Checklists are used in many mundane situations on a daily basis — like when we need to remember what to buy at a grocery — but they are also used for many critical (possibly life or death) situations on a daily basis, like during surgery or when a pilot is preparing his airplane for takeoff.

GAWANDE, in his book THE CHECKLIST MANIFESTO, posits that “(Although) we have accumulated stupendous know-how ... (and) put it in the hands of some of the most highly trained, highly skilled, and hardworking people of society ... that know-how is often unmanageable ... the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us”.

To overcome this, GAWANDE recommends the use of a "(simple) strategy" — a checklist.

In one story, the book describes the aftermath of a test plane crash. The subsequent investigation stated the MODEL 299 crash cause as "pilot error" (resulting from, basically, having too many things to to do in a defined sequence).

Since the test pilot involved in the crash was the Air Corps' Chief of Flight Testing (and therefore was arguably the most experienced and skilled pilot in the Corps at that time), additional training was not deemed as a solution. They devised a different, and unexpected, approach to address the issue — a pilot's checklist, written on an index card.

Through the use of the formalized checklist (later duly incorporated into a training manual), the airplane was ultimately deemed safe enough to use, and pilots went on to fly the aircraft around 1.8 million miles without a single accident. The US Army ultimately ordered almost 13,000 MODEL 299s, thereafter named the B-17 Flying Fortress — which, according to WIKIPEDIA, became the third-most produced bomber of all time.

Replica of B-17 Checklist above. Click here to view more of the B-17 checklist, as taken from the B-17 Training Manual. Source: www.303rdbg.com.

Note that there may be other IMPORTANT steps that can (and probably should) be omitted from the checklist, but will need to be done anyway. The rationale in omitting these steps is that skilled persons will do these critical steps without prodding, and therefore will just “clutter up” the checklist.

Checklist basics

1. Determine which key event (called a pause point¹) will trigger the use of a checklist (e.g. "Preparing dough for pizza") for performing the defined task.
2. Determine if you need a DO-CONFIRM² checklist or a READ-DO³ checklist for the critical task. Discuss steps needed and appropriate sequence.
3. Have only 5-9 items in the checklist. Each item must be clear and precise, serving as reminders of only the most critical and important tasks.
4. The Checklist should (ideally) be just on one page, and text should be easy to read.
5. Have the users go through the checklist, until it becomes 'second-nature'

¹ Pause point or checklist trigger(ing) event
² DO-CONFIRM checklist items are tasks that are done from memory or experience, and are ticked off in the checklist when done (e.g. "tie your shoes")
³ READ-DO checklist items are more like a recipe, wherein you are told exactly what to do and tick off the item when done (e.g. "pour 100ml of water into the pancake mix in the bowl.")

So are checklists still relevant today?

Yes, they are still quite relevant at this day and age, even more so as a guide for skilled persons performing important tasks.

A checklist shouldn’t tell you HOW to do a certain task, but it should tell you WHAT to do — by defining the key steps needed for the task, in the right sequence.

Whether these steps are needed to resolve a life or death situation, or ensure compliance to key goals and objectives; a checklist can be used to help ensure that things are done right.

For further reading, you should be able to get your copy of THE CHECKLIST MANIFESTO from AMAZON.COM.