The Simple Genius of Checklists(blog.nuclino.com) |
The Simple Genius of Checklists(blog.nuclino.com) |
Note that a flight-training generation is less than a human reproductive generation; it's the time from first lesson taken to first lesson taught (plus some). It had to wait for the older instructors to retire.
We are still in transition, in medicine. Many physicians have not yet cottoned to hand-washing, yet.
Anyone with medical knowledge, feel free to inform me if that idea is totally off-base.
What?!? How many generations has it been since Louis Pasteur?
This isn't really true. They know it's important.
1) Have you ever washed your hands 12 times a day for a week? Think about what your hands would be like.
2) Washing hands properly takes somewhere around 2 minutes. That's a significant fraction of an hour--just spent washing your hands.
Given this, disposable gloves seem like a much better answer.
It gave me the idea to great a free open source mobile app called Umbrella. It's a free, open source app with dozens of best practice lessons and checklists on digital and physical security. The idea being to help people at risk (travellers, journalists, aid workers, activists etc) have somewhere to turn to in an emergency. Everything from sending a secure mail to dealing with a kidnap. You can read more about it at https://www.secfirst.org or try the checklists for yourself https://itunes.apple.com/us/app/umbrella-security/id14537153... or https://play.google.com/store/apps/details?id=org.secfirst.u...
What I'd like is something where you can set a per-checklist timeout after which the list resets everything to unchecked and maybe allow two different ways to view each checklist (or modes): 1. All at once with little check marks that you can check in any order 2. Strictly ordered checklists where you only see the current task and check it to get to the next, ideally with a "3/14" indicator or progress bar to know how far you've got through the checklist.
Which apps can you recommend?
Taking the good kidney out instead of the diseased one is practically murder.
In IT, some cases are obvious (such as deploying new releases). However, if a process is so repeatable that you could have an accurate checklist, then you could probably automate the process and eliminate the need for the checklist.
I would love to know what parts of my life I could relegate to checklists so I could free my mind to focus on just the things that I excel at...
My main feedback from having witnessed thousands of organizations set up their checklists is that they can be used to help teams succeed and they can be used in an oppressive way to "ensure people do what they're supposed to do". Almost always they contain too many steps compared to what they should have and that is usually because the people creating/editing the checklists are often not the users of the actual checklist. When the users and editors are the same people, then the quality of the checklist goes up. We use our own tool on a daily bases for processes that have high risks or for processes that we don't do very often. They are great safety nets.
http://www.projectcheck.org/uploads/1/0/9/0/1090835/checklis...
https://www.bbc.co.uk/programmes/b00729d9/episodes/player?pa...
EDIT: I pressed "update" with my sausage fingers before I wrote anything coherent.
Some improvements that can be done:
1. Divide the checklist into "required", "lower priority" and "optional" sections. Will help in just focusing on "required" for time critical implementations, and tackle the rest later if needed.
2. Eliminate requiring evidence and start trusting. If trust is broken (found via audit) then take action. Don't penalize everyone for the mistakes of a few.
3. Add examples for vague cases. Having pre-polulated dropdowns are better than open ended questions. Just add a comments column / field if needed.
4. 200 questions? Seems like overkill. And if all are necessary, then make sure management knows the time that it will take to fill, verify, rectify and submit that sheet.
Questions that irrelevant should be removed from the checklist. When things are found that have been missed, they should be added.
When used properly they do remove stress and free up mental space. If you travel a lot, making a checklist of what to pack makes it so much easier to leave the house.
Manual Work Is A Bug: https://queue.acm.org/detail.cfm?id=3197520
Makes a lot of sense and something I advocate for in my department.
I’ve done a procedure 100 or a 1000 times? Still going down the checklist in the Tech Manual every single time.
Humans can’t multitask well and if you miss a step, people can die and planes could crash.
Obviously, in a field like investing no checklist is perfect but at-least it'll help you avoid common pitfalls.
Source: Many of their shareholder's letters contain references to their approach. I found another one online.
[1]https://hurricanecapital.wordpress.com/2016/08/12/the-buffet...
A lot was learned, some of it costly stuff that we as a species really didn't need to pay for again, and some things that were new and valuable as a result of failure that ethnically could never be intentionally replicated.
One of the better lessons might be to avoid deviating from pre-planned test procedures, and for every major step to have an 'abort' path (or two) for safely entering either safety or normal operating procedures.
Or is it more about why checklists are good?
I was also poor, which means there was no way to enforce my internal policy which means today, 20 years later, I'm using 99% of my brain power to solve issues a simple state/high-powered enforcement checklist would do.
At my 90%+ I still dreamed of a better future. Now I only wish my own death. Tomorrow I hope and make sure you all die.
[citation needed]
If nobody replies with a quality app that does this, I'm going to make it for myself and share it here.
This needs to be configurable because it depends on task frequency and how long a checked checklist stays relevant.
It might be overkill, just having an easily accessable (but not to easy?) reset button for each list might work as well.
Also, I haven't read the book yet, so my requirements might not be the best.
The checklist is (a key part of) the documentation for the automated solution, and would not, as such, stop being necessary just because the automated solution existed; it would be a key resource for change management.
Automation eliminates the need for the people acting on the checklist, not the checklist itself.
To flip this on its head though, writing (and following) a checklist for a process is perhaps a good first step to automating it.
I've seen checklists abused, however, in project management. Where some folks are apt to generate a "one-size-fits-all" checklist for every project large or small. It ends up becoming boilerplate, and worse, people take their tasks less seriously if trivial, nebulous or non-applicable stuff is grouped onto the same footing as things which take hard work. Everything ends up being a checklist item with check-box and a date on it.
First getting up in the morning
Leave the house
Leaving the garage
Parking in the parking lot
Starting work in the morning
Leaving work
Parking in the garage
Arriving in gym locker room
Leaving gym locker room
Packing for a trip
Unpacking from a trip
The bugaboo is an interruption that could make you forget a step. Or forget to memorize something.
I often bring two plug adapters, as there's always another guy at the conference who forgot his :-)
Checklist templates that repeat based on day of week; auto-archive after X days. Tools for organization into groups, subgroups, etc. A way to view completion over time.
I use it for daily things (daily autocreate, daily autoarchive), weekly things, monthly things, and things I do in order but without a set time (manual creation and... autocreation after completion? no i dont think that's a feature).
Wonderful app for implementing checklists and it's a cornerstone is my toolbox for making sure I'm living my life with intension.
Yet, it's long abandoned and I dont know if it's still for sale in the app store. Probably made little money in a sea of Todo apps.
- distinguish Read-Do- - Pause-Points - Read-Do vs. Do-Confirm - 5--9 items - Only killer items - No clutter and unnecessary colors - Wording simple and exact - Use language of the profession - Fit on one page - Has to be tested in the real world - Also don’t forget Communication checks
And about 150 years, so 4-5 generations of surgeons. Not exactly many.
Two or three are absolutely fastidious about hand washing.
The rest are not.
- The CEO's semi-monthly emails have either contained a) reminders to get the flu shot in flu season and b) statements about washing hands.
- Thirty minutes of your new employee orientation is used to discuss handwashing with some funny stories about diarrhea and they go around to every single person to make sure they're washing them correctly.
- Upon entering a patient room, anyone entering is supposed to wash their hands
- Anyone can call out a doctor and ask if they've washed their hands and there are signs to make patients comfortable asking them to do so as well.
So yeah, 2019 and people still need all that as reminders.
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.
Among this cohort, the mean self-estimated handwashing rate was 73% (range, 50%-95%), compared with the covertly observed rate for this cohort of 8.6% before and 10.8% after patient contact, with an individual mean rate of 10% (range, 0-33%).
[1] https://www.mja.com.au/journal/1996/164/7/teaching-hospital-...
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.