The holy grail of checklists may be the one created by Dr. Peter Pronovost of the Johns Hopkins University School of Medicine. Intensive-care units (ICUs) often use intravenous lines to deliver medication, and these lines can become infected, causing nasty health complications. Pronovost, frustrated by these preventable events, compiled a five-step checklist.
The checklist contained straightforward advice: Doctors should wash their hands before inserting an IV, a patient’s skin should be cleaned with antiseptic at the point of insertion, and so forth. There was no new science and nothing controversial – only the results were surprising. When Michigan ICUs put the checklist into practice over a period of 18 months, line infections were virtually eliminated, saving the hospitals an estimated $175 million, because they no longer had to treat the associated complications. Oh, and it saved about 1500 lives.
How can something so simple be so powerful? Checklists are good because they can educate people about the best course of action, showing them the ironclad right way to do something. As Pronovost told Atul Gawande in The New Yorker last winter, his five steps were black and white and backed by solid medical research. You could ignore the checklist, but you couldn’t dispute it.
Checklist simply make big screwups less likely. “We wanted people to standardize on the mission-critical elements – the areas where we have the strongest evidence,” Pronovost says. “And these things that are mission critical, we’ve got to do them every time.”
What does your business have to do every time? Put it in a checklist. You may not save a life, but you’ll avoid a painful blind spot.
Source: Heath, Dan & Heath, Chip. 2008. The Heroic Checklist. Fast Company, March 2008.
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