Checklists Build Teamwork, Improve Execution

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Checklists are only now being recognized as a powerful tool in the medical community while they have long been in use in the military -- particularly in military aviation. For the past 13 years Afterburner, Inc., a team-building and business consulting company that teaches the tools and techniques developed in the low tolerance world of military aviation, has been touting the value of the checklists in performance improvement.

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January 22, 2009

Atlanta, GA - Two unlikely sources demonstrated a strong link between the use of checklists and team building this month -- this week's US Airways incident in New York and the release of a study on medical checklists.

Let's look at the latter first. The January 2009 Special Article of the New England Journal of Medicine highlights the surprising results of a medical study involving the use of checklists. Research physicians proposed that since approximately half of all surgical complications are avoidable, and that there is a strong body of evidence linking teamwork to improved outcomes, checklists may help prevent avoidable deaths and complications. The researchers did not anticipate as dramatic an impact as was demonstrated in their research. During the course of the study, death rates dropped from 1.5% to 0.8%, and serious complications fell from 11% to 7% -- a 47% and 37% improvement, respectively.

Checklists are only now being recognized as a powerful tool in the medical community while they have long been in use in the military -- particularly in military aviation. For the past 13 years Afterburner, Inc., a team-building and business consulting company that teaches the tools and techniques developed in the low tolerance world of military aviation, has been touting the value of the checklists in performance improvement.

Afterburner's Director of Enrollment Programs, Brigadier General (retired) Charles "Chaz" Campbell, U.S. Air Force, states "The medical community is one of the few professions that has recently adopted standardized procedures. They have now condensed those procedures into checklists much like military aviation. Most organizations don't invest the time to develop standards and checklists and suffer from the lack of execution discipline that results."

In addition to demonstrating the value of checklists, the study also reinforced the links among checklists, briefing and debriefing. "To implement the checklist," reports the study, "all sites had to introduce a formal pause in care during surgery for preoperative team introductions and briefings and postoperative debriefings, team practices that have previously been shown to be associated with improved safety processes and attitudes and with a rate of complications and death reduced by as much as 80%." That's no surprise to Afterburner.

The process and organizational improvement model they developed, which they named 'Flawless Execution', consists of a cyclical process of Plan-Brief-Execute-Debrief. Proper briefing and debriefing are critical processes in successful military aviation missions, as are checklists. "The act of opening a checklist," says General Campbell, "speaks to the individual and the team, sending the message that there is a deliberate intent to be disciplined. This intent is often a self-encouraging step that results in improved performance. This occurs in addition to eliminating the obvious errors of omission for which the checklist is designed."

Afterburner, Inc. began work in early 1997 with a select group of doctors focused on the growing numbers of errors in our hospitals. James D. Murphy, founder and CEO of Afterburner, states that the Joint Commission and other patient safety groups have been incorporating tools that military pilots use not only to reduce errors but improve OR and ER team performance during surgery. "The U.S. Air Force," says Murphy, "learned first hand in the 50's and 60's that as pilots transitioned to much faster jets from propeller-driven aircraft without proper planning, briefing, and debriefing procedures more pilots were dying in training than in combat."

Even in the super-high-reliability of modern-day aviation, we can see, for example, the US Airways accident in the Hudson River, the importance of checklists and good standardized operating procedures. "Captain Sullenburger did an incredible job," believes Murphy, "and I bet he would tell you that his training and preflight briefing emergencies, just like the one he encountered, had been planned, briefed and previously executed in his simulator training and visualized in his head many times before. Think of the impact these simple principles would have in business or, as we are now seeing, in saving lives in our hospitals."

About Afterburner

Afterburner, Inc. is an international management training company that teaches the techniques of Flawless Execution and peak performance, born in the high-reliability environment of fighter aviation, to the world's top corporations through keynote speaking, corporate teambuilding events, seminar workshops and leadership development. Afterburner has trained the sales teams and top executives of more than 100 of the Fortune 500 companies. Inc. magazine has named Afterburner to its prestigious Inc. 500 LIST twice. Over the past two years the company has expanded its operations to Australia, Canada and the United Kingdom.

�Afterburner, Inc. 2009 www.afterburnerseminars.com 404-835-3500



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