Increasing demands for cutting cost and improving quality continues to plague hospitals and physician groups nationwide.  They are all challenged with finding methods of making their operations and practices more efficient, while improving quality and increasing their bottom lines. Although checklists are not the answer to solving every problem or improving every process, they still provide a straightforward solution when there is a need to clarify a process to ensure the steps set forth in hospital protocol are being taking each time.  Checklists establish priorities, set deadlines for completion of tasks and minimize the risk of errors that ultimately result in poor quality and increased costs. Example: John Hopkins Hospital has saved $2 million dollars with a five-item checklist that reminds hospital personnel to first wash their hands.  So what important factors should we consider when applying the checklist methodology to improve a problem or process?

1. Develop the checklist to address the specific needs of the process.  Does the checklist need to be performed in a certain order so the process is performed correctly or does it just need to confirm that everything has been addressed and/or completed?
2. Keep it simple.  Checklists should only include the critical and important steps needed in a complex process and/ or address issues that have the most impact on the outcomes you desire.
3. Align with strategic initiatives.  Don’t use checklists just to have a checklist. Carefully select the areas within your hospital or practice that you will gain the most value towards meeting your overall goal, or in problematic areas where performance is less than desired.  The utilization of a checklist should be determined based on factors involving safety risks, quality of patient care and financial impact.
4. Implement, monitor and enhance.  Monitor the performance of implementing each checklist to verify that they are providing the desired outcome.  If they seem to be effective, continue to fine tune the checklist overtime to enhance performance. Share the positive results to increase their adoption and encourage continued use among staff that utilizes these routine checklists.