A little under two decades ago, nine hospitals in Michigan began implementing a different procedure in their intensive care units. Within three months, the additional procedure had cut the infection rate of patients by 66%. At the year and a half mark, the method had saved 75 million dollars in healthcare expenses. Best of all, this intervention saved the lives of more than 1,500 people in just 18 months. Healthcare professionals were stunned by the outcomes, and the strategy was quickly published in a blockbuster paper for the New England Journal of Medicine.
This medical miracle was also simpler than most of us would imagine. It was a checklist.
Don’t Miss a Step
The checklist strategy was led by a doctor named Peter Pronovost and was later popularized by surgeon Atul Gawande. In Gawande’s book, The Checklist Manifesto, he describes how Pronovost’s simple checklist could have such a dramatic impact.
But let’s start with the basic expectations. Before inserting a line in a catheter site, doctors are supposed to:
- Wash their hands with soap.
- Clean the patient’s skin with chlorhexidine antiseptic.
- Put sterile drapes over the entire patient.
- Wear a sterile mask, hat, gown, and gloves.
- Put a sterilized dressing over the catheter site once the line is in.
Check, check, check, check, check.
These weren’t new steps for these doctors; they had been known and taught within the medical community for years. To many, it seemed silly to make a checklist out of them. Nevertheless, Pronovost asked the nurses in his I.C.U. to observe the doctors for a month and record how often they completed each step. In more than a third of situations, they skipped at least one.
Think about that for a minute. There were no technological innovations. There were no new pharmaceutical discoveries or cutting-edge procedures that were implemented. The doctors just stopped skipping steps. They simply executed the practices they already knew on a more consistent basis.
I’ve Heard This Before
On the surface, we all know that there is a difference between “knowing” and “doing.” Even more significant, we also know that just because a solution is performed occasionally doesn’t mean it is executed consistently. Every doctor knew the five steps on Peter Pronovost’s checklist, but few did all five steps flawlessly each time. The challenge is self-awareness, organizational awareness, and humility to acknowledge that our challenges aren’t necessarily a knowledge gap but a performance gap.
There are plenty of examples of behaviors and actions, big and small, that could drive progress in our lives if, that is, we just did them with more consistency. Say please and thank you. Never miss a workout. Floss every day. Perform that fundamental business task each day, not just when you have time. Write personalized notes each week to those in your orbit.
No, mastering the fundamentals isn’t ground-breaking, but it works. Regardless of what work you are doing, there is probably a simple guide that you can follow right now—fundamentals that you have known about for years—that would immediately yield better results if you just followed them more consistently.
It’s our experience that progress often hides behind underused insights. You probably don’t need more information. You might not even need a different strategy. You just need to do more of what already works.
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Let’s Act: Take a moment to create a checklist for a task you “know” how to do but maybe don’t execute on as well as you would like. Now use that list to improve your effectiveness.
