Improve Your Effectiveness Without Increasing Your Knowledge

An airline pilot and copilot begin the process of warming up the large aircraft in which they will shortly take off. The pilot and copilot may know each other from prior flights, or they may not; either way, they must work together to fly the aircraft.

A surgery patient requires the insertion of central lines into his veins and arteries for the delivery of life-preserving medication, yet these lines can deliver deadly infections if they are not inserted properly and continually monitored for signs of contamination.

A pipefitter on a multimillion – construction project discovers a pool of water gathering near the elevator bank on an unfinished floor. The project is about halfway complete.

These stories and others play a role in Atul Gawande’s book, The Checklist Manifesto: How to Get Things Right, and each story has something to teach educators whom wish to improve their effectiveness. Gawande’s New York Times bestseller, uses examples from a variety of fields and shows how using simple checklists have the potential to help professionals at all levels of expertise minimize mistakes and improve their desired results without having to increase their skill.

A practicing surgeon, professor, and author, Gawande does not mention the field of education, yet educators interested in better outcomes from those they serve would benefit to study and implement the insights of The Checklist Manifesto. The challenges faced by educators can be just as challenging as performing surgery, operating an aircraft, or building a skyscraper. Educators using checklists can increase their opportunity for success just as much as professionals in other fields. Like a medical team needing to follow specific steps to prevent a patient’s central lines from becoming infected, teachers need to transfer knowledge to a room full of children working at various levels. Like a team of pilots working together that may or may not know one another and having to accomplish numerous steps to safely navigate an airplane, teachers must work together to prepare students to meet a minimum of state and federal standards. Like a construction team that has to address unforeseen issues in the middle of a project when no easy answer is evident, teachers need to anticipate problems from a plethora of areas and successfully address them to maintain the focus on student learning.

The use of checklists help counter the fallibility of human memory and attention, specifically when it comes to routine and mundane matters that are easy to overlook particularly in stressful situations.

Gawande relates a remarkable tale of how a simple checklist made a significant difference in saving lives and money. Peter Pronovost, a critical care specialist at John Hopkins Hospital chose to create a simple checklist to minimize the chance for patient infection when putting in a central line. Five steps were to be followed by doctors each time installing a central line. 1. Wash hands with soap. 2. Clean patient’s skin with chlorhexidine antiseptic. 3. Put sterile drapes over the entire patient. 4. Wear a mask. 5. Put a sterile dressing over the insertion site once the line is in. For one month, Pronovost had ICU nurses watch doctors perform this procedure before using the checklist and record how often doctors carried out each step. In more than a third of patients, doctors had skipped at least one step.

Next, Pronovost had nurses stop doctors if they saw them skip any of the steps from the checklist. Pronovost monitored for one year what happened and the results were so dramatic he wasn’t sure whether to believe them. He monitored and followed the implementation of the checklist for fifteen more months and discovered that the checklist prevented forty-three infections and eight deaths and saved the hospital two million dollars in costs.

With extraordinary results in hand, Pronovost traveled sharing his information to hospital after hospital. Despite the success from the checklist, many were not receptive to using it. Doctors were offended and some questioned the results as they came from only one hospital. In 2003 the Michigan Health Hospital Association came on board using the checklist and went from having the one of the highest infection rates at their hospitals to outperforming 90% of hospitals in the nation, having reduced infections by 66% and saving about 175 million dollars and over fifteen hundred lives. The results have been sustained all as a result of a simple checklist.

How does the above story impact the work of educators? Planning lessons are at the heart of what teachers do. Well crafted rigorous lessons help ensure student success, however, like doctors inserting central lines into a patient, teachers often find planning lessons as mundane and routine. Having this view, teachers like doctors are more prone to leave out and overlook steps that make the difference between success and failure. And like doctors, teachers too can feel offended by the thought of using a checklist, yet results should trump feelings. Like doctors, teachers have the ability to save lives and the use of a checklist has the ability for us to increase our effectiveness without improving our skill (we still want to improve and increase our knowledge). So check your ego at the door and see how after reading The Checklist Manifesto: How to Get Things Right, you can create checklists to increase your effectiveness.