If it can save lives during surgery and keep planes from falling from the sky, then maybe a checklist can help us preach better sermons, plan better worship, and implement ministries that more nearly approach excellence.
I began to wonder these things as I read Atul Gawande’s new book “The Checklist Manifesto: How to Get Things Right.” Gawande, who is a fine writer as well as a general surgeon and educator, learned the power of checklists while leading a World Health Organization project to decrease complications from surgery around the world. In a world of increasing complexity, checklists can help prevent even the most seasoned experts from making mistakes.
For example, when hospitals in Michigan began using a checklist for inserting central lines in patients -- the checklist reminded doctors and nurses to do five basic things like wash hands with soap and water -- most ICU’s decreased their central line infection rate to zero. This checklist saved Michigan hospitals an estimated $175 million, plus fifteen hundred lives, in the first eighteen months.
According to Gawande, when pilots experience any unexpected difficulty in flight, they know better than to rely on their experience alone to solve the problem. Their experience tells them to the relevant checklist. And do what it says.
Gawande’s case is convincing. After his team completed its surgical checklist and tested it in eight hospitals around the world, the results exceeded expectations. Major complications from surgery fell 36% and deaths fell 47%. Billions of dollars are spent developing new medical technologies and pharmaceuticals when a piece of paper can save an untold number of lives. For free.
As I read the book I couldn’t stop thinking about my church’s Christmas Eve service. I didn’t know who would be running the sound system. No one was in the booth before the service started. I didn’t know if anyone was planning to turn off the lights during “Silent Night,” so I whispered to our assistant minister to do it after we started singing. When we got to the second verse and I saw him walking up the aisle still lighting candles, I snuck across the front of the sanctuary to turn the lights off myself (I didn’t know that his son was already planning to do it). I am still expecting an email from the head of our altar guild informing me of all the other things that went wrong that night.
When the service was over, someone asked me who would clean up before Sunday morning. I said, “No one has ever asked me that before. I assume whoever is responsible will get it done.”
It didn’t get done. The next Sunday morning at 8:30 I was walking through the pews picking up Christmas Eve bulletins while the facilities manager, who was supposed to be on vacation, was vacuuming dried poinsettia leaves.
The layers of missteps and miscommunication were deep that night and in the days leading up to it. And I know exactly what Gawande would tell us to do to keep us from repeating these mistakes next year: make a checklist and use it.
My mind has been racing since I finished the book, thinking about all the other places in my work and our work as a staff team that checklists could help us get the mundane and eminently forgettable things right. Such things make the difference between pretty-good and excellent. Imagine the possibilities -- a sermon preparation checklist, a funeral checklist, a wedding checklist, a bulletin checklist, a new member checklist, a worship checklist. I could go on.
The staff is going to hate me.
Ministry might not be as complex as surgery or flying a plane, but we serve a God who thinks the stakes are just as high and who expects us to be faithful in the little things. Because getting the little things right is key to getting the big things right, and when the big thing is witnessing to God’s Kingdom, surely a checklist is worth a shot.
Roger Owens is co-pastor of Duke Memorial United Methodist Church in Durham, NC.
