Checklists ain't all

I am often approached by people who have read Atul Gawande's excellent work and who ask me if we use checklists to improve the quality of care in our hospital. We do, in order to reduce variability where appropriate, but stating the issue in terms of checklists is simplistic. This 2009 Lancet article by Charles Bosk, Peter Pronovost and others, entitled "Reality check for checklists," states it clearly: