Two unique sources demonstrated a strong link between the use of a project checklist and building effective teams in January 2009: the US Airways incident in New York and the publication of a study on medical checklists. The January 2009 special article of the New England Journal of Medicine highlights the surprising results of a medical study involving the use of checklists. The physician researchers proposed that since approximately half of all surgical complications are preventable and there is strong evidence linking effective team building to better outcomes, a project checklist may help decrease medical errors and improve outcomes. patient safety.
The researchers did not anticipate as dramatic an impact as their research showed. Over the course of the study, mortality rates fell from 1.5% to 0.8%, and serious complications fell from 11% to 7%, an improvement of 47% and 37%, respectively. The project checklist is only now recognized as a powerful tool in healthcare, while it has long been in use in the military, particularly in military aviation, where tools and techniques developed in this environment of low tolerance for error have highlighted the value of the project. checklist on performance improvement as well as effective team building initiatives.
‘Plan-Brief-Execute-Debrief’ encourages the creation of effective teams
Brigadier General Charles “Chaz” Campbell, now retired, spent a significant portion of his US Air Force career in the cockpit of a frontline fighter aircraft. During his career, he logged more than 3,700 hours in high-performance fighter aircraft. And in all those flights, Chaz flew without an essential piece of equipment for any pilot only twice: his flight checklist. “Those two times I forgot my checklists,” says Chaz, “I was very nervous, even though I knew each step represented in the checklist by heart. Despite that knowledge, the distraction resulted in a significant drop in performance.” Chaz continued, stating that “the medical community is one of the few professions that has recently adopted standard procedures. Now they have condensed those procedures into checklists like military aviation. Most organizations don’t invest the time to develop standards and draft of checklist initiatives — and suffer from the lack of enforcement discipline that results.”
In addition to demonstrating the value of a project checklist, the study also reinforced the links between project checklists, such as the debriefing and final report, that play a role in effective team-building strategies. “To implement the checklist,” the study reports, “all sites had to introduce a formal break in care during surgery for preoperative team introductions and briefings and postoperative briefings: Effective team-building practices which have previously been shown to be associated with improved safety processes and attitudes and with the rate of complications and death reduced by up to 80%.” Proper briefings and briefings to foster collaborative and effective team building, as evidenced in the Plan-Summarize-Execute-Report cycle, are critical processes in successful military aviation missions, as is the checklist of the project.
“The act of opening a project checklist,” says Chaz, “speaks to the individual and the team, sending the message that there is a deliberate intention to be disciplined. This intention is often a self-encouraging step that results in better performance. This happens in addition to eliminating the obvious errors of omission for which the project checklist is designed.”
The Role of a Checklist and Building Effective Teams in the Medical Industry
The Joint Commission and other patient safety groups have been incorporating tools that military pilots use to not only reduce errors, but also improve the performance of the OR and ER team during surgery. The US Air Force learned firsthand in the 1950s and 1960s that as pilots transitioned to much faster jets from propeller-driven aircraft without adequate planning, briefing, and debriefing procedures , more pilots died in training than in combat. Even in the super-high reliability of modern aviation, we can see, for example, the US Airways accident in the Hudson River and the importance of checklists and good standard operating procedures. Captain Sullenburger would probably say that in his preflight training and briefings, emergencies, just like the one he encountered, had been planned, reported, and executed previously in his simulator training and visualized in his head many times before. Think of the impact these simple principles would have on business or, as we are now seeing, on saving lives in our hospitals.
Checklists have long been a tool in military and commercial pilots’ professional bag of tricks to foster both effective team building and personal confidence. “When you walk into the cockpit of an F-16, there’s only one seat,” says Chaz, “and when you realize that it’s all up to you to make the right decisions, that there’s no one else to lean on when something comes up. wrong”. wrong, a checklist provides a powerful sense of security and allows you to focus on the mission.” The project checklist is becoming widely recognized as a powerful tool in many different professions. Some of the main benefits are obvious. A checklist helps make sure you do all the critical steps in a process, but as Chaz knows, checklists have much greater and little-understood value.
Mutual support: the value of process planning
That value is as much about individuals as it is about Chaz’s reassuring psychological need for his checklist and effective team building. When teams seriously commit to referencing a project checklist, proper execution discipline emerges. To encourage effective team building initiatives, teams are often assigned objectives that contain both routine and innovative operations. Routine operations, which can often be numerous and critical to success, can be taken for granted as ‘handled’ by ‘them’, and the finger of blame comes when the team fails to achieve its goal. Part of the surgical project checklist study included a concept Chaz calls peer support. Chaz explains, “Peer support is simply looking out for one another and demanding that teammates speak up when something is overlooked or someone makes a mistake. Checking in on each other’s actions and holding each other accountable during any effective team activity is an important part of proper use of a project checklist. So when you’re a pilot supporting a team of other pilots on a mission, you look out for each other and maybe even use your checklist to help someone else”.
“In a crisis,” he says, “innovative genius isn’t always helpful. What’s absolutely critical to success is doing the things that we know from experience and collective wisdom are the right things. Develop a good checklist of the project and using it correctly is a great way to make sure we always do the right things.