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Developing the ‘checking’ discipline
  1. Wai Yoong1,
  2. Hashviniya Sekar2,
  3. Maud Nauta3,
  4. Helienke Yoong4,
  5. Tomas Lopes5
  1. 1 Obstetrics and Gynaecology, London, UK
  2. 2 Department of Obstetrics and Gynaecology, Royal Free London NHS Foundation Trust, London, UK
  3. 3 General Practitioner, Camden Health and Wellbeing Board, London, UK
  4. 4 School of Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
  5. 5 Department of Anaesthesia, Les Franciscaines Clinic, Versailles, Occitanie, France
  1. Correspondence to Dr Wai Yoong, Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London N18 1QX, UK; waiyoong{at}


We explore how engagement with checklists and adoption of a strict ‘checking’ discipline help avoid unintentional individual, team and systemic errors. Paradoxically, this is equally important when performing repetitive mundane tasks as well as during times of high-stress workload. In this article, we aim to discuss the different types of checklists and explain how deviations from a ‘checking’ discipline can lead to never events such as wrong side or site surgery. Well-designed checklists function as mental notes and prompts in clinical situations where the combination of fatigue and stress can contribute to a decline in cognitive performance. Furthermore, the need for proactive discussion by all members of the team during the implementation of the surgical checklist also reinforces the concept of teamwork and contributes towards effective communication. Patient safety is often a product of good communication, teamwork and anticipation: a ‘checking’ mentality remains the lynchpin which links these factors.

  • education & training (see medical education & training)
  • health & safety
  • protocols & guidelines

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  • Contributors WY proposed the topic, performed literature search and co-wrote the article. HS performed literature search and co-wrote the article. MN, HY and TL co-wrote the article. All authors have given final approval to the submitted paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests WY and MN are trustees of Haemorrhage After Childbirth Foundation as well as honorary faculty members of Trainetics, a human factors training organisation allied to British Airways Flight Training. WY and MN are associate members of Chartered Institute of Ergonomics and Human Factors.

  • Provenance and peer review Not commissioned; externally peer reviewed.