One Checklist Could Change Everything

If you’re a parent, you’re thankful for Virginia Apgar, a woman you never met. Virginia Apgar was a doctor from the 1950’s who very name has saved the lives of thousands (maybe millions) of infants over the past 6 or 7 decades. When we think of legacy and making the kind of impact that long outlives us, there are few greater examples than Dr. Apgar. And what is this legacy that she provided that has so impacted humanity? I’m so glad you asked. Dr. Apgar created a simple checklist when no one thought one was needed. This simple, five step checklist performed twice within the first five minutes of life has impacted life in profound ways.

Virginia Apgar’s contribution to the medical community was great. She helped to establish anesthesiology as a medical specialty, worked to improve obstetrical anesthesia, and significantly advanced the study of birth defects. She helped organize and administer the first Division of Anesthesia at Columbia University College of Physicians & Surgeons, her alma mater, and became the first woman to be a full professor there. Her work as vice president with the National Foundation for Infantile Paralysis, later known as the March of Dimes, led the way in research and advancement in the field of birth defects. She was an amazing woman, but nothing has had more impact than the APGAR test, a “backronym” both named after her and describing the five things every infant would be tested for.

Prior to the 1950’s, newborn babies received little medical attention. There was not an objective way of evaluating a newborn’s health and issues were addressed only when symptoms later developed, often creating very serious situations. Virginia Apgar developed a quick assessment that was performed within one minute of birth and again five minutes later. The items tested were:

• skin color
• heart rate
• reflexes
• muscle tone
• breathing

A newborn’s score on this quick assessment performed twice would notify medical staff of issues needing attention. The item names were later modified to align with Dr. Apgar’s name:

• Appearance
• Pulse,
• Grimace
• Activity
• Respiration

If you’re a parent, you’ve seen the medical team perform this test. I remember the nurses checking pulse and reflexes as we anxious awaited holding our newborn children. You’ve been influenced by this simple checklist. It’s likely that nothing was wrong, but serious complication were resolved for countless children because of this checklist. It’s amazing how just one checklist can change everything.

Checklists are good. Medical professionals follow a countless number of checklist, many of them critical for each situation. But there are some checklists that change everything for so many people.

What about our ministries? Yes, we need countless checklists to ensure that we do what we intended to do. However, what are the checklists that have significant impact? What are the checklists that change everything?

What’s the checklist for a child who makes a decision for faith? How do we ensure that this fragile decision is re-enforced so that it isn’t questioned a decade later as a foolish or whimsical moment.

What is the checklist for a first time visitor? So many things happen on that first visit. How do we ensure that the experience and what follows the experience causes a family to want to come back?

What is the checklist for a new volunteer? Within the first few weeks of serving, a volunteer may experience frustration that may eventually push them away – keeping them from serving ever again. How do we make this an overwhelmingly positive experience that will make them a volunteer for life?

Checklists are important. However, some have the power to change everything. Do you know what those checklists are for your ministry?