Do You Have Checklists You Use? Would You Share Them With Us?
Tuesday, March 9th, 2010
Prompted by a recent post by Jon Udell, I’ve been thinking about checklists over the last few days. Checklists, we are finding out, can be incredibly powerful things for any procedure one does repeatedly. How powerful? Consider the story of Peter Provonost, who wondered what would happen if ICU units compiled checklists, instead of relying on memory of their staff:
Pronovost recruited some more colleagues, and they made some more checklists. One aimed to insure that nurses observe patients for pain at least once every four hours and provide timely pain medication. This reduced the likelihood of a patient’s experiencing untreated pain from forty-one per cent to three per cent. They tested a checklist for patients on mechanical ventilation, making sure that, for instance, the head of each patient’s bed was propped up at least thirty degrees so that oral secretions couldn’t go into the windpipe, and antacid medication was given to prevent stomach ulcers. The proportion of patients who didn’t receive the recommended care dropped from seventy per cent to four per cent; the occurrence of pneumonias fell by a quarter; and twenty-one fewer patients died than in the previous year. The researchers found that simply having the doctors and nurses in the I.C.U. make their own checklists for what they thought should be done each day improved the consistency of care to the point that, within a few weeks, the average length of patient stay in intensive care dropped by half.I have some skepticism about grand pronouncements (Checklists will save the world!), but the truth is that professionally I often use checklists when it is critical to get something right, or when I am steering into territory unfamiliar to me. And they work — I couldn’t do my job without them. So I’m wondering two things:
- Are there any faculty that have “teaching” checklists they want to share? (E.g. “This is the procedure I use when introducing a new concept”.)
- Are there any faculty that have student facing checklists out there? (E.g. “10 things to check your paper for before you turn it in.”)

