QUERI – Quality Enhancement Research Initiative

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Quality Improvement Methods

7. Checklists

a. Definition: The idea of a checklist is a rather simple and obvious tool. However, critical quality Steps are sometimes overlooked without one in use. Many healthcare functions, such as preparation for surgery and emergency department care, benefit from a checklist which makes explicit the requirements for quality results. A good checklist assures work has been done correctly and completely. It is an important ingredient for other methods in this handbook when improvements must be consistent and sustained.

b. Literature:

  • Gawande, Atul. The checklist manifesto: How to get things right. Profile Books, 2010.
  • Gawande, Atul. "The checklist." The New Yorker 83.39 (2007): 86-95.
  • Oyvind, Thomassen, et al. "Implementation of checklists in healthcare; learning from high-reliability organizations." Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 19.

c. Example: Checklists are a common practice throughout healthcare (or at least should be). Often they are written as a protocol but not always in familiar use with the staff. A checklist of critical actions is very helpful in many situations such as prior to surgery or checking in a new patient. Their power is often overlooked, but they are a powerful aid to assure ongoing and consistent quality. A checklist may be a way to assure consistent implementation of a change resulting from research.

d. Steps: Beyond the simple list of items, a checklist process can include a description of standard practices to assure the checklist has been properly executed, that a copy has been kept, that the necessary individuals were involved in its creation and the necessary individuals have been trained in its use. It is possible to have a checklist for developing checklists. Like many improvements and changes it will be helpful to make the transition in an incremental and iterative manner (see PDSA, Section 33)