The best-selling book, The Checklist Manifesto, by Dr. Atul Gawande shows how a hospital’s introduction of a simple, 19-item checklist reduced surgical errors by a third and deaths by almost half.

The author goes on to discuss how checklists are used in other potentially life-threatening settings, including construction. With regard to construction, he focuses primarily on checklist use in scheduling large projects, but he doesn’t mention their common use in jobsite safety audits or for pre-task job safety analyses (JSA). Nevertheless, a few of the things he learned from his surgical research seem relevant for construction checklists as well:

  • Checklists have to be simple and quick. You can’t include every possible item. It is hard to decide what to leave off, but if the checklist is too long or takes too much time to complete, it won’t be used. You have to concentrate on the most common problems. It also has to be clear enough for everyone to understand, so that little is left to interpretation.
  • You have to make decisions about who is going to conduct the check and fill out the list. It shouldn’t necessarily be the person in charge or the highest authority. It is good to involve a team.
  • Improving communications among everyone on the team is critical. Going over the checklist, even if some of the items seem obvious, has real value. It is also important for team members to introduce themselves so everyone knows everyone else. In construction, some of this can get done at a morning toolbox meeting.
  • Checklists can be classified in two ways: READ-DO and DO-CONFIRM. Using a DO-CONFIRM checklist, you check off something after you’ve checked to see that it’s been done. A READ-DO checklist tells you what you need to do and is checked off as you complete each item. Pilots use READ-DO checklists as they get ready to fly a plane.
  • It is useful to field test your checklists to make sure that they are useful and well-understood by everyone who will use them.

Checklists can help us catch common errors that might otherwise get overlooked. The LHSFNA’s Occupational Safety and Health Division has developed a series of construction checklists called FIND IT, FIX IT to help find hazards on jobsites. LIUNA signatory employers and union officials can access and download these from the LHSFNA’s website. In addition, the Fund publishes a short booklet, Auditing Your Job-site for Safety that contains eight short checklists for common hazards. It may be ordered from the online catalogue. Also available through the catalogue is the Highway Work Zone Safety Checklist, recently updated to incorporate the December, 2009, MUTCD changes, and the Fund’s newest safety poster, which promotes jobsite safety audits.

[Scott Schneider is the Fund’s Occupational Safety and Health Division Director.]