Good Checklist Design from The Checklist Manifesto

The Checklist Manifesto: How to Get Things Right by Atul Gawande discusses how the effective use of checklists can help in areas where complex tasks are performed repeatedly. He primarily looks to the great success that the aviation industry has had in preventing airplane crashes by having the pilots rigorously use checklists to consistently perform the various functions to fly aircraft with minimal errors compared to the complexity of their operation. Atul discusses his journey in applying the use of checklists to his work as a medical doctor. He found great success using checklists to prevent errors during medical practice.

Figure 1: Book cover of The Checklist Manifesto [1].

I would encourage you to read his book to learn more about how he learned about the importance of checklists by exploring their use in a variety of industries. A variety of fields require increasing training to be successful because of the large amount of knowledge amassed in various fields, whether it be medicine, law, or engineering. Checklists applied in fields such as these are a tool to help professionals effectively apply the knowledge that they have gained through their extensive training. This has, hopefully at least, partially introduced to you how and why checklists are important. I wanted to share and discuss with you some of the elements of good checklist design that Atul shared in his book.

Figure 2: A checklist for checklists from The Checklist Manifesto [2].

Development

A check list should cover critical steps in a process without hindering the actual performance of a task. This is not a checklist as one would use as a shopping list that could as easily be three items as it would be thirty items. It is a carefully curated list of items that will aid a person or group of people in consistently performing all of the necessary steps in a complex task. An aspect that is important in this development process is keeping this checklist simple. It needs to be easily read and understood by the user. Speed and ease of use are helpful in a variety of areas but obviously necessary in situations such as engine failure on a plane or during an emergency medical procedure. The checklist is meant to be a tool that assists the user in consistently applying the knowledge that they have spent time acquiring. Complex environments can amplify the natural human imperfections that exist in memory and attention. Checklists are meant to help prevent errors as a result of those imperfections.

An area where checklists can be especially important is processes where missing a single step causes failure of an entire task. For example, missing a step on a medical procedure could mess up the entire procedure.

Figure 3: An example of a checklist used by a pilot [2].

Drafting

The checklist should be short, roughly five to nine items, so that it can be easily run through by the user and not impede the completion of the actual task. Not every possible task that a person should need to complete should be placed on a checklist. The focus should be on steps that are the most catastrophic if missed or the steps that are most easily forgotten. These are not always easy to identify, so it can be helpful to collect data on this sort of information whenever possible.

The wording of the checklist must be simple and easily understood by the user. It may depend on the application whether the user only has seconds or minutes to go through the checklist but the language should communicate the idea as quickly and simply as possible. In addition, the checklist should be a simple black and white design that is easy to look at and read.

A use of checklists that might not be normally thought of is its ability to increase collaboration. There are key times where team members may need to communicate on important progress or problems of a task. From this perspective, checklists can help not just individuals to perform consistently but teams as well. 

Figure 4: Surgical safety checklist example for various stages of surgery [3].

Validation

An important part of making a checklist that is used by a professional is to actually test it out with users in real or simulated situations to allow for the checklist to be refined. It needs to actually help the professional stay on target. A checklist needs to be effectively inserted into the workflow of a professional so that it magnifies their abilities to perform their work. This validation process is similar to the importance of performing market testing when developing a product to get actual feedback from users.

The checklist design described here is not for making a casual list of items to be completed on Saturday afternoon. This is a tool that when rigorously developed allows professionals performing complex tasks to consistently perform them with minimal error. I encourage you to look for places where checklists are used by professionals in your day to day life and places where a checklist could be used to improve the quality of work.

References

[1] Gawande, Atul. The Checklist Manifesto: How to Get Things Right. Metropolitan Books, 2009. Amazon, www.amazon.com/Checklist-Manifesto-How-Things-Right/dp/0312430000.

[2] Gawande, Atul. The Checklist Manifesto: How to Get Things Right. Metropolitan Books, 2009.

[3] "WHO Surgical Safety Checklist." World Health Organization, www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery/tool-and-resources. Accessed 27 Jan. 2026.

To cite this article:
Smith, Eli. “Good Checklist Design from The Checklist Manifesto.” The BYU Design Review, 28 January 2026, https://www.designreview.byu.edu/collections/good-checklist-design-from-the-checklist-manifesto.