When human beings are placed in positions of responsibility with life and death consequences of failures of omission or commission, there has been a clear demonstration of better outcomes when checklists are used. Checklists force attention to details. Due to human nature, such details can be overlooked because of the known tendency to become less alert in the absence of recent memory of harm. The more the potential for harm, the greater the value and need for a stepwise methodical reminder method for focusing attention on essential details.
For airline pilots, healthcare workers, nuclear power plant operators, divers, military specialists, astronauts, oilrig operators and many others, following a checklist is literally a lifesaver. I believe a checklist for political leaders is needed.
The medical literature recently related how using a checklist in the operating room had nearly immediate benefits by simply having each member of the team identify themselves and their responsibilities before starting the case. Clarifying who was present and what their job was made it clear whether all were present, ready and able to perform. Each was given a chance to state if there was a problem with equipment or supplies that needed addressing before proceeding. Adopting the checklist method has improved surgical outcomes in every instance.
Airline pilots historically follow checklists mostly for all the plane’s mechanical systems but also for their own physical condition including amounts of sleep and use of substances which influence performance prior to flight. Airline pilots for the most part have an excellent record of attention to details, following the checklist model.
What of legislators and political leaders? Could their job performance benefit from checklists? Does their job have an impact on lives? What would a political leadership checklist look like? I have a few ideas. If you have been paying attention to political events of the last few decades, perhaps you will recognize times where such a checklist may have been useful in changing outcomes.
Suggested daily checklist for legislators or persons in positions of authority whose decisions have important consequences:
- Are all staff members present and competent to perform their duties?
- Are all appointed officials in place or temporary managers for all management positions functioning and free of influence from forces counter to their mission statements?
- Are all existing sources of relevant, evidence-based information available and being considered prior to taking a position, writing legislation or responding to a crisis?
- Are the Armed forces enabled and supported before, during and after deployments?
- Are appropriate regulations in force to prevent repetition of known errors attributable to lack of regulation and oversight?
- Is existing law – domestic and international - being followed and enforced for all citizens and persons under our control?
- Are long-term solutions and impacts being considered for all activities?
- Are programs that have failed to be effective at their stated task being terminated?
- Is funding for all activities considered as part of a balanced budget and long-term planning?
- Are all citizens enabled to succeed, live long and prosper?
- Are plans of action in place for potential disasters with clear command and control responsibilities and redundancy to remain effective in the event of losses?
I don’t know how a United States political administration could function well without attention to such a checklist. When failures have occurred in the past, one or more of the checklist elements were clearly being ignored or overlooked. Some failures are ongoing. I believe we can do better.