Don’t Skip the Checklist

If you’re going to use a checklist, commit to the checklist. Choosing not to use it can undo all the efforts you’ve worked so hard to establish. Not using the established checklist can sometimes be the result of having the best of intentions. However, deviating from an established process, regardless your intentions, could be putting your work or even your organization at risk. This exact situation happened a few years ago in regard to her visit at a emergency medical center. A failure to follow a checklist put her life in jeopardy. 

My wife, Sara has several food allergies. It’s become a comical routine when ordering food eating out. Does this dish have:

• Kale?
• Squash of any kind?
• Pumpkin seeds?
• Kale?
• Avocado?

Unfortunately, Sara doesn’t always get to eat what she wants because the salad contains kale or the entree features an avocado sauce. She carries an epi-pen in case she accidentally eats one of these foods, buying her an extra 15 minutes before her throat swells shut and she’s unable to breath. Pleasant thought, right? Most of these allergies are somewhat new. We used to enjoy a delicious grilled squash and zucchini medley just a few years ago. However, there have been days where we’ve eaten dinner and a few hours later, Sara’s throat starts getting itchy and we add another item to the “DO NOT EAT” list. A few years ago, Sara was experiencing this incident once again. There was a medical center only 5 minutes away and we had just put the kids to bed. Sara was enough concerned that she needed to go to the doctor, so she grabbed the keys an headed to the medical center while I stayed home with the kids.

She walked into the facility where she was greeted by the guy at the front desk. We usually don’t go to these emergency centers, so you usually have to fill out all this paperwork before you see the doctor. Once Sara explained that she was having an allergic reaction and was concerned about her ability to breath, the guy behind the desk jumped to action. He disregarded the forms and immediately put her in a room for a doctor to come visit. Sara was glad to be getting immediate attention.

5 minutes go by.

10 minutes go by.

20 minutes go by.

Her reaction wasn’t getting any worse, but she was concerned that no one had come. What if the reaction had been worse. Why was this taking so long?

Just as she was getting ready to go look for someone, the door opened. However, instead of a doctor it was a janitor coming to clean the room.

“Wait, what are you doing in here?” asked the janitor.

For whatever reason, no one knew that Sara was in the room. In the hurry of Sara’s check-in, the normal process had been abandoned. There was a breakdown in communication and the doctor on duty did not know that Sara had been waiting to be seen, even though she was having a medical emergency. Eventually, the doctor came, took care of Sara and gave her paperwork to file a formal complaint. This doctor was fully expecting repercussions for the negligent care. This could have been a disaster.

What happened in this situation is not a rare occurrence. The guy at the front desk did the right thing by getting Sara back to a room as fast as possible, but by doing so, he broke protocol. He didn’t follow the normal process and because of that, the doctor didn’t know of his new patient having a medical emergency. Sometimes we have to break protocol, but when we do, we need to know that unless we’re highly intentional, everything could fall apart.

I’ve seen this happen personally in ministry. My team had spent months establishing a simple system for processing new volunteers. If we put leads in the right place, they would be called, emailed, processed, interviewed and scheduled. It was a great process that allowed for a consistent experience. However, there were times when I had a special volunteer lead. It was someone I’d had a personal conversation with or someone I was friends with. Because I knew them, I wanted them to have a more personal experience. I didn’t put them in the system, but chose to follow up with them personally. In almost every occasion, this “personal experience” was not as good of an experience as the process we had established. I’m too busy. I can be forgetful. In almost every occasion, the people I personally tried to connect took 2-3 times longer to go through the process.

When faced with a crisis or special situation and we think that breaking protocol is the right course of action, we really should ask ourselves two questions:

• Is this really an emergency? Will breaking protocol be faster/better or should we just give extra care while following the established process?
• If I break protocol, what will I put in place to ensure that this doesn’t fall through the cracks? Since you’ll been in unsupported territory, what will you do to make sure your are successful?

Checklists are good. Processes are in place for a reason. Going around them is always an option, but it’s important to understand the implications if this course of action is followed.