14 KEYS TO CREATE A CHECKLIST

LET'S IMAGINE YOU ARE A senior manager and you have the opportunity to increase productivity, workers' safety, team morale and become a more effective team.

Just like with the TV infomercial there is more!

This opportunity will close more sales, increase the top line, reduce re-work and increase the profitability of the organisation. And it is not going to cost you big bucks- for new tooling, equipment, training and more personnel.

You would be crazy, if not negligent, not to at least find out more about this wonderkid of a development ? Yes? Yes!

Atul Gawande (@Atul_Gawande) in his book Checklist Manifesto writes of the origin of Checklists. A successful surgeon and author Gawande draws on his own experience to operate, literally, in a world of growing complexity.

At first, he writes of his own experience in the world medicine but broadens it to take in all areas of our community and life. Gawande was concerned by the exponential increase of surgical operations worldwide combined with complexity and specialisation of medicine, resulting in millions of deaths and disabilities that were not decreasing with the economies of scale.

With investigation, Atul realised, that level of death and disabilities from surgery came not so much from the fault of ignorance of knowledge, this was progressively being addressed by training and research break through, but the simple known aspects overlooked. What Gawande called ineptitude, where the knowledge exists but failed to be applied correctly.

Atul was asked by World Health Organisation (WHO) to improve Patient Care but without the support of a budget to invest in equipment or major training. He proposed Checklists be trialled in 8 hospitals in both developing and developed countries.

The result was a significant reduction in death and disabilities. It is now being rolled out in hospitals globally.

Checklists are not a To Do List.

Related but TO DO LIST is an endless list of things- both important and non important. A transactional, an analogue process which is often largely filled with just stuff (technical term is Crap).

A Checklist is concise and brief, comprising important items which MUST be done that moves us towards our Purpose or Goals. It is strategic 'must do’, having significant effect if it is not exercised.

Importantly Checklists will have a major effect on an organisation's results if the concept is understood and implemented in a correct manner. Its application doesn't require new million dollar machinery. Does not affect CapEx. In fact the cost to implement is minuscule . It's ROI incredible and impressive.

But it does require a much greater effort. It requires THINKING and Discipline to commitment.

But any CEO or Senior Manager has the courage to implement will be rewarded by great results and accolades.

Embracing Checklists will:

• Gain more prospects and clients-if included on a sales representatives Sales call Checklist, i.e. Last action before end of call: 'Ask for Referral’.
• Prevent error in prescribing drugs in Emergency (which happened to the writer’s relative and was fatal).
• Reduce rework (e.g., as simple as 'measure twice, cut once’).
• Get one last sale: 'Fries with that?'
• Facilitate cross selling ( ‘now is there anything we can further help you with…financial planning?"
• Focus employees in meetings (" Lets be clear on the purpose of todays meeting").

What's in it for me?

• Brings Focus to yourself, managers' and team as to what is important and what should be in focus
• Gives senior managers influence right to the frontline on correct process and procedures
• Ensures safety guidelines and shows diligence by senior managers to ensure they are complied- considering serious penalties for not following can be jail time.

14 Keys to Checklists 

1/ Know the difference between a Checklist and To Do List (often used wrongly and interchangeably).

2/ Ask what is the purpose of introducing a Checklist.

3/ Know that Checklists are limited to finite number of points - this could vary depending on the process but kept ideally kept to a minimum (a manageable and critical 5-7 items in many areas).

4/ Expressed in simple easy to understand language.

5/ Items included are 'must do', strategically aligned with the purpose and goals.

6/ Does not include items not regarded as important that would be done as a matter of course.

7/ The Checklist should be tested and trialled in operation until the correct items and number included are agreed.

8/ Implemented with a training program so there relevance and importance is understood and contrast to a To Do List.

9/ Can be Do and then Checkoff, or Check then Do.

10/ Could take a couple of minutes ( 90 seconds to 2 minutes- ideal to administer or complete).

11/ Checklist may be undertaken at pause points ( aircraft crew before pushback and then cockpit crew immediately before takeoff ).

12/ Could be adopted by a single person as a reminder and personal disciple to stay on track and help with their personal focus, or as an effective medium to coordinate a high performing team.

13/ Slowly introduce into your business where you can supervise the introduction.

14/ Must become a habit through repetition and used 100% at all times by senior management. ( Who are not exempt, or above the process because of rank.)

Be warned. As simple and as effective as Checklists are they will not be embraced by all in your business. There will be some who question their value, of having some of the items included and why it has to be strictly followed EVERY time.

These people, who are likely to pushback, should be consulted early and asked for their input, and understand why their support is crucial to the adoption of the new process of Checklists. They are often the most senior and most experienced. But also the most influential in adoption of change.

Atul Gawande acknowledges the pace and complexity of change has driven the necessity.

The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us." 

It is a long way and time from the origin of Checklists, back to a 1936 crash of the prototype US military plane. An event which shaped the pre flight lists we are all familiar with flying, that have saved possibly millions of lives.

The origin of Checklists can be seen in the link to a preceding post:

http://www.linkedin.com/pulse/article/how-old-ww2-bomber-can-effect-your-bottomline-d-keith-millar/edit

In summary, senior managers willing to implement the merits of Checklists will not be disappointed with outstanding results and accolades on offer for their leadership.

if you found this blog interesting and of value we invite you to LIKE and SHARE for others also to gain from the benefits of CHECKLISTS. 

OTHER POSTS INCLUDE:

• Darwin Awards for Sales people
• What is your Coaching philosophy
• Remarkable People leave their mark

Checklists saves Lives and Dollars

 

Okay, okay I am a convinced.

"To what?” You ask.

To the importance and the necessity in today’s complex world of #Checklists.

There very existence has directly affected our freedom, the way we travel and our and our families’ health, big time.

Please let me explain. Beginning with a plane crash.

On October 30, 1935 at Wright Air Field in Dayton, Ohio a prototype military aircraft took off captained by Boeing’s most experienced test pilot, Major Ployer Hill.

This was no ordinary bomber. Nor was it just a run of the mill test flight (if there is such a thing).

The new super bomber was powered by 4 powerful engines, which would allow it to fly faster and twice as long than previous bombers and carry 5 times more bombs than the military requested. But this major advancement would come at a supreme price in that it was far more complex than any comparable military aircraft flown.

The flight was a trial to win the lucrative contract to be awarded by the US government at the lead up to the second world war.

The bomber crashed shortly after take off killing the experienced test pilot and another of the five member crew. Seemingly putting an end to the bombers possible inclusion in the US air force. In a subsequent inquiry it was deemed the aircraft with its four engines to complex for ordinary human beings to fly irrespective of their experience and capability.

End of story. Not quite.

A group comprising Boeing engineers, and a group of experienced test pilots, addressed the idea of complexity advocating and later to be adopted the measure of a checklist to overcome the frailty of the human memory and ability for the brain to operate in a high pressure environment. The result was the advent of the pre-flight checklist. The forerunner of what we all know and what gives us comfort in knowing that before each flight, there is a group of people at the pointy end running through a check list.

“Okay we have two engines, check, two wings-a starboard and a port, check…” Maybe not to that extent but those items critical to the well being and safety of the souls aboard.

Just like the many commercial applications that have spurned from the aviation and space industry you would have expected the Checklist to be another common day application in the making (remember plastic, teflon, navsat came from such developments).

Not so.

Fast forward 75 years.

The explosion of surgical operations worldwide (in 2004 230 million operations annually) resulting in 3-17% complication rate leaving 7million disabled and one million dead.

And has not seen an improvement from such scaling up the explosion in surgical operations. It was of such concern that the World Health Organisation wanted to address this major problem, but with no budget.

Hmm! Big problem. The question was how could surgery become safer but without the resource of money to promote the idea.

Enter a young surgeon with Bollywood  looks, not only the Brad Pit of his game but a fellow professor at Harvard Medical School.

Atul Gawande ( @Atul_Gawande), the learned professor, come surgeon had been seeking the answer why there were so many injuries and death from surgery.He saw that errors came in two forms. The first from insufficient knowledge and the second from incompetence, or ineptitude as he phrases.

Further training and better equipment could address the first. However the complexity of surgical operations resulted in the flourishing of ‘dumb’ errors by skilled surgeons and their surgery team who should have known better. It was in the ‘dumb stuff by experienced theatre staff that this proportion of theses errors were outgrowing the first of insufficient knowledge.

Atul began to develop on the idea of a Checklist adopted into surgery in early 2000 by surgeon Dr Peter Pronovost. The concept borrowed from Boeing, the sophisticated TO Do List and Project Management tool builders used to create the complex Skyscrapers , and dated back to the 1935 Boeing bomber prototype crash.

With WHO support and encouragement Gawanda arranged a trial run in 8 hospitals
 globally- spread over developed nations and poor countries. 

With no budget it relied on the goodwill and visionary of both Gawanda and the respective hospital management. The results were outstanding.From these initial results the Checklist program has rolled out globally and still the results outstanding, and an obvious success.

His greatest challenge was the ego, and gravitas of the surgeons and their teams who saw the Checklist as below them and challenged that they weren’t experienced to know what they were doing. On the contrary it was that they were highly skilled and experienced that they used short cuts and overlooked boring incidentals and the most basic but critical decisions and process. Even Gawande admits to mistakes he made while surgery that nearly killed a patient only saved because his surgery team followed the checklist.

The Checklist is more than a To Do List, it is concise list of key (i.e. Gawende calls killer steps) that must be followed.

It is surprising that it has taken three quarters of a century to be broadly adopted by the business community.You will ask: Has its application to business and management realised the sort of benefits experienced by the aviation and medical sector? You betcha.

It is has as much potential to affect productivity and decision making just as when Bethlehem Steel owner Charles Schwab parted company with serious money to reward a consultant to review how the steel work process can be improved. And the humble spiral note book become the 'it ‘ business accessory of the day.

Where else could the Checklist have relevance and major impact? Just about every aspect of life when applied. It has the potential to increase results, save money and has been shown save lives.

Such a tool when adopted could help close more sales, reduce rework, increase health and safety effectiveness , improve the performance of athletes, even help improve the results of investment decisions (as outlined by Gawande). And more, only limited by our imagination.

So what is the secret to developing a Checklist:

• It is simple and concise ( with no more than 7 items)
• Unlike a To Do list it only lists the critical points that must be undertaken ( Gawanda calls these killer items)
• Ideally used in groups of 2 or more people relies on people knowing each other and their roles
• Must be user friendly
• Can be Check and Do or Check then Do, in its form
• Takes 90 seconds to 2 minutes max. to complete
• Tested and refined in real life situations
• Can be done at specific pause points ( planes do it before they push back from the terminal then just before they rumble down the tarmac)

In summary the complexity that we now find ourselves apart has gone beyond the capability of one human being ( irrespective of how smart he or she could be).

Without an aid such as Checklist to human frailty and fallibility of the human memory. As Atul in his book #Checklist Manifesto makes mention the Checklist can best be used when there is humility by the decision makers in critical and complex stages and no longer the domain of one superhuman being.

If you are a leader in any area of the economy and looking to quantum improvement, and want to reap the reward of not relying on major investment or cost. With an effective communication and implementation program the Checklist is a no brainer. Even 75 years later after the initial Checklist came into use, it is still the potential force majeure.

Even in writing this blog using a Checklist:

• Identify topic
• Research and draft key points
• First draft
• Final Draft , sub edit, proof, spell & grammar check
• Headline- test
• Image- test

Seems okay . Now press Publish.