Checklists have been used in healthcare practice to ensure that clinical practice guidelines are followed. An example is the WHO Surgical Safety Checklist developed for the World Health Organization and found to have a large effect on improving patient safety and subsequently found to have a nil effect in a cohort of hospitals in the Province of Ontario in Canada. According to a meta-analysis after introduction of the checklist mortality dropped by 23% and all complications by 40%, higher-quality studies are required to make the meta-analysis more robust. However, checklist use in healthcare has not always met with success and the transferability between settings has been questioned. In the UK, a study on the implementation of a checklist for provision of medical care to elderly patients admitting to hospital found that the checklist highlighted limitations with frailty assessment in acute care and motivated teams to review routine practices, but that work is needed to understand whether and how checklists can be embedded in complex multidisciplinary care.
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Excessive dependence of checklists may hinder performance when dealing with a time-critical situation, for example a medical emergency or an in-flight emergency. Checklists should not be used as a replacement for common sense. Intensive training including rote-learning of checklists can help integrate use of checklists with more adaptive and flexible problem solving techniques.