Rational Thinking: Checklists

Rational thinking helps you understand the value of tracking. You can keep track of what you need to do and when you need to it for the best chance of achieving the success you seek. Here is a story about rational thinking that we hope you will appreciate.

Have you ever seen 14 pieces of pumpkin pie with just 1 bite missing? I have, last year at a family Thanksgiving dinner. My niece made 3 pumpkin pies based on a recipe passed down in the family from Wik, my father in-law. They looked great, they smelled great, and since pumpkin pie is one of my favorites, I anxiously awaited dessert.

Why 14 pieces of pie with only 1 bite? Because she thought we should have ‘healthy’ pie and substituted sugar with sugar look-a-like and non-fat milk. Long story short – it was not pumpkin pie, it was not what we had all anticipated, the reality fell considerably short of our collective expectations.

I share that story because following the recipe (a checklist), in this situation, would have resulted in success vs. failure – failure to be a successful conclusion of a great dinner.

NOTE: As with any situation, we always seek to learn several things. For example, in this case we can learn:

If you’re going to ‘modify’ a checklist – understand why the checklist was created in its current form BEFORE you modify it, and

If you’re modifying a ‘confirm and done’ type of checklist – test it or do a dress rehearsal for the desired end result before using it in a real situation.

Don’t get me wrong, after a considerable amount of ribbing and laughter, my niece delegated the preparation of next year’s dessert to my wife.

Why do I bring that story up? Simply because a recipe is another word for checklist. A carefully designed checklist is one of the most effective, powerful, left-brain ‘tools’ one can use to increase their probability of success in organizing, understanding, interpret- ing, executing, etc. almost anything including a task, planning an event, making a decision, or trading the markets.

Here are three illustrations highlighting the effectiveness and power of the checklist. The first from the aviation industry and the second from the health care industry.

Chesley Sullenberger’s landing of US Airways flight 1549 on the Hudson River on January 15th, 2009 in which he, his co-pilot, and crew saved the lives of all 155 passengers.

Flightglobal – November 14, 2009 Issue:

“From then on, Sullenberger and Skiles had to draw on every last drop of experience and ingenuity, while staying calm and making split-second decisions. With a call of ‘My aircraft’, the captain took control, with his co-pilot handling the emergency checklist.”

Wikipedia – US Airways – Flight 1549:

First Officer Skiles was at the controls of the flight when it took off to the northeast from Runway 4 at 3:25 p.m., and was the first to notice a formation of birds approaching the aircraft about two minutes later, while passing through an altitude of about 3,200 feet on the initial climb out to 15,000 feet. The aircraft collided with the birds at 3:27:01. The windscreen quickly turned dark brown and several loud thuds were heard. Both engines ingested birds and immediately lost almost all thrust. Capt. Sullenberger took the controls, while Skiles began going through the three-page emergency procedures checklist in an attempt to restart the engines.

Suggested reading: Highest Duty by Chesley Sullenberger.

Checklists Save Lives

In 1937 Boeing delivered their Model 299 (Later named the B-17) with Major Hill, a highly qualified pilot at the controls, the plane took off, reached an altitude of approximately 300 feet, stalled and crashed killing the pilot and one other crew member.

An investigation later revealed it was ‘pilot’ error due to the complexity of the requirements needed to fly it. As a result of the investigation, the Model 299 was deemed “too much airplane for one man to fly”.

As the story goes, a group of test pilots tackled the one man issue a came up with the idea of a checklist. Long story short. The Model 299 became the B-17 Flying Fortress and over 1.8 million miles without one accident and gave the Army a decisive air advantage in World War II.

Suggested reading: THE CHECKLIST by Atul Gawande (The New Yorker Magazine – Archived)

Peter J. Pronovost, MD, an intensive care specialist at Johns Hopkins in Baltimore, MD. He is a professor at the Johns Hopkins University School of Medicine in the Departments of Anesthesiology and Critical Care Medicine, and Surgery, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, and Medical Director for the Center for Innovation in Quality Patient Care.

He introduced an intensive care checklist protocol that during an 18-month period saved 1500 lives and $100 million in the State of Michigan. According to Atul Gawande in The New Yorker, Pronovost’s “work has already saved more lives than that of any laboratory scientist in the past decade.”

“Pronovost and his colleagues monitored what happened for a year afterward. The results were so dramatic that they weren’t sure whether to believe them: the ten-day line-infection rate went from eleven per cent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. They calculated that, in this one hospital, the checklist had prevented forty-three infections and eight deaths, and saved two million dollars in costs.”

Checklists Alone Won’t Change Health Care: (www.huffingtonpost.com/peterpronovost)

Checklists have a role in improving patient safety. But they only get us part way down the field. To reach our ultimate goal – making patients safer – we must engage teams to embrace the concepts behind checklists and become full partners in developing and improving this life-saving tool. And, we must measure our results to make sure that every patient always gets the care they deserve.

Suggested reading: Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out.

In working with clients, both entrepreneurs and independent practicing professionals, and involved in their start-ups, expansions, turn-arounds, acquisitions, and liquidations, L learned a lot. My role was very clearly defined. I facilitated processes that clarified options (positive and negative) into what I called ‘CIPs’ (Continuous Improvement Plans). While the name, letters and all, sounded impressive, the actual printed items I prepared were checklists – nothing more – nothing less. These checklists were derived from the mind maps I co-developed with my client. The primary benefit of those checklists were that they:

Directed actions in a specific area and insured completion of a task or project.

Improved performance and provided the basis for tracking and measuring results.

Provided feedback and mitigated many barriers to execution and completion.

Kept focus, goals, and objectives foremost while decreasing wasted resources.

Provided structured. clarified priorities and facilitated the solution to problems.

Advanced ‘culture’ with the organization.

And, last but not least, some of the ways traders use checklists in support of their trading are:

creating and improving their trading plan or plans,

pre-session preparatory work and briefing,

session management, and

trade execution and management, and

post-session wrap and de-briefing.

 

Suggested reading: The Checklist Manifesto by Atul Gawande.

Until next time . . .

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