A checklist is a type of job aid used to reduce failure by compensating for potential limits of human memory and attention. It helps to ensure consistency and completeness in carrying out a task. A basic example is the "to do list". A more advanced checklist would be a schedule, which lays out tasks to be done according to time of day or other factors. A primary task in checklist is documentation of the task and auditing against the documentation.
Use of a written checklist can reduce any tendency to avoid, omit or neglect important steps in any task.
A pilot of a DC-10
consulting his checklist
- Pre-flight checklists aid in aviation safety to ensure that critical items are not overlooked.
- Used in quality assurance of software engineering, to check process compliance, code standardization and error prevention, and others.
- Often used in industry in operations procedures
- In civil litigation to deal with the complexity of discovery and motions practice. An example is the open-source litigation checklist.
- Can aid in mitigating claims of negligence in public liability claims by providing evidence of a risk management system being in place
- Used by some investors as a critical part of their investment process
- An ornithological checklist (Category:Ornithological checklists), a list of birds with standardized names that helps ornithologists communicate with the public without the use of scientific names in Latin
- A popular tool for tracking sports card collections. Randomly inserted in packs, checklist cards provide information on the contents of sports card set.
- The creation of emergency survival kits
- In professional diving, checklists are used in the preparation of equipment for a dive, and to ensure that the diver and life support systems are fully prepared before they enter the water. To a lesser extent, checklists are used by a minority of recreational divers, and by a larger proportion of technical divers during pre-dive checks. Studies have shown checklists to be effective at reducing the number of errors and consequent incidents.
Health care use
Checklists have been used in healthcare practice to ensure that clinical practice guidelines are followed. An example is the WHO Surgical Safety Checklist developed for the World Health Organization and found to have a large effect on improving patient safety and subsequently found to have a nil effect in a cohort of hospitals in the Province of Ontario in Canada. According to a meta-analysis after introduction of the checklist mortality dropped by 23% and all complications by 40%, higher-quality studies are required to make the meta-analysis more robust. However, checklist use in healthcare has not always met with success and the transferability between settings has been questioned. In the UK, a study on the implementation of a checklist for provision of medical care to elderly patients admitting to hospital found that the checklist highlighted limitations with frailty assessment in acute care and motivated teams to review routine practices, but that work is needed to understand whether and how checklists can be embedded in complex multidisciplinary care.
Mode of use
A checklist may be used to identify the action, after which it is done, then checked off as complete and the next item identified, known as the Read–Do process, or the tasks may be done, and then the checklist consulted to ensure that nothing has been left out, the Do–Confirm process, in which the status of tasks must be remembered until checked off, which may result in more errors.
Checklists are often presented as lists with small checkboxes down the left hand side of the page. A small tick or checkmark is drawn in the box after the item has been completed.
Other formats are also sometimes used. Aviation checklists generally consist of a system and an action divided by a dashed line, and lack a checkbox as they are often read aloud and are usually intended to be reused.
Effectiveness of checklists
Ranapurwala et al. (2017) found:
[T]he use of memorized checklists was similar to not using any checklist at all; hence the use of written checklists should be encouraged, instead.
Some characteristics of effective checklists include:
- Checklists should be simple and convenient to use. Each listed item should be necessary and together they should be sufficient.
- Checklists focused on the responsibilities of a specific person, or a group who will work together, are less likely to have items left out.
- Grouping items which can be done at the same time or place, or by the same person, often improves efficiency.
- A group may have a checkbox to indicate completion of the group. This is more likely to be helpful if there are several groups.
- Where reasonably practicable the items to be checked by a specific person can be grouped on the list. This makes it easier for them to keep track of what they have done and must still do. In some cases it may help to split them off as a separate checklist
- Items should not be over-detailed in description nor ambiguous. A checklist should not try to define or describe procedures which should be familiar to the checker, though critical steps may usefully be listed in order when order is important.
- Ordering of the list should be logical. Where chronological order is important, it should be indicated by order on the list. Where items to be checked are spatially distributed, an order minimising travel or search time is efficient.
- The most convenient and reliable checklists are normally completed from top to bottom in a single session. It should be easy to recover from any interruption without risking missing an item or redoing a check unnecessarily.
- The physical checklist must be convenient to use on site. It should not require special effort to read, or protect it from the environment.
- In some cases it may be useful to cross-reference to the standard procedure, particularly for training and audit purposes.
- Some checklists must be signed off and kept as evidence, others may be re-usable. This may affect the format and materials.
- Checkboxes at the beginning of each item are easier to find and follow to the next incomplete check. A keyword at the beginning of the text will help ensure that the correct box is ticked
- When several checklists are used, due to complexity of the task, or the need for several people to make checks at different places, a master checklist indicating the completion of each subordinate checklist may be used.
- If instructions are necessary, they should be included. If not, they should be left out as they will distract the user
Design of checklists
The design of a checklist should fit the purpose of the list. If a checklist is perceived as a top-down means to control behaviour by the organisational hierarchy it is more likely to be rejected and fail in its purpose. A checklist perceived as helping the operator to save time and reduce error is likely to be better accepted. This is more likely to happen when the user is involved in the development of the checklist.
Rae et al.(2018) define safety clutter as "the accumulation and persistence of 'safety' work that does not contribute to operational safety", and state that "when 'safety' rules impose a significant and unnecessary burden on the performance of everyday activities, both work and safety suffer".
Excessive dependence of checklists may hinder performance when dealing with a time-critical situation, for example a medical emergency or an in-flight emergency. Checklists should not be used as a replacement for common sense. Intensive training including rote-learning of checklists can help integrate use of checklists with more adaptive and flexible problem solving techniques.
Experimental work has shown that memorised checklists are less effective than written checklists in identifying unsafe conditions when time is not critical.