The Checklist: Recognize Limits, but Harness Its Power

A checklist can be many things, as simple as “a list of items required, things to be done, or points to be considered, used as a reminder,”1 or, according to the Agency for Healthcare Research and Quality, “an algorithmic listing of actions to be performed in a given clinical setting, the goal being to ensure that no step will be forgotten.”2 Since the Institute of Medicine’s scathing report on medical error,3 checklists have gained substantial attention, owing to reports of their pivotal role in driving the success of numerous patient safety initiatives. Greater notoriety naturally precipitates greater scrutiny, however, so both the promise as well as the limitations of checklists need acknowledgement. This editorial will consider the often heralded and sometimes belittled checklist for its general benefi ts, potential utility, and range of evidence attesting to its value in quality and safety improvement.