Spotlighting the Importance of Checklists

Do you consider workplace checklists an important part of ensuring all necessary safe work procedures are consistently followed? Or do you consider a checklist a slow, tedious, and largely unnecessary procedure for work you already know how to do?
Here are two interesting accounts where checklists have been used to great effect. One is a matter of history that changed an industry, and the other occurred much more recently, demonstrating that there can be human resistance to following demonstrably better procedures.
Boeing B-17 and the First Checklist

On a B-17 test flight, in 1935, the aircraft stalled on takeoff because the elevator lock was accidentally left on, and pitch control didn’t work. Three men were injured, and two later died.
Because this new airplane was much more complicated to fly, it was determined that even experienced pilots would need a checklist. Instead of relying on memory every time, a checklist would ensure that all necessary steps were completed to keep the airplane safely in the air. Because of this simple, new process, Boeing was able to get the government to mass produce the B-17, and it went on to be a very successful asset for the United States in World War II.
Believe it or not, Boeing’s checklist is considered the first. Certainly, checklists are a very common practice in aviation today, where a focus on safety requires numerous variables to be checked before every flight. There are more than 25,000 daily commercial flights in the U.S. each day.
Hospital Checklist Slashes Infection Rates
In 2003, Dr. Peter J. Pronovost established a simple, five-step checklist to be followed every time a common catheter (central venous catheter) was inserted at 108 intensive-care units in Michigan. Over 18 months, catheter-related infection rates dropped from 4% to 0, saving 1,500 lives and nearly $200 million.
As you can see, the checklist is as simple as it gets:

1. Wash hands with soap.
2. Clean patient’s skin with chlorhexidine antiseptic.
3. Put sterile drapes over the entire patient.
4. Wear a sterile mask, hat, gown and gloves.
5. Put a sterile dressing over the catheter site.

According to Dr. Pronovost, he wanted to change behavior, which he says is the biggest opportunity to improve health care. Still hospitals lag in implementing similar checklists. However in the news, the CDC procedures where health care workers who may come into contact with Ebola patients will have another person guide them through the step by step process of putting on and removing PPE amounts to a checklist.
Some reasons people resist using checklists include:

• Experts such as doctors don’t want to be monitored by others
• Experts want to have the freedom to act as they see fit
• Standardized tasks are associated with bureaucracy, and more paperwork
• There is a focus on new medical procedures rather than ensuring current ones are enforced

Checklists in the Workplace

So, looking at these two examples, can you see where workplace safety can benefit from following a checklist? Anywhere a series of steps has to be followed correctly every time, a checklist can be implemented to make sure everything has been covered and nothing is missed.
Here are a few places where creating a checklist may be helpful:

• Making sure a first-aid kit is fully stocked with necessary materials
• Daily and monthly inspections of vehicles such as: forklifts, cranes, and ladders
  
• Annual workplace inspections
• PPE maintenance and repair schedules
• Required monthly and quarterly fire-extinguisher inspections
• Equipment inspection and repair schedules
• Start-up and shutdown procedures
• Established lockout/tagout procedures