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 research physicians proposed that since approximately half of all surgical complications are preventable and there is strong evidence linking effective team building with better outcomes, a project checklist may help decrease medical errors and improve patient safety.

The researchers did not anticipate such a dramatic impact as demonstrated in their research. Over the course of the study, mortality rates dropped 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 being recognized as a powerful tool in healthcare, whereas it has long been in use in the military, particularly military aviation, where tools and techniques developed in this environment of low error tolerance have highlighted the value of the project. checklist on performance improvement as well as effective team building initiatives.

‘Plan-Brief-Execute-Debrief’ encourages effective team building

Brigadier General Charles “Chaz” Campbell, now retired, spent a considerable portion of his US Air Force career in the cockpit of a frontline fighter jet. During his career, he logged more than 3,700 hours in high-performance combat aircraft. And in all those flights, Chaz flew without an essential piece of equipment for any pilot just twice: his flight checklist. “Those two times I forgot my checklists,” Chaz says, “I was very nervous, even though I knew every step represented on the checklist by heart. Despite that knowledge, the distraction resulted in significantly reduced performance.” Chaz continued, stating that “the medical community is one of the few professions that has recently adopted standard procedures. They have now condensed those procedures into checklists like military aviation. Most organizations don’t invest the time to develop standards and projects.” 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, which play a role in effective team-building strategies. “To implement the checklist,” the study reports, “all sites had to introduce a formal pause in care during surgery for preoperative team presentations and briefings and postoperative briefings: Effective Team Building Practices which have previously been shown to be associated with improved safety processes and attitudes and reduced complication and death rates by up to 80%.” Proper briefings and debriefings to encourage collaborative and effective team building, as evidenced by the Plan-Summarize-Do-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 intent to be disciplined. This intent is often a self-encouraging step that results in better performance. This occurs in addition to eliminating the obvious errors of omission for which the project checklist is designed.”

The role of a checklist and effective team building in the medical industry

The Joint Commission and other patient safety groups have been incorporating tools that military pilots use not only to reduce errors, but also to improve the performance of the operating room and emergency room 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 proper 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 crash in the Hudson River, and the importance of checklists and good standard operating procedures. Captain Sullenburger would probably say that in his pre-flight training and briefings, emergencies, such as the one he encountered, had been pre-planned, reported and executed in his simulator training and envisioned 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 the professional bag of tricks for military and commercial pilots to foster both effective team building and personal confidence. “When you get 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 goes wrong wrong”. wrong, a checklist provides a powerful sense of security and allows you to stay focused on the mission.” The project checklist is becoming widely recognized as a powerful tool in many different professions. Some of the major benefits are obvious. A Checklisting helps ensure that you perform 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 related both to individuals and to 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 foster effective team-building initiatives, teams are often assigned goals that contain both routine and innovative operations. Routine operations, which can often be numerous and critical to success, can be taken for granted as being ‘managed’ by ‘them’, with the pointing finger coming when the team fails to achieve its objective. Part of the surgical project checklist study included a concept Chaz calls peer support. Chaz explains, “Supporting each other is simply looking out for each other 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 a important part of proper use of a project checklist.So when you are 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 more”.

“In a crisis,” he says, “innovative genius is not always helpful. What is 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.