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In praise of the checklist: an essential tool for safety and health

October 29, 2020

When was the last time you went grocery shopping without a checklist? How soon after did you have to go back for something you forgot? Checklists play an important role in our lives, not just by reminding us to buy milk — they also help us stay safe and healthy as we move about the world.

In honor of National Checklist Day (Oct. 30), let’s explore the past, present and future of this simple but powerful tool.

A brief history of the checklist

Did cave people carve their to-do lists in stone? It’s certainly possible, but the first checklist on record was developed after a 1935 plane crash in Dayton, OH, that killed two people and injured several more. (1)

The flight was a test of a new military aircraft, the Boeing Model 299 B-17, to ensure it was airworthy. A post-crash investigation revealed the incident wasn’t caused by faulty machinery, but human error. The pilot had forgotten to unlock the elevator flight control. (2)

In response, a group of test pilots created the first preflight checklist, the use of which became common practice for military and commercial pilots.

The idea has since made its way into other industries. In 2001, Dr. Peter Pronovost of Johns Hopkins Hospital in Baltimore, MD, observed that intravenous lines used to administer medication often became infected, killing thousands of patients each year.

The doctor created a simple, five-step checklist:

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

The result? Infection rates plummeted from 11% to nearly zero.

Intensive care units in Michigan began using the checklist and over a period of 18 months, they saved an estimated 1,500 lives and $175 million in hospital expenses. (3)

Citing Dr. Pronovost’s experience as well as his own, writer and surgeon Atul Gawande posited in his book, The Checklist Manifesto: How to Get Things Right, that no matter how much of an expert you are, a well-conceived checklist can improve outcomes.

How businesses use checklists today

Doctors and pilots aren’t the only professionals who leverage checklists at work to protect themselves and the public; people in many industries use safety checklists every day.

Frequent safety inspections are required on construction sites, which are notoriously dangerous. Workers and site managers employ site safety inspection checklists, crane pre-use checklists, height safety checklists, heavy equipment inspection checklists and more to ensure a safe working environment.

In another high-risk industry, oil and gas, workers often use a drilling safety management checklist, an oil rig safety inspection checklist, or a mine site safety inspection checklist to stay safe on the job.

Utility crews, who frequently work at height and out in the elements, use checklists for vegetation management, welding safety, transmission line inspections and more.

Workplace hazards can be found anywhere — not just in high-risk industries. Checklists make it easy to identify and remediate these issues before someone gets sick or hurt — or the business gets fined.

For example, the Occupational Safety and Health Administration (OSHA) recently cited eight Target stores in the northeastern United States for safety violations for close to a half-million dollars. (4) The offenses included blocked or obstructed access to emergency and fire exits and unsafe storage of materials in back rooms and storage areas — issues that would have been noticed with the use of a facility health and safety inspection checklist.

Facility managers also use things like an exit sign and emergency lighting inspection checklist and fire safety checklist to protect their teams and stay OSHA compliant.

And this year, all kinds of businesses implemented employee and visitor screening checklists and cleaning inspection checklists to reduce transmission of COVID-19.

The digital checklist 

Today’s mobile technology has made checklists more powerful than ever.

In many cases, completing a checklist is just the first step in a process to ensure not only safety, but compliance and even high-quality performance.

In the past, you’d conduct your inspection with a pen, paper and a clipboard. Then you’d have to get that checklist into the right hands — by either physically taking, faxing, or scanning and emailing it to the office, where it would have to be transcribed and entered into the appropriate system before anything else could happen.

This process would often take hours (at a minimum) — usually days or even weeks. When your employees’ safety is on the line, that’s time you can’t afford to waste.

Now, with a no-code mobile data collection and workflow automation platform like Fulcrum, your crews can conduct inspections with their smartphone or tablet. As soon as they complete the checklist, the data is instantly available to anyone in your organization who has access.

Managers can visualize the progress of their workers in real time and see where the checklists are being used. That information can be viewed alongside safety and quality data to see where failures are occurring, and whether it’s a result of employees not following protocols, or if the protocols need to be updated.

And if checklists need to be modified — as they inevitably do — a no-code platform enables users to make changes and redeploy them in minutes, rather than having to remake, print, and distribute new checklists.

Your teams can even send formatted reports from their mobile devices to prove compliance directly from the field, or alert the appropriate parties to a dangerous situation with automated workflows that can send an email or text to initiate action the moment certain conditions are met.

In less than 100 years, the humble checklist has come a long way.

  1. https://nationaltoday.com/national-checklist-day/#:~:text=National%20Checklist%20Day%20%E2%80%93%20October%2030%2C%202020
  2. https://www.aerocrewnews.com/monthly-features/special-features/the-history-of-the-pre-flight-checklist/
  3. https://blog.nuclino.com/the-simple-genius-of-checklists-from-b-17-to-the-apollo-missions
  4. https://www.dol.gov/newsroom/releases/osha/osha20201019-1