Human error is inevitable—particularly under stressful conditions. It has been demonstrated that levels of cognitive function are compromised as stress and fatigue levels increase, as is often the norm in certain complex, high-intensity fields of work. This can lead to increased errors in judgment, decreased compliance with standard procedures, and decreased proficiency. An important tool in error management across all of these fields is the checklist, a key instrument in reducing the risk of costly mistakes and improving overall outcomes.
A checklist is used as an aid to memory. It helps to ensure consistency and completeness in carrying out a task. A basic example is the "to do list." A more advanced checklist would be a schedule, which lays out tasks to be done according to time of day or other factors. It is typically a list of action items or criteria arranged in a systematic manner, allowing the user to record the presence/absence of the individual items listed to ensure that all are considered or completed. A sound checklist highlights the essential criteria that should be considered in a particular area. Checklists can provide guidance to a user and act as verification (a “check”) after completion of a task, without necessarily leading users to a specific conclusion.
A checklist is an internal control tool provided to the managers for evaluating their internal control structure and general compliance, while also promoting effective and efficient practices. Internal control in its broader sense is defined as a process designed to provide reasonable assurance regarding the achievement of objectives.
Following are the applications of checklists:-
- To increase effectiveness and efficiency of operations
- To enhance reliability of reporting
- To enhance compliance with standards
- A tool that is used as a human factors aid to ensure that a long list of items are not forgotten.
- Used to ensure that practice guidelines are followed.
- Used in quality assurance, to check process compliance, code standardization and error prevention, and others.
- Often used in industry in operations procedures.
- Can aid in mitigating claims of negligence in public liability claims by providing evidence of a risk management system being in place.
Checklists can have several objectives, including memory recall, standardization and regulation of processes or methodologies, providing a framework for evaluations or as a diagnostic tool. However, regardless of the nature of the checklist, the principal purpose of their implementation is commonly error reduction or best practice adherence. When extrapolated into the Healthcare, error reduction can correlate directly with improvements in patient outcomes, patient safety, and efficacy of resource utilization. The effective utilization of the checklists strengthens controls, improves compliance, and eliminates many “potential miss”.
This study was done with the aim to prepare check lists of various service departments of PGIMER, Chandigarh to improve the internal control. The checklists/reports already in use were also studied and modified. The exercise was done with the participation of all the incharges/supervisors of the concerned departments.