How to Create an Effective Checklist for Emergencies

Why Checklists Are Important During Emergencies and How to Create an Effective One

3 Feb 15

In 1935, 2 experienced pilots crashed a B-17 during its first test flight. Their years of experience and extensive qualifications weren’t enough to ensure a successful takeoff, and pilot error caused serious injuries resulting in the death of a few crew members. Even when we feel totally comfortable with a task, even when we’ve done it hundreds of times, we can still miss the important steps that prevent disaster.

The first checklists were conceptualized as a response to the B-17 crash. It was proven that something was needed to remind pilots of everything that was required to safely pilot the aircraft. After checklists were created for the B-17, pilots flew 1.8 million hours with 18 B-17s without incident and proved to the government that the aircraft was safe.

Even the most skilled professionals can make mistakes sometimes with disastrous results. Expert knowledge is more accessible than ever before, but remembering all the information we acquire over the years can be a difficult task. At any point in time, the human brain is limited to what can be held in working memory (usually around only 7 items or less!) and thoughts and the ability to stay on task can become even more scattered depending on how stressful the situation is.

With the implementation of checklists, the chance to forget important steps to a process or procedure is significantly mitigated no matter how stressful the situation. With a well-designed and effective checklist, it is simple to ensure that the vital yet routine activities are taken care of to allow the brain to fully focus on the tasks and activities that require full attention and action.


World-renowned surgeon, author, and public health researcher Atul Gawande was elected by the World Health Organization to improve surgical safety worldwide and as a result created the WHO Surgical Safety Checklist as well as a book on the importance of checklists titled, “The Checklist Manifesto: How to Get Things Right“.  By implementing checklists, Dr. Gawande cut major surgery complications by 36% and slashed death rates by 47% in 8 hospitals. The use of checklists allowed surgeons to itemize their procedures in a simple, effective fashion ensuring that every step of the operation followed protocol, thus reducing the chance for human error.

Checklists can also make a positive impact in the culture of the workplace. Teams that work on projects and utilize checklists must be able to work together to complete each step and hold each other accountable for their responsibilities. The more often a team works together with a pre-defined list of steps and pre-designated roles, the more likely the organization will develop a stronger culture of discipline and teamwork.

How do you create an effective checklist?

1.       Determine what kind of checklist to use.

The first step in creating an effective checklist is by deciding which of the 2 most basic kinds of checklists to create: a “read-do” (read each step and then perform the action) or a “do-confirm” (do the steps from memory and pause to check) checklist. It is thought that a read-do checklist is more useful when a user has limited experience with the process and a do-confirm checklist is more useful when a user has memorized the majority of the steps to the list.

2.       Keep it simple

Each portion of the checklist should be broken down to small, digestible steps that easily flow from step A to Z. Ensure that pause points are included after at most 10 steps and occur in a logical manner and are clearly marked. Try to keep the list to one page as to not overload the user. If a checklist is too long, users may become overwhelmed and abandon the checklist. Lastly, ensure that the purpose of the checklist is clearly stated and labeled. Everyone using the list should have no questions on what the result of the following the checklist will be and why it should be used.

3.       Execute, test, and revise.

A great checklist usually isn’t conceived on its first build. There are many variables that can create a more efficient, effective, and user-friendly checklist. Try to see how changes in pause points, number of check points, length of checklist, and even the layout of the checklist can affect processes.

Give it a shot; create your own checklist for something you’d like to improve. Chances are you won’t be disappointed with the results!

For additional resources, has a great checklist for building an effective checklist here.