The Amazing Power of the Simple Checklist

Areas of Focus checklist Earlier this year, I read David Allen’s book, Getting Things Done. Since writing the book, Allen has acquired a cult-like following of people who think his way is the way to “get ‘er done.” I, too, was impressed with his concepts and many of his suggestions and I took copious notes to prove it.

I review those notes periodically to further cement the concepts in in my mind so I can best implement them into my life. One of the points he made that really struck a chord in me was regarding checklists. 

All you really need to do is manage lists. You’ve got to be able to create a list on the run and review it easily and as regularly as you need to. Once you know what to put on the lists, and how to use them, the medium really doesn’t matter. Just go for simplicity, speed, fun. (underlining is mine)

I intuitively had an idea of what Allen was talking about, as I am famous (in my own mind) for my lists. I’ve written on numerous occasions about my MIT list—my Most-Important-Things-to-do-today list. This is just one of many of the lists that I have to keep me on track.

Life-and-Death Checklists

After reading Getting Things Done, I came across some totally unrelated articles that demonstrate the true effectiveness of the simple checklist. One of the most impressive, in terms of measurable effectiveness, is a medical checklist pertaining to “central lines,” which is the tube inserted by needle into a patient’s vein to deliver medications and for other purposes. These lines have been a common source of serious infection in hospital intensive care units. Johns Hopkins University Medical School professor Peter Pronovost pioneered the use of hospital checklists to reduce infections.

The checklist is not elaborate nor complex. It includes things like donning a sterile gown and gloves, hand-washing and disinfecting the skin before the central line is inserted (things you would think would be second nature to medical professionals and certainly not require a reminder).

The results of using this “simple” checklist were far from simple, however. One article summarized, “The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.”

If you watch movies, you are aware that pilots also use a checklist to ensure that the plane (and the pilots) are ready for flight.This practice began after a 1935 crash near Dayton, Ohio, that killed both pilots. “Investigation found that the pilots had forgotten to disengage a critical wing adjustment mechanism prior to take-off.” I infer from the quoted statement that the step the pilots forgot was a simple one. It was not a matter of hard work, just remembering to do it. Though simple, it was critical.

As a result of this accident, the “pilot’s checklist” was developed. It was a way of making sure all the appropriate steps were taken, that nothing was overlooked.

Another medical checklist with serious ramifications is the “Safe Surgery Checklist.” The World Health Organization (WHO) asserts that a surgical safety checklist could save hundreds of thousands of lives. “At least half a million deaths per year would be preventable with effective implementation of the WHO Surgical Safety Checklist worldwide. These results, obtained in the World Health Organization’s 2007-2008 pilot study of its Surgical Safety Checklist have now been confirmed by new studies: the use of checklists significantly reduces surgical morbidity and mortality.”

And because a picture is worth a thousand words—and a video clip is more entertaining—here is a link to a clip from a popular TV show that demonstrates how this particular checklist plays out in “real”/TV life.

These three checklists demonstrate how something so simple can make a dramatic difference.  If nothing else, these examples show that it is possible to forget important things, even things that should be ‘second nature’ to us. If it is possible to forget things that we do repeatedly on a daily basis, how much easier would it be to forget an idea, a dream, an inspiration, a lofty goal? Might we be able to implement this simple little tool—the checklist—to improve the quality of life, to stretch us out of our “comfort zones,” to spur us to being or doing something that “crossed our minds” once upon a time?

More than likely, you’re already using checklists quite regularly. A daily to-do list is the most common one. It serves as a reminder of the things you need to do on any given day. My MIT list is a list of the important, but not urgent, actions that I want to observe regularly to become a woman of developed character and substance rather than one driven by circumstance. A prayer list helps you remember the people/things you want to pray for on a consistent basis. A shopping list reminds you of the things you need to buy. I could go on.

“Areas of Focus” Checklist

I was particularly intrigued by a special list Allen suggests in his book:

I recommend you make and keep a list called “Areas of Focus.” You might separate this into Personal and Professional sublists. You’ll want to use both for a consistent review. This is one of the most useful checklists you can create for your own self-management. It won’t require the kind of once-a-week recalibration that the Projects list will; more likely it will have meaning on a longer recurring cycle. Depending on the speed of change in some of the more important areas of your life and work, this should be used as a trigger for potential new projects every one to three months  (underlining emphasis is mine).

That last sentence is the kicker, in my opinion: the lists should be used as triggers. In other words, unlike the daily to-do list, these special “Areas of Focus” lists are not so much about reminding you of things to do, but more about reminding you of who you want to become, long-term goals that you want to accomplish, relationships you want to develop, dreams that you have dreamed and ideas that have popped into your head in a flash of inspiration. And, yes, they should eventually lead to action, but for a while (sometimes for a long while), they may only serve as triggers, reminders, fodder for inspiration and dreaming. Without such lists, who knows what great things might be lying dormant within us because a seed that was planted long ago has not been watered and nurtured and cultivated?

We’ve already seen how effective a simple checklist can be. Why not build upon that concept and take the checklist to a new level? Deliberately use it as a “trigger” to keep ‘possibilities’ in your mind, and to one day—at just the right time—to launch you into action, simple and not-so-simple, that could deeply impact your life!

A Word to the Wise

If you decide to create your own unique, personalized checklist triggers, here are three guidelines you’ll need to observe to keep the practice potent.

1) Keep your lists “true to you”; make them a reflection of your personality.

Don’t try to mimic someone else’s style. Don’t necessarily put “great endeavors” on your list (unless that’s truly who you are). List things that are important to you, that you want to do or be someday. As an example, my lists range from the mundane (clean the attic) to the exotic (plan Hawaii vacation), from costly (pave our driveway) to priceless (build a strong marriage), from creative (create beautiful photo arrangements of grandkids) to necessary (prepare tax paperwork for accountant), from simple (update software) to ‘great endeavors’ (write book).

2) Continuously morph and tweak your list as new interests come into your life, as you learn new things.

This past month, I read something about thinking long-term and being visionary. As a result, I was inspired to add a simple question to a list that I review on a weekly basis: Do I have new thoughts regarding goals/dreams/visions in the next 1-5 years?

And speaking of questions, they could actually comprise a list.  A list of personal questions to ask yourself on a regular basis can be powerful in helping you “keep the main thing the main thing.” Again, if that fits your personality, it may be more effective than a checklist that resembles a to-do list.

3) Finally, you must review the lists on some kind of regular basis—weekly, monthly, quarterly.

Don’t review them so frequently that they lose their “punch.” The danger in any checklist (especially one that you use regularly) is that it can become rote and automated to the point that you don’t really pay attention. But don’t review so infrequently that it loses the ability to spur you to action, either.

I attempt to review my lists weekly. I make it part of my weekly planning session. However, if I miss a week because of lack of time, I don’t get bent out of shape. The idea is to use the lists as a trigger, not only to remind you of things, but to inspire you to action. Sometimes that longer lapse in time seems to create more inspiration. On the other hand, I do find that the weekly review does provoke more action on the more mundane tasks. Chores that have a tendency to “slip between the cracks” (like cleaning the attic) are more likely to find their way into my schedule even without being on my task list—because I have created a system to remind myself.

I would really love to hear your thoughts on this subject. Do you keep any sort of inspirational checklists? If so, how often do you review them? Do you have suggestions for making it more effective?

If you are considering setting up some checklists for periodic review, what will be your “areas of focus”? Your ideas may be inspiration for someone else! Please leave a comment.

Photo compliments of Daniel Kulinski via Compfight

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