Specific advice concerning the tasks and users is included under these major categories. These may be grouped into two general categories: knowing the task and knowing the users. Fortunately, guidelines for checklist design are available.
A poorly designed or overly lengthy checklist can harm performance just as easily as a good one can improve it. Any system has the power to complicate or assist-the design of the checklist determines its utility. Indeed, use of these principles has led to two strikingly successful and widely discussed medical checklists: a surgical safety checklist that resulted in more than a one-third decrease in deaths and complications ( 3) and a checklist guiding the activities surrounding the insertion of central venous catheters that reduced bloodstream infections up to 66% in approximately 100 Michigan intensive care units.( 4) The success of medical checklists even has resulted in government mandates to use them after repeated surgical errors in some hospitals.( 5)Ĭhecklists, however, are not a panacea for medical mistakes. This theoretical focus allows for generalizing beyond a specific checklist or environment. Much research on checklist design and effectiveness originated in the field of human factors psychology.( 2) Human factors research stresses the importance of looking beyond a specific technology to the guiding principles that govern human behavior. The reluctance of medical professionals to adopt checklists is often framed as pushback against "more paperwork" and "cookbook medicine," or due to disbelief in their effectiveness.( 1) However, a rich literature has helped establish many best practices in checklist design, and health care now stands to benefit. Checklists have long been used in fields such as aviation and space exploration but have only recently made headway in medicine. The use of checklists is a primitive yet remarkably effective strategy for ensuring accuracy in complex tasks.
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