Back to basics: checklists in aviation and healthcare (12 May 2015)

Summary

Healthcare safety activists have looked to checklists to solve a myriad of problems, particularly with the current iteration of checklists that have been imported from aviation. Large-scale implementations with conflicting outcomes suggest that these tools are not as simple or effective as hoped. Scholars debating the efficacy of checklist implementation in healthcare have identified important reasons for varying results: that success requires complex, cultural and organisational change efforts, not just the checklist itself; that results may be confounded by a mix of the technical and socioadaptive elements, and that local contexts may either augment or undermine the implementation's outcomes.

When ideas are translated from one industry to another, the assumptions underlying the original concepts may be lost or diluted. As checklists are increasingly imposed through a variety of professional and regulatory mandates in North America, Europe and elsewhere, perhaps it is time to review the fundamental principles of checklist use, including why they might work and how we can implement them better.