Few occupations carry greater stress and have higher stakes than being a surgeon or a commercial airline pilot. In both
instances, the lives of patients or passengers
hang in the balance. We rely on these highly
skilled professionals to recall from
memory a litany of information that
helps them assess conditions, use
their judgment, and respond accord-
ingly. It should come as no surprise
then, that pilots and surgeons (as well
as a host of other professionals) rely
heavily on the use of checklists to per-
form critical tasks before an operation
begins or just prior to take-off.
If checklists can help improve
patient care and keep passengers safe,
might they also provide a benefit to
healthcare compliance professionals
when conducting complex reviews
or investigations? Given the present
regulatory landscape and a fixation
by the federal government on compliance
programs and their efficacy, could the devel-
opment and implementation of a checklist
approach to conducting investigations help to
mitigate risk? We believe the answer to both
these questions is a resounding “yes.”
Behold the power of checklists
In his 2009 book, The Checklist Manifesto: How
to Get Things Right, surgeon and author Atul
Gawande makes a compelling case for the
expanded use of checklists.1 Gawande explains
that “checklists defend anyone, even the experienced, in many more tasks than we realized.
They provide a kind of cognitive net. They
catch mental flaws inherent in all of us — flaws
of memory and attention and thoroughness.
And because they do, they raise wide, unex-
Gawande recalls a program (the Keystone
Initiative) that implemented a five-item check-
list in Michigan-area hospital ICUs during the
early 2000s to reduce central line infections.
These infections had become a scourge in
the affected ICUs. After putting the five-item
checklist in place, which included simple steps
by T. Jeffrey Fitzgerald, Esq. and Asher D. Funk, Esq.
A checklist approach for
» Creating and using a checklist that outlines your compliance investigation process has genuine advantages.
» In other professional settings, checklists have been shown to be highly effective.
» Checklists help to reduce mistakes or process errors while increasing consistency and uniformity.
» A checklist-based process will help reduce the emotions and stress that often comes with an internal investigation.
» Using a checklist will help demonstrate that a compliance program is “effective” by documenting and explaining the provider’s
compliance investigation process.
T. Jeffrey Fitzgerald ( email@example.com) is a Shareholder in the Denver
office and Asher D. Funk ( firstname.lastname@example.org) is a Shareholder in the Chicago
office of Polsinelli PC.