• Jim Payne

Using Checklists for Systems Improvements

Here is an interesting comparison. Hospital mistakes kill more than 250,000 people each year. Yet airlines, with arguably processes that are just as complicated, rarely kill anyone. How can this be?

It could be that the reason is that airline pilots make extensive use of checklists. This observation comes from Dr. Atul Gawande in the book The Checklist Manifesto. Pilots use all kinds of checklists from preflight to shut down. There are also checklists for various emergencies such as what to do if there is a fire, an engine out, or the galley runs out of coffee. Hospitals on the other hand rarely use checklists.


While you would think that washing your hands before touching a patient would be so ingrained in medical people that they would do it without thinking. Apparently, that is not the case. Sample testing groups were setup in some hospitals which required people to sign off on a checklist that they had washed their hands. These groups had a significant drop in patient infections. The lesson here is that steps that we think can be done without thought are missed on a regular basis.


This is worth thinking about by business owners. We all have some processes that are critical to our success and others that are not so critical. Checklists could be the answer to getting those critical ones right every time. Just imagine what it might be like to run a business that rarely makes a procedural error.

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