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Can a Simple Checklist Transform Your Business? If checklists are useful for building a skyscraper or performing complex surgery, they just might be right for you, too.

By Thomas Smale Edited by Dan Bova

Opinions expressed by Entrepreneur contributors are their own.

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What do test pilots, surgeons, architects and hedge fund managers all have in common? They all turn to one simple tool to make them more efficient: the humble checklist. In his book, The Checklist Manifesto, renowned surgeon and author Atul Gawande explores how breaking down complex processes into boxes to be ticked off on a list can save lives and stop something as significant as buildings collapsing.

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After personally adopting this simple rule in the processes at my own business, I've found Gawande's simple solution of using a checklist to be surprisingly effective. So, I want to spread the word on how entrepreneurs can incorporate checklists to optimize their business operations' efficiency. Here's how to do that.

Break it down.

No matter what the industry, professionals face more complexity in the workplace than ever before. Breaking down complex tasks into simple, verifiable steps can have remarkable effects, even when those steps appear explicit or mundane.

In The Checklist Manifesto, Gawande tells the story of Peter Pronovost, a critical-care specialist at John Hopkins Hospital. Pronovost developed a five-step checklist designed to prevent a common and sometimes deadly complication faced by patients in the hospital's intensive care unit (ICU): the lcentral line infection.

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The steps in this list aimed at prevention are basic. For example, one calls for caregivers to "wash their hands with soap." Despite such an obvious precaution, Pronovost's team discovered that in over a third of patients observed, at least one step of the five recommended ones was skipped. As part of the solution, Pronovost empowered nurses to stop doctors from proceeding if they witnessed even one step in the checklist being bypassed.

This simple regimen led to staggering results. In one hospital, over the course of just over two years, the central line infection checklist "prevented forty-three infections and eight deaths, and saved two million dollars in costs," Gawande wrote. Caring for patients in an ICU is extremely complex, but the wisdom of the checklist is that it breaks patient care down into incremental and verifiable steps.

Keep it short.

One key to creating effective checklists is to keep them short. A good rule of thumb, Gawande says in the book, is to "keep it between five and nine items, which is the limit of working memory." You must also "define a clear pause point at which the checklist is supposed to be used." Keeping the list short forces you to boil down complex processes into the essential, required steps.

"Keeping it short" also means that you will most likely end up with multiple checklists, each tailored to a clearly defined set of circumstances.

Keep it simple.

Hand-in-hand with keeping checklists short is keeping them simple. Checklists should use clear and exact language. Gawande also stresses the importance of formatting. Limit your list to one page and avoid clutter and the unnecessary use of colors. Your lists should be clean, simple, and concise.

Daniel Boorman, the checklist guru at airplane manufacturing giant The Boeing Company, has suggested the use of both upper- and lower-case text for ease of reading, as well as the use of a sans serif font like Helvetica.

Boeing makes extensive use of checklists -- for everything from routine processes like readying an airplane for takeoff to emergency situations like smoke in the cockpit. Every situation that a pilot might encounter comes with a corresponding checklist, as is shared in the book.

Decide between "Read-Do" and "Do-Confirm."

There are two types of checklists: READ-DO and DO-CONFIRM. A READ-DO checklist is similar to a recipe. It consists of a set of clearly defined tasks that you check off as you complete them. With a DO-CONFIRM checklist, "Team members perform their jobs from memory and experience, often separately."

But then they stop. "They pause to run the checklist and confirm that everything that was supposed to be done was done." Before building your checklist, you will need to decide which of the following two options to use.

Use checklists to facilitate communication.

Even extremely complex tasks, like the building of a modern skyscraper, can benefit greatly from the use of checklists. Not only can the floor-by-floor construction of the building be broken down into many small individual tasks that must be ticked off as completed, but a checklist can also help facilitate problem-solving and communications when complications inevitably arise.

Gawande discovered that the builders he interviewed relied on "one set of checklists to make sure that simple steps are not missed or skipped and another set to make sure that everyone talks through and resolves all the hard and unexpected problems." Using checklists to ensure that the appropriate experts consult with one other to resolve any issues that come up and reach an agreement on how to move forward is one of the tool's most valuable applications.

Despite buildings' being bigger and more complex than ever before, creative and diligent use of checklists has significantly sped up the building process, according to the experts Gawande consulted for his book.

Where to start

Not surprisingly, a plethora of tools are available to help you incorporate the use of checklists into your business process. Here are just a few:

  • Checklist. The eponymous Checklist app offers a robust free plan with unlimited checklists, team management, due dates, reminders and more. The app is available for iOS and Android, or on the web. One of Checklist's greatest strengths is its community. You can choose from thousands of user-submitted checklist templates to help get you started.

  • Tallyfy.Tallyfy is a powerful solution for automating your business processes with a particular emphasis on collaboration. If you and your team can benefit from applying the principles behind The Checklist Manifesto, Tallyfy is well worth a look.

  • Manifest.ly. If your team, like mine, relies heavily on Slack for collaboration and communication, Manifest.ly is a checklist tool that boasts seamless Slack integration. You and your team can work on checklists and receive notifications without ever leaving Slack.

Final thoughts

Checklists are a potent tool that have been shown to work in a wide variety of industries and circumstances. There are almost inevitably processes in your business that the clever application of checklists will improve. Even the most complex tasks, such as the building of a modern skyscraper, open heart surgery and flying a commercial airliner have been shown to benefit greatly from the use of checklists. As Gawande wrote, ""Checklists seem able to defend anyone, even the experienced, against failure in many more tasks than we realized."

Related: Business Plan Updating Checklist

Using checklists to establish a higher level of base-line performance for you and your team can similarly pay big dividends in making your business more efficient and error-free.

Thomas Smale

Entrepreneur Leadership Network® Contributor

Founder of FE International

Thomas Smale co-founded FE International in 2010. He has been interviewed on podcasts, blogs and also spoken at a number of industry events on online businesses, exit strategy and selling businesses.

Want to be an Entrepreneur Leadership Network contributor? Apply now to join.

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