Recently, one of my readers pointed me to an old New Yorker article from Atul Gawande. In “The Checklist”, Gawande describes how one simple change seems to be revolutionizing medicine: the use of checklists.
Modern medicine is complicated. There’s a lot of stuff that doctors and nurses need to know and do in order to provide effective care. Health-care professionals are smart and capable, but they’re also human. It’s easy to forget (or casually neglect) important details during the heat of the moment or the crush of monotonous routine.
That’s where checklists come in: By creating and using checklists for important procedures, health-care providers can be certain that they haven’t forgotten to do something important. Gawande’s article explains that pilots have used checklists for decades to make sure they don’t forget about important steps in prepping and flying their planes. Now, hospitals are realizing that checklists can help them prevent infections and save lives too.
Gawande’s article is great — interesting and insightful — and you should read it if you haven’t already. (I readily admit I may be the last person on Earth to have seen it since it was published seven years ago.)
For me, this idea of checklists has more profound personal implications.
One of the side-effects of my ADHD nature is that I often forget to do the most basic things. I forget to brush my teeth, to wash my face, to comb my hair. I forget to close cupboards, put dishes in the dishwasher, pick up my dirty clothes. It’s not that I don’t care about these things — I do care — but that I get distracted and forget to finish what I was doing. (“Complete the cycle,” Kim tells me when she notices I’ve left something out on the counter once again. She means that I should follow one action complete to the finish before moving onto something else.)
It occurred to me after reading Gawande’s article that checklists might help me manage my life more effectively. One common ADHD coping mechanism, one that I’ve learned to love, is the to-do list. If something needs doing, it’s important for me to get it out of my head and onto a piece of paper because otherwise I’ll forget. I keep a running to-do list on a whiteboard in my office.
Actually, I keep three lists:
- One list for high-priority tasks (“prep laptop to sell”, “do year-end business finances”).
- Another list is for medium-priority tasks (“get maintenance on Mini”, “sort storage unit”).
- A final list for low-priority tasks (“repair grandfather clock”, “learn three songs on guitar”).
My to-do list is great, but there’s a weakness. It doesn’t capture items that need to be done every single day. To that end, inspired by Gawande’s article, I’ve decided to adopt a series of checklists to help me stay focused, to help me establish a routine.
I have one for morning:
Drink a glass of water
Wash face
Moisturizer
Take meds
Get ready for gym
Eat a healthy breakfast
Inbox zero
Brush teeth
¡Exercise!
I have one for during the day:
Drink greens powder
Take fish oil
Shower and shave
Read 30 minutes
Write something substantial
Eat a healthy lunch
Brush teeth
Drink a glass of water
Practice guitar
Practice Spanish
Run errands
Complete one to-do item
Inbox zero
¡4pm Clean sweep!
And I have one for before bed:
Record calories and exercise
Flip checklist on computer
Brush teeth
Wash face
Moisturizer
Take meds
Drink a glass of water
As you can see, the things I’m asking myself aren’t tough. In fact, most are easy. For some of you, this may seem crazy. Checklists for basic life tasks? Who needs that!?! Well, I need that. In fact, even with checklists, these things can be a challenge. I can quickly become blind to the checklists, can begin to ignore them.
One of my goals for 2015 is to force myself to go through each list every day. My hope is that in time, all of this stuff will become routine. I realize that I probably won’t get every item done every day, and that’s okay. The important thing is for me to get in the habit of doing most of these things on most days. If I do, I’ll be a better man.
This sort of thing is also useful for aging people who are beginning to notice short-term memory loss, or for those who take the type of medications that affect mental acuity.
There’s no shame in using tools to help us function better.
I use a checklist when I am packing for a trip ….works the same for two days or two months.
I like the saying “Complete the cycle” Sounds better than “Clean up your mess”!
When life gets especially complicated, I have always resorted to check-lists. When I traveled a lot, I had a master packing list on excel (computer, power cord, spare power cord, printer, paper, printer cable…) which I modified for each trip. Now, I have aging relatives who always create the chaos and emergency de jour, so I keep a check-list of basic functions just such as you set out above; partly because in chaos, such as my recent life, it’s possible to lose even the most basic functions like brushing your teeth. In my case, this began because I have began taking a short-term medication that must be taken at a particular time throughout the day. I found, on days with emergencies, I could not get that done with perfect accuracy. So my daily check-list began. It’s on excel again, so easily modified. I print it out and scratch out each task as I go along. I have been doing this for about 6 months and it’s grown to include even spiritual goals such as (I am Buddhist so) Generate Bodhisattva Motivation in the beginning of the day and Dedicate the Merit at the end of the day. Sometimes I feel almost unbearably nerdish, but it’s helped me remain grounded in things I think are important while all around me is chaos, not perfectly, but better than nothing and better than anything else I have found.
I relate on many levels, with varying degrees of “…failing to complete the cycle…”
Brain dump? Please explain this further, or point me in the direction of a post that discusses the process?
Thank you.
Flylady.net was instrumental in helping me with her check lists, many years ago. Another thing you might want to look into, JD, is seriously going gluten free. I’ve found a great improvement in my short term memory, among other things.
Happy new year!
Checklists are a great idea. One of my daughters has ADHD and a morning checklist has been great for her. She’s old enough to “know” what she needs to do each morning, but it’s easy for her to get off track. She’ll be heading to the bathroom to brush her teeth, but she’ll see something that reminds of her something else and on and on. We typed up some checklists and have them on a mini-clipboard that she carries around with her in the morning. She loves checking off each item as she completes it and it keeps her focused on the next thing.
I love the idea of completing the cycle, too!
Awesome idea! You’re doing what works best for you.
I’m a huge fan of to-do lists, because if I don’t write it down, like you I’ll forget it and consequently won’t do it. I also feel super satisfied when I cross items off my list, so they work well for me.
I do have some 2015 resolutions that might be best conquered by making a daily checklist; maybe I’ll give it a try. Thanks for sharing!
I love lists! My favorite way to organize my to-do list is a four quadrant square. The top row is for important items and the bottom for unimportant; the first column is for urgent and second for non-urgent. For example, filing taxes would be important but not urgent until April when it would move to the urgent column. Ideally we should spend most of our day in the important row and question whether things unimportant and non-urgent ever need to be done….I’ve been meaning to buy a plant for the bathroom…..
I really like your little lists and how you use them. A regular daily checklist can help you feel like you have some structure and achievement throughout the day. My 11 yr old son keeps a running list on his hand, of work he had to do for school he just wipes them off as he does them with a wet finger! I’m cool with that even if his teachers don’t like it, it works for him.
I personally am not so inclined. I do believe there is great focus to be achieved by such lists but I am a great believer that one can get very tied down by them. Sometimes one needs the freedom to think and do stuff in a very incoherent way. Inspiration and a certain lightness comes from not giving a damn about some stuff. This has been my attitude towards email for many years, which my co workers have often been shocked at. I have thousands of emails. I flag important ones but I do not waste half my life filing them. They are virtual things after all,they are not blocking entry to my door. Life is too short to worry about emails. So I leave em, occasionally delete them but I don’t worry about them at all. Somehow, my brain has managed to deal with what’s important and what isn’t without spending hours filtering through my emails. I feel that I have resisted the obsessive expectation to organise. Yes, I am disorganised in many ways but I manage my family and life quite well, cook healthy food, spend good time with my kids, have a job where I am privileged to help others in often great difficulty , I encourage thinking and sometimes do the opposite of what is expected in modern life. I would probably do better in a crisis, if it happens….