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Tick box or check list, what's the difference?

5th August 2011

Michael Blastland looks at the question of tick box v check-list and why one may be better than the other.

medicalrecordsQ

A tick box and check list both entail a list of things to do and a tick when they're done.

Both need forms but why is one the “most almighty curse of our paranoid, pettifogging times” and the other to be inspiringly brilliant?

After hearing that probation officers only spend a quarter of their time dealing with offenders, Justice Secretary Ken Clarke blasted the “tick box culture” and vowed to put an end to it.
Meanwhile, surgeon and thinker Atul Gawande subjected the check-list culture to an experiment.

Arguing that complicated or stressful jobs made mistakes more likely, he spoke to surgeons and then met pilots, who swore by the cockpit check-list, and engineers building skyscrapers.

He then took that idea back to medicine, where his research team counted the number of errors and the survival rates of patients treated with and without check-lists.

The results were strongly in favour.

There was opposition to the tick box culture and he found that checklists could be done badly while clarity, design, relevance and the authority of the person ticking the boxes all mattered.

We don’t want people so preoccupied with ticking boxes that they scarcely do anything else but are we sure we know where the line is between tick box neurosis and taking proper care?
Gawande’s research suggests not.

The elementary point is that there can be virtue or vice in checking the simple stuff.

 

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