Checklists save lives, enhance teamwork, enrich leadership

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In October 1935, at a military air base near Dayton, Ohio, a competition took place that changed the course of aviation history.

An experimental long-range bomber took to the air. It took off, turned out of the traffic pattern, rolled over and crashed. The pilot was the most experienced test pilot in the Army Air Corps.

THE ACCIDENT investigation showed that flying this new airplane using one pilot and no checklists could – and did – lead to disaster. Hence, it was in 1936 that the use of checklists in the cockpits of airplanes became the norm. The test airplane, built by Boeing, that crashed that day was to become the B-17, the most successful long-range bomber in the war in Europe.

This story of airplanes and checklists is outlined in a brilliant book: The Checklist Manifesto: How to Get Things Right, by Atul Gawande.

Taking the aviation lessons of the 1930s and applying them to the medical profession, Dr. Gawande has gained some important insights. He has demonstrated that operating rooms that routinely use standardized checklists in a sophisticated way have a much lower error rate and death rate than those operating rooms that don’t use checklists, use them only occasionally or use them haphazardly.

According to Dr. Gawande, a big breakthrough in the use of checklists in operating rooms came at Johns Hopkins University Hospital after using standardized checklists for a period of time. The leaders of this hospital, often ranked as the best hospital in America, made the decision to give nurses the power to remind doctors when they had missed a step in a checklist. To quote Dr. Gawande: “The new rule made it clear: If doctors didn’t follow every step, the nurses would have backup from the administration to intervene.”

ANOTHER AREA in which the systematic use of carefully crafted checklists can lead to better safety and more efficiency is in the construction of very large and very tall buildings. In this area, the checklists are focused largely on communication tasks. The 16 (or more) top leaders of the building trades are required, on a tightly scheduled basis, to meet and make decisions on when and how to go forward. The vital lesson here is that when key leaders are required to communicate, the result is better teamwork, fewer work stoppages and greater productivity.

The use of checklists to enhance safety in airplanes, hospitals and construction sites is only part of the story. Checklists, by enhancing communications,
teamwork and productivity, ultimately enhance leadership. Leaders of large organizations can better exercise a key element of leadership – trust – if they know that the use of well-designed checklists are an essential element of the work of every employee and associate.

WHEN JEFF FOLEY and I worked together this past year to produce the fourth edition of Rules and Tools for Leaders, we felt it essential that this practical guidebook should include handy, easy-to-use checklists. Hence, in this book there are checklists on introspection, hiring, firing, making decisions, handling crises, thanking associates, conducting meetings, managing electronic devices and dealing with the media. There is even a 25-step checklist on fund-raising.

So how can this discussion be of help to you? If you are about to raise money for a good cause, examine a fund-raising checklist. If you’re about to be interviewed for a new job and want to anticipate the questions you may be asked, study a hiring checklist. Dealing with a crisis in your job, your family or your church? Take a look at a crisis management checklist.

One caution: Checklists, if used too rigidly or not kept up to date, can lead to bureaucratic “checklist management.” Hence, everyone should monitor checklists and their uses to ensure they don’t become counterproductive.

PLEASE NOTE: Jeff Foley and I will be conducting a number of book signing sessions in the Augusta area between now and Christmas. Open to be public will be a session at the Augusta Museum of History from 4 to 5:30 p.m. Nov. 26. The books Rules and Tools for Leaders and Medal of Honor will be on sale at large discounts.

Incidentally, this is a grand time to visit the museum. It will be open every day of Thanksgiving week (except for Thanksgiving Day), and on display in the museum’s rotunda will be the always-popular holiday gingerbread village creations.

(The writer – a retired U.S. Air Force major general – is the secretary of the Congressional Medal of Honor Foundation. His email address is

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Riverman1 11/03/13 - 06:53 am
Yes, Yes, Yes

Yes, yes, yes. I could give you many examples in my field. I use checklists every single day that I have personally come up with. As many years as I've done my job, I MAKE myself do a written and mental checklist constantly. When things are going along smoothly, it's time to go over your checklist once again to ensure something hasn't changed and slipped up on you.

deestafford 11/03/13 - 10:07 am
One very successful management technique for leaders is to make

a checklist at the end of the day of the five top things to do in priority the next day and then do them with no interference or distractions with the exception of REAL emergencies. This allows the leader to focus on what HE believes is the most important things to be done...not what others think is the most important. Of course, sometimes bosses above one will impose tasks that changes one's priorities but is usually seldom.

avidreader 11/03/13 - 10:32 am

It is extremely easy to become distracted in an educational setting. My daily checklist keeps me focused, and I seldom stray from my objectives. Public educators teach the Common Core standards. Every time I teach a standard, I check it off. As the school year progresses, I see the check marks in front of me. As examples, I know how many times I have included "inferential reading skills" or "contextual vocabulary clues" in my lessons.

However, I have to admit that I am anal retentive! At least that's what my wife says. I like to refer to it as being well organized.

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