Checklist Manifested: Get your Return on Investment

If checklists are to be effective as behavior-management tools, you must manage the behavior of using checklists!

Today is the day our family vacation is to begin. We have so much to remember: Take the pets to their hotel; go to the bank; take out the trash; pack power cords, prescriptions, underwear; turn down the heat; make sure my 18 year-old brings his ID to the airport this time… the list continues. We know that once we’re on the road we’ll realize we forgot something. Wondering what we’re forgetting while we’re forgetting can be maddening.  

Recently, before taking any trip, I’ve adopted a good habit of making a list on my iPhone and checking off each item as soon as it is accomplished. When I am disciplined enough to do this, I tend to be a happier and more successful traveler.

A couple years back, Atul Gawande put out his popular Checklist Manifesto that described the use of checklists in the operating room and arguing that this marvelous tool can be used to reduce injuries, quality errors, and perhaps even travel forgetfulness. This started a wave of checklist mania from a dozen groups marketing their particular take on checklists. Funny though, we’ve been using checklists in behavioral safety for almost a half a century now.

My behavioral science colleagues and I have been studying checklists for decades. We have been publishing research investigating the checklist’s efficacy in improving quality, sales, sanitation, and, of course, as a tool for promoting safety. It is no accident that we made the checklist the primary tool of Behavior-Based Safety.

Checklists offer a nice mix of antecedents that clarify for users which of their specific behaviors require prompting at the moment. Completing each of the items on the checklist can be mildly reinforcing feedback. Checklists also can be designed to be associated with other more powerful consequences. Pilots, for example, cannot gain clearance to take off until they complete their checklists. In other cases employees are required to submit their checklists so supervisors will provide work permits.

Creating checklists, however, isn’t necessarily a ticket to success. In fact, sometimes they can prove counterproductive.  

Checking a check is a behavior

You see, while checklists can be used effectively to manage behavior, we must remain mindful of the fact that the act of using checklists is itself a behavior. If checklists are to be effectively used as tools for managing behavior, the behavior of using checklists themselves must be managed and reinforced.

Once I was engaged in an oil field, attempting to identify and manage critical behaviors that lead to losses such as injury, process safety incidents, or service delivery interruptions. We found that on a particular piece of equipment most of the incidents could have been avoided with preventative maintenance.  

Operators were supposed to conduct the preventative maintenance routine within a 60-minute interval when the machine was idle between cycles of operation. Managers had been assuming preventative maintenance was ongoing because all operators turned in the required checklist to their support engineers to verify they completed all the items. Piles of these completed checklists could be found on every site.

I picked up a stack that had just been turned in. As I paged through them, I noted that they were all the same… exactly the same. They literally had been photocopied! The person who submitted them had been so brash as to mark out the photocopied date and write in a new one! The checklists were being pencil whipped and the “completed checklists” were never verified.  

I’m sure some engineer spent substantial time working with equipment specs to make the perfect checklist… but to what end? The behavior of actually completing the checklist accurately had not been considered. 

Case in point, the checklist contained over 100 items! It was not physically possible for anyone to accurately complete all 100 items in less than 60 minutes. The design of the checklist had failed to consider the context of the work.  

Behaviors are Costly

Let’s have a lesson in the behavioral concept of Response Cost. The more effort it takes to do something, the more punishing it is, and, consequently, the less likely it is to get done. This is a basic principle that governs nearly everything we do.  

Consider relaxing comfortably on your couch and deciding you want a beer from the kitchen in the next room. While you’re about to get up you remember you moved all the beer to the basement refrigerator. You then sigh and settle back in your couch. The response cost of getting that beer had become greater, to the point it outweighed the potential reward…even from beer.

In our oilfield case, completing a 100-item checklist demanded too much response cost of the operator.

A famous behavioral consultant Tom Gilbert once wrote that “behaviors are costly”. Consider behaviors as currency - effort to be invested. Therefore, our behaviors are going to seek the greatest immediate impact for the least amount of effort – a ‘Return on Investment’. A 100-point checklist, therefore, requires considerable behavioral currency, but provides little return on that investment.  

The use of checklists in surgery or piloting an aircraft probably is worth the investment. By comparison, skipping the checklists targeting preventive maintenance does not produce immediate consequences nor the catastrophe of a botched surgery or downed plane. 

Increase your return by lowering the investment

Reduce the response costs (in terms of time and effort) associated with checklists. In the oil fields, we gathered a focus group of employee/operators with some support folks and supervisors responsible for the equipment and guided them through a structured method of identifying and prioritizing critical preventive maintenance behaviors that would lead to the greatest reduction in loss.  

A 100+ item checklist was reduced to 6 items that were most related to the incidents they had suffered. The other 94+ less important tasks were transferred to other points in the operation or to the maintenance yard where they are more likely to be done.

After the employee-designed checklist was implemented in a pilot region, the use of these “checks” (not called a “checklist” any longer) increased 300% and incidents dropped over 60%.

Checklists should be living documents. Our plan was to keep the check dynamic so it could adapt to changing conditions. After operators demonstrated mastery by completing the check to standard nearly 100% of the time, it would be time to take those behaviors off the checklist and replace it with another critical behavior. Knocking an item off a checklist can be reinforcing. Managers can sincerely praise these events because this mastery is linked to operational success. No response cost there, only something worth investing in.

Are your checklists “Manifested”? 

  • Build them smartly by involving your people. 

  • Target critical and readily doable behaviors

  • Keep them short and dynamic

And they will be nimble, a worthy investment, and you will be a happier traveler.

Timothy LudwigComment