Monday, February 8, 2010

Checklist after Checklist

FIN 264 (A 319) at rotation painted in Air Canada's old livery. Photo taken by "tail spotter" Erik.

A short time before, the CVR (cockpit voice recorder) would have recorded, "the before take off checklist is complete!"

Here's an email I received from a follower regarding checklists in the aviation world.

Hi Doug. I saw an interview with an author who wrote the book "The Checklist Manifesto". It's a checklist system for the health industry - for doctors/surgeons/nurses to follow. The author talked about how they came up with the idea of checklists from the aviation industry, since,as you know, no action is taken in an airplane before a checklist is read. It was just really interesting to me how well the checklist system has worked for the aviation industry, and how the health industry has caught on so slowly. I thought I'd share the clip of the interview with you.

Welcome to the most regulated and regimented industry I know. If you watch this short clip it claimed Boeing takes distinction for implementing checklists in the aviation world after a B17 Bomber crashed with their top notch pilots on board.

During a pilot's initial training, we learn how to implement checklists. It's second nature. (That's why some pilots don't adapt well with non-aviators and spouses/family because life has no checklist.
They also have to realize CRM isn't just for the flight deck, but I digress).

At Air Canada we have mechanical checklists, there's electronic ones with our new birds, plasticized checklists, memory items, QRH (Quick reference handbook) checklist, ECAM (Airbus talk) checklist, and so on.

It's so en grained with me, I came up with a clever way of depicting my table of contents in my book using our checklists:


1. Before-Start Checklist — The Life of a Pilot

Getting into the Business




Keeping up to Speed

Virtual Weather

2. After-Start Checklist — Getting to Know the Aircraft

Building an Airplane

Paint by Numbers

Taking Wing

Window on the World

Forward Force

Fill ’er Up

Airbus A340 versus Honda Civic

Airplane Tails

A Day in the Life

Just Checking

Ask the Pilot

3. Before-Takeoff Checklist — From the Gate into the Air

Captains on the Ground

Over-the-Top Weather

Plotting a Path

Cracking the Code

The Shipping News

Why All the Rules?

On the Job

View from the Ground

Deiceman Cometh

Moving the Heavy Metal

Sounds Good

56 Seconds Barreling Down the Runway

A Typical Flight

4. After-Takeoff and Cruise Checklists — Flight, Weather, and Turbulence

Why the Bumps?

Sky Snakes

Weather Watch

Wind Beneath the Wings

Under Pressure

A Breath of Air

Rules of the Road

Highways in the Sky

The Sound of Speed

Airplane Heaven

Stormy Weather

Going for a Ride… In a Thunderstorm?

’Tis the Season for Hurricanes

Mixed Measurements

Night Flight

Santa the Aviator

A Bird’s-Eye View 

5. Predescent and In-Range Checklists — Landing at Airports Around the World

Destination Unknown

Foggy Landings

Smooth Landings

Crew Control 

6. After-Landing and Parking Checklists — Layovers, Traveling the World, and Beyond

The Pro’s Guide to Jet Lag

Put Yourself in the Cockpit

Extreme Flying

Have No Fear

Trek to the Taj

Grueling Grouse Grind

The Beginning of Time

A Day of Infamy

Prepare for Blast Off

As this clip infers the medical field  approached the aviation world and realized how well we have been doing things for all these years. Crusty ole doctors will have to learn they are not the only ones in the surgery room and they will have to abide by checklists. Just like pilot war veterans had to change their thinking in the flight deck. It's going to take some getting used to, but it's a smart thing to do. I wonder if they will take it one step further and incorporate devices equivalent to FDRs (Flight Data Recorders) and CVR (cockpit voice recorders) in hospitals. Heck, they record things in a court room. What about check rides for doctors and nurses? Lots to think about.

I know of a couple of Air Canada pilots that have taken this concept on the road and are doing quite well as a company convincing hospitals to convert to checklists. Hospitals around North America are coming on side. But it doesn't have to stop at the medical field. Maybe you readers can see how this concept could apply to your profession?

At Air Canada, and most airlines, all checklists end by stating," 'such and such' checklist complete!"

"The procedures for posting this post checklist is complete."


Jack said...

Hi Doug,
Being interested in both aviation and medicine, I find this cross-over fascinating. I've been following the writing of Dr. Richard (Dick) Karl, a columnist for Flying Magazine for the past few years. He's a very experienced surgeon, and an accomplished pilot and has a business that is working with medical professionals to implement aviation-style checklists.

Less than 2 years ago, I was in the operating room with my wife for the c-section birth of our son. They used a concept called "surgical pause" - the head surgeon called everyone's attention, double checked the patient, her wrist band and the procedure before starting. It did remind me of a pre-take-off checklist!


From the Flight Deck said...

Hi Jack. Seems like many people are jumping onboard with this. And you experienced it first hand!

Thanks for the post.

Doug on a Victoria, B.C layover

Chris said...

Hi Doug,

I currently work in the computer industry, specifically in the mainframe operations area, and have for a number of years. In most places checklists are the norm as a memory aid in the wee hours to complete the necessary tasks to deadline.

It's a fairly complicated technical environment and lends itself to a checklist pretty well. One problem is a tendency to use them in place of documentation and knowledge.

The checklists themselves get constantly revised according to changing work requirements, and refinements resulting from incident investigation. That's also a field aviation can teach a lot of businesses.


From the Flight Deck said...

Chris. Thanks for your comments. When you think about it, checklists, procedures, SOPs can apply in tons of industries.

Captain Doug

Ian said...

Funnily enough...we have a fully qualified Medical Doctor flying as a first officer on the Boeing 747-400s. His practising certificate will now no longer be current of course!

Here in the UK, you can go to Medical School at 18, 5 years later come out with your MB ChB (MD), and then get on with your post degree training. At 25 he thought "sod" this, and built up hours wherever he could, ending up in Electras (a fine machine I would have loved to get my hands on), then onto a regional player, then onto the Speedbirds, and now an SFO on the Jumbos.

Maybe we could get him to post something on checklists...