Do Checklists Change Human Behaviors? Thoughts from Medical Lawyer Dr. Argy
Today a post from friend Dr. Nicolas Argy, MD, JD and professor at Boston University School of Public Health in the Department of Health Law, Policy and Management. His legal and medical training combined with strong interpersonal and problem solving skills has made him a highly effective and productive educator and consultant in the field! Here in his post “Changing Human Behavior With Checklists: Do They Enhance Patient Safety?”, Dr. Argy questions the effectiveness of education:
The downfall of the checklist is not inherent to the list or the process itself but the more important question of how we create sustained changes in human behavior. The literature is nascent regarding successful use of implementation science. The business world talks about change management. Behavioral psychologist, economists and neurocognitive researchers struggle to achieve sustained changes in human behavior. Kahneman has shown our flawed decision making regarding economics but the poor rationale appears in all spheres of life.
The natural consequence of flawed decision making is flawed behaviors that follow. Research continues on specific techniques to achieve the goal of influencing behaviors. Some focus on creating intrinsic motivation to cause change. Others rely on education or typical carrots and sticks approaches. More are moving to neurocognitively aware methods using heuristic techniques, progressive participatory dialectic techniques, exaggeration, gamification and closed loop data collection with realtime feedback including video and simulation training.
Other articles by Dr. Argy include:
- An Essential Tool for the Culture of Safety
- Process Improvement: A Philosophy of Life
- Reconciling Personal Accountability and System Failure
- Near Misses: An Invaluable Asset for Risk Management, Quality and Safety
- Safety Culture and Clinical Decision Support Software in Diagnostic Error Mitigation: Next Steps