The Power of Checklists

A small hospital in Austria saves a 3 year old hypothermia/drowning victim who had stopped breathing for over 6 hours.

An airline experiences severe engine throttle back due to sudden loss in fuel, the pilot recovers the engine by throttling back even more despite his intuition screaming at him to throttle up.

A hospital reduces central line infection rates from 11% to zero, resulting in saving 8 lives and two million dollars.

A 49 year old man burns 10% more calories than his personal best immediately after writing down 5 items on a piece of paper.

Although the last example (mine) is not as powerful as the other three, all four have one thing in common. They unlock the power of a checklist. The first three examples are from an excellent book called ‘Checklist Manifesto’ by Atul Gawande.

You may be thinking one of two things; either ‘I love checklists’ or ‘what’s the difference between a checklist and a to-do list’.

A to-do list is like a laundry list or a grocery list. A checklist pushes you to peak performance.

Checklists work in  life or death situations – and let’s face it – we’re all in a life or death situation as long as you expand or contract the timeline accordingly.

In the case of the Austrian hospital, the 911 operator followed a checklist immediately after taking the call and dispatching rescue operations. The checklist allowed the operator to ensure every single expert needed was ready and waiting at the hospital with complex equipment that was in perfect working order. If any one of those people were not there or piece of equipment malfunctioning, the little girl would have stayed dead.

Dr. Peter Pronovost created a simple checklist for performing the central line insertion procedure. Five simple yet powerful steps –  1. Wash Hands 2. Use Antiseptic 3. Wear a mask, gown and gloves 4. Drape the patient 5. Use sterilized dressing on the site. At least one of these steps was being missed at least thirty percent of the time. Nurses had the authority to halt the procedure if all 5 steps were not being followed.

An investigation revealed that a plane which had followed the polar flight path had developed ice crystals in the fuel. These crystals bunched together and clogged the engine’s fuel intake. If you’re a pilot and your plane experiences sudden power loss, you don’t want to read about polar flight path ice crystal investigation findings. You want to read: THROTTLE BACK.

If you can order a book from Amazon, you can execute a checklist. You don’t need ‘Amazon book ordering’ training. Now, imagine if you do have specific skills. A unique checklist designed to call on your specialized skills in a specific situation is like having super powers.

My exercise bike checklist pushes me like a personal trainer.

  1. 00:00 – 07:00 – Take-off – Set Working Load (12-13)@95 RPM – MAX HR 150
  2. 07:00 – 30:00 – Oscillate – [(15-16) – (10-11)]@95 RPM – MAX HR 160
  3. 30:00 – 32:00 – Tumble – (10-11)@85 RPM
  4. 32:00 – 35:00 – Approach – (11-12-13)@90 RPM – MAX HR 150
  5. 35:00 – 40:00 – Land – (10-11)@85 RPM – READ CALS
After a   while this checklist will become a specialized skill called 40 Minute TOTAL Cals

Welcome to the nerd side, we have pi.

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