, as Mr. Gawande puts it, “a stupid little checklist” be so powerful, especially when the people using them are very smart, educated, and come loaded with experience (i.e. doctors and lawyers)? The short answer is they reduce complexity:
Four generations after the first aviation checklists went into use, a lesson is emerging: checklists seem able to defend anyone, even the experienced, against failure in many more tasks than we realized. They provide a kind of cognitive net. They catch mental flaws inherent in all of us — flaws of memory and attention and thoroughness. And because they do, they raise wide, unexpected posibilities.
But a good checklist is like a good wine: it has be cultivated with great care, and have certain characteristics in order to not be immediately worthless. So mind the following:
1) Checklists should be brief. Usually just a few lines on a single page.
2) Never include anything vague or imprecise.
3) Do not spell out every single step. Provide reminders of only the most critical and important steps.
4) Shoot for efficiency and ease of use, even in the most difficult of situations.
5) Shoot for between 5 and 9 items.
6) Make sure language is crystal clear. Avoid colors or distractions on the page, and employ a large sans-serif font.
7) Checklists should be tested by those using them in real-world situations.