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Nick Bamford: Don’t be dumb, use a checklist

I was lying on a hospital bed being wheeled into surgery (nothing serious, I am pleased to say) as I tried to distract myself listening to the conversation between the anaesthetist and the theatre nurses. The anaesthetist was speaking out loud as she carried out her work: “First, I will inject the antibiotic…”

I believe she was carrying out a ‘do-confirm’ checklist. A checklist that works on the basis of confirmation of an action rather than telling you what you need to do next. But by the time I realised this I was well and truly under the general anaesthetic.

If there is one book I would recommend to advice business owners, it is The Checklist Manifesto by Atul Gawande. Not only is it an interesting read, it is one of those books that really makes you think about the way you do things.

Some people believe checklists are not particularly valuable. After all, a lot of the work we do is complex, so they may think such things get in the way of us applying our skill, experience and knowledge. They may believe checklists are beneath us.

However, the evidence suggests that is not the case. Gawande quotes multiple examples of the likes of surgical procedure, engineering and indeed financial services, where well designed checklists have saved millions of dollars and, in some instances, a great many lives.

Gawande sums it up nicely: checklists stop the dumb stuff from happening.

In a recent article, I suggested the FCA and Financial Ombudsman Service publish the checklists they use when considering the suitability of defined benefit transfer advice.

Some may believe the complexities and nuances of advice in this field are too great for a checklist to handle. But, they miss an important point: a checklist prevents the dumb stuff happening and, importantly, shows an intent to consider a wide range of factors in the advice process.

A checklist can ensure everyone involved in the delivery of advice (or those judging it with hindsight) have considered all of the relevant factors in arriving at a decision. With DB transfers, there is a lot to consider.

There is a fear among advisers that the regulatory world has too narrow a focus when it comes to suitability. Certainly, the example I have seen from the FOS is so focused on the relationship between a calculated critical yield and a client attitude to risk that it has entirely missed multiple points of suitability.

Many complex services use checklists to ensure consistency of outcome. Take the aviation industry. Gawande’s best example in his book is the landing of an Airbus on the Hudson River in New York in 2009. The captain and crew were rightly hailed as heroes saving the lives of 155 passengers by the application of their skill and teamwork. The captain wanted to set the record straight, though: the outcome was as much about adherence to procedure as any individual skill he might have had. Flight crew use checklists; shouldn’t we?

Nick Bamford is executive director at Informed Choice

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Comments

There are 3 comments at the moment, we would love to hear your opinion too.

  1. As a former military service person, where checklists were part of the daily drill, I’ve advocated this to financial advisers for years. Give someone the right checklist and see the results of accurate procedure, what does good look like.

    • Philip Castle 9th May 2018 at 8:28 am

      Snap.

      I originally trained as an Army vehicle mechanic (reserve) when my main job was as a bank cashier. My friend who was an electrician by qualifciation did his VM course at the same time as me. 8 engines for fault finding and we rotated as part of our tests… he finished 7 faster than any of the rest of us, but he just couldn’t get one engine working as he was working by experience/inuition (he was a petrol head unlike me)while I finished all 8 at exactly the same time overall as him as I was simply following a checklist…. no experience and no intuition. Monkey see…. monkey do.
      I’ve seen potential catastrophic actions where either someone ahs thought they know better than a checklist (Browning 9mm and making safe…or NOT)and simple colour blindness (in my own case, running a firing detail on an old rifle range with red flag & butts, I learnt to put in an extra check to the standard checklist to reflect my own limitations, i.e. colour blindness, NO wind and you don’t see a flag…. so ask someone who isn’t colour blind to check before you act)
      One of the most appropriate things about the Army’s range management qualification was unlike CII exams, instead of learning and memorising a rule book and then being tested on it, the Range management courses were “open book” as they wanted you to check the current range details against changes in weapons used (danger area varies from weapon to weapon)BEFORE acting, not assume you know.

      • Philip Castle 9th May 2018 at 8:35 am

        If someone had given me a promotion checklist I wouldn’t have trained as a mechanic (you can’t get furtehr than the equivalent of a private if your colour blind as you can’t get an HGV licence so can’t roadtest/checklist the vehciles you’ve repaired). You can’t progress further than Staff Sargeant as a Metalsmith/Welder (my second trade, learnt by checklist) and whilst you can progress beyond Staff Sargeant as an Armourer/Small Arms Weapons (the most checklist based job with inspections within tolerances especially for tripods for use in static firing training)is that at the time I was looking to get promoted beyond Sargeant, they had a checklist for civie job.. (mine meant they thought I should retrain and recap badge to progress… NAH, not doing that)
        So my point, as Nick said in his article, if you want to get the best out of someone (i.e. the F-pack) SHOW the checklist you will measure people by as soon as practicable so they can decide what they need to add to yours to make the checklist work for you as well as whoever has drafted the checklist and you will get a better outcome for all parties.

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