The Power of Checklists: Why aviation-style checklists help labs and clinics communicate better

In aviation, checklists are treated like safety equipment. They turn complex routines into simple, reliable steps—especially when people are busy, tired, or stressed. Labs and clinics face the same pressures: time-critical work, handovers, instruments with quirks, and decisions that affect patient safety. Bringing aviation-style checklists into healthcare is a low-cost way to cut errors, speed up teamwork, and make communication crystal clear.

Why communication breaks down in labs and clinics

Even skilled teams miss things when:

• Workloads spike and cognitive load is high
• Staff rotate across shifts and locations
• People rely on memory or informal habits
• Background noise and interruptions break focus
• There’s no shared mental model for who says what, when

Checklists don’t replace expertise; they support it. They create a shared sequence, common language, and clear pause points where the team slows down just long enough to confirm the right next step.

What makes aviation-style checklists different

A good aviation checklist is not a policy document. It’s a short, action-oriented tool designed for the moment of use.

Core features:

• Phase-based: before, during, after (e.g., before collection, during analysis, post-result).
• Challenge–response: one person calls the step (“Patient ID?”), another confirms (“Two identifiers matched.”).
• Read-do or do-confirm: either read each step then do it, or do the routine and confirm critical items at the end.
• Plain language & verbs: “Label tube” beats “Ensure proper labeling.”
• Built-in communication checks: call-outs (“Critical potassium 6.8”) and read-backs (“Confirming six-point-eight”).
• Role clarity: a named checklist leader guides the flow, others respond.

Where checklists help most in healthcare

• Specimen collection & labeling (mislabeling is a tiny mistake with huge consequences)
• Instrument startup/shutdown and maintenance
• Pre-analytical acceptance (sample integrity, transport time, temperature)
• Result verification & release (delta checks, reflex testing)
• Critical result communication (who to call, what to say, read-back)
• Shift handovers (reduce “I thought you did it”)
• Emergency response (spills, exposure, code situations)

Anatomy of a high-impact checklist

Keep it short and visible. Aim for 5–9 items per section.

1. Trigger: When to use it (“Before any blood draw”).
2. Roles: Who leads; who responds.
3. Steps with verbs: One line each, minimal words.
4. Pause points: Small stops to confirm the critical few.
5. Verification style: Read-do vs do-confirm.
6. Time/initials: Space to sign or tick—creates accountability.
7. Version date: So staff know it’s current.

Ready-to-use sample checklists

1) “Before Specimen Collection” (Read-Do)

Leader: Collector Responder: Assistant (or self-confirm if alone)

1. Patient identity: Two identifiers matched with wristband and order.
2. Order verified: Test, priority, and site confirmed in LIS.
3. Allergies/precautions: Anticoagulants, latex, infection status checked.
4. Tubes & labels ready: Barcodes printed; labels match patient & test.
5. Site prepped: Correct patient, correct limb/site, clean & dry.
6. Time stamp: Collection time recorded on requisition/LIS.
7. Label at bedside: Label applied in presence of patient.
8. Specimen integrity: Invert as required; temperature/ice if needed.
9. Handover: Transport logged; chain of custody if applicable.

Pause point: “Team agrees to proceed?” → Yes.

2) “Critical Result Call & Read-Back” (Challenge–Response)

Leader: Caller (lab) Responder: Receiver (clinician/ward)

1. Identify yourself & lab (name, department).
2. Confirm receiver (name, role, patient location).
3. Patient identity (two identifiers).
4. State critical result (call-out exact value and units).
5. Receiver read-back (word-for-word result and units).
6. Action window (is action time-sensitive? yes/no).
7. Next step & responsibility (who does what, by when).
8. Document call time, names, read-back success in LIS.
9. Escalation if no answer or disagreement (define levels & timing).

Pause point: “Do we both confirm the same value and plan?” → Yes.

3) “Shift Handover: SBAR Mini-Checklist” (Do-Confirm)

S – Situation: Today’s status, pending runs, out-of-service equipment.
B – Background: Relevant patient or batch notes; QC trends.
A – Assessment: Risks (stock low, instrument drift, staffing gaps).
R – Recommendation: Next actions, who is responsible, deadlines.

Tick when done: ☐ LIS notes updated ☐ Whiteboard updated ☐ Keys/cards transferred

4) “Instrument Startup (Analyzer X)” (Read-Do)

1. Power on; self-test complete (no major faults).
2. Reagents within expiry; onboard volumes above thresholds.
3. QC levels loaded; lot numbers match LIS.
4. Run daily QC; review flags; document corrective actions.
5. Temperature/pressure within limits; print or save auto-log.
6. Maintenance tasks done (waste emptied, probes cleaned).
7. Status set to “Ready” in LIS; notify bench lead.

How to roll out checklists without resistance

1. Co-design with users: Techs, nurses, phlebotomists, residents. Ask, “Where do mistakes hide?”
2. Start small: Pilot in one workflow (e.g., blood culture collection).
3. Run short simulations: Practice the call-and-response rhythm.
4. Make them easy to find: Laminated copies at workstations + quick links in the LIS/EHR.
5. Name a checklist leader: On each shift, someone owns updates and answers questions.
6. Audit lightly, learn weekly: Track near-misses, mislabels, turnaround times, and communication delays. Share wins quickly.
7. Keep it living: Trim steps that add no value; bold the critical few; review quarterly.

Measuring impact (simple scorecard)

• Specimen mislabel rate ↓
• Critical result notification time (collection → clinician informed) ↓
• Turnaround time outliers ↓
• QC/maintenance misses ↓
• Staff confidence & onboarding speed ↑
• Incident reports tied to communication breakdowns ↓

Even two or three of these moving in the right direction can justify the effort.

Common pitfalls (and fixes)

• Too long: If it doesn’t fit on one page or one screen, it won’t be used. Fix: Split by phase.
• Vague wording: “Ensure” and “appropriate” invite confusion. Fix: Use clear verbs and measurable checks.
• No trigger: People forget when to use it. Fix: Put trigger in the title (“Before Result Release”).
• No owner: Checklists decay without stewardship. Fix: Assign an owner per area with a review cadence.
• Punitive rollout: Staff hide mistakes if tools feel like surveillance. Fix: Frame as safety support, not policing.

Quick template you can copy

TITLE (Trigger): e.g., “Before Specimen Collection”
ROLE: Leader ______  Responder ______   VERSION: ______  DATE: ______

[ ] Step 1 (verb + object, measurable) 
[ ] Step 2
[ ] Step 3
PAUSE POINT: Team confirms _______________

NOTES (limits, units, ranges):
ESCALATION: Who to call if blocked: ____________________
SIGN/OFFICIAL: _________  TIME: ________

Conclusion

Aviation-style checklists help labs and clinics do the right things, in the right order, at the right time—together. By building short, clear lists with challenge–response, read-backs, and defined pause points, you turn individual know-how into team reliability. Start with one high-risk task, co-design with the people who use it, and track a few simple metrics. In a matter of weeks, you’ll see fewer miscommunications, faster handovers, and safer care—without adding cost or complexity.