The Importance of Checklists

This weekend, I had a frightening experience with my two-year-old son. He had a fever that escalated so fast that it caused what we think was a seizure. For almost a minute, he was unresponsive and seemed to stop breathing. That minute felt like an eternity. I told my husband to call 9-1-1, while I made an amateur, untrained attempt at giving him life breaths. Luckily, he came out of it, and we did not need an ambulance. We rushed to the Emergency Room at Children’s Hospital where he was evaluated, and the nurses brought his fever down. Within a couple of hours, he was back to his normal self, running around the trauma unit. The doctor told us he had a common virus, and that it was the escalation of his fever, not the height of his temperature (103.4 was recorded when we got to the ER), that may have caused a seizure.

I am grateful it was nothing serious and that he is happy, healthy, alive, and well. It helped tremendously that we had a friend, a nurse practitioner, on duty who stopped in to check on us. Melissa, you are a saint.

Now that I have had a few hours to digest, I am embarrassed that I have no formal CPR training. If I had, I would have known to check for a pulse and look for his chest rising to confirm breathing. I did neither of these things. I thought he wasn’t breathing at all, but there was probably very shallow breath. In a situation like that, there is no time to develop a plan, you are operating on adrenaline and instinct. My one saving grace is that I remained calmer than most, a trait that I seem to have been born with. I will, however, be taking a CPR class as soon as possible.

A few years ago, I read The Checklist Manifesto by Atul Gawande. Gawande is a surgeon who noticed that simple errors are made in surgical procedures that should be easy to avoid – operating on the right side instead of the left, leaving foreign objects inside a body, forgetting to sterilize an instrument. These simple mistakes have horrifying consequences, and they are made by some of the most skilled and trained medical professionals in the world. Gawande also points out that they can be avoided by implementing a simple solution – the use of checklists.

THe CPR checklist begins with checking for pulse and looking for the chest rising to confirm breath. Both steps would have reassured me that he was not in immediate danger.

We use checklists a lot in our business. There are checklists for introducing new clients to the firm, opening new accounts, trading, an onboarding process, and a routine service model for existing clients. I rely on these checklists daily, and they allow me to operate on a level of efficiency I’ve never experienced before. I spend less time thinking about how to accomplish tasks and more time DOING them. I am amazed at how much of my time is spent doing things that are valuable versus doing busy work. Clients feel this because I spend more time talking to them, meeting with them, and thinking about their financial plans.

The combination of a trained professional and the use of checklists is powerful, but in the case of my son, a checklist would have empowered an amateur.


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