75 years ago, on 30 October 1935, the prototype Boeing B-17 Flying Fortress was getting ready for its second test flight. The pilot, Ployer Hill, was one of the most experienced in the US Air Force. He'd been flying planes since 1918 and had test flown more than 60 aircraft. Everything looked good as the bomber accelerated down the runway and lifted off. But then those watching from the ground caught their breath. Instead of gradually gaining height, the B-17 went into a steep climb - then it stalled and crashed to the ground, killing Hill.
The cause was trivial, but deadly. Before he started the flight, Hill had forgotten to disengage the gust lock, which held the plane's flaps and rudder in place while it was on the ground. The moment the plane's wheels left the tarmac, Hill lost all control of the plane, and was doomed.
This is a particularly vivid - and gruesome - example of how even the most experienced and conscientious people can make simple mistakes. Not only that, the consequences can be out of all proportion to the scale of the error.
At a much less onerous level, this is a problem we all encounter when we set about improving quality in labour-intensive operations such as logistics. In these operations quality is mainly about making sure people carry out the right actions at the right time in the right sequence - over and over again.
This isn't easy - people have good days and bad days, sometimes they forget things, and sometimes they get bored. You can't watch them all the time (and even if you could, what's to say you make a mistake yourself?).
So it's worth finding out how the USAF prevented another pilot repeating Hill's fatal error. They introduced a pre-flight checklist for all pilots - and this is the first record of a checklist being used to prevent human error.
The great thing about a checklist is that it's simple - but remarkably effective. Here's one example of how much difference it can make - from another environment in which eliminating error is vital.
The World Health Organization has developed a 19-point surgical safety checklist to reduce complications and improve consistency of care. The result of using this checklist is astounding. The rate of death fell from 1.5% beforehand to 0.8% after the checklist was introduced- in other words, almost halved. There's been no investment in new equipment, no new drugs, no new techniques - just a method of checking that everything has been done properly.
This is a huge improvement from introducing just one simple technique - and there's no reason why you wouldn't see the same kind of change where you work.
Here are a few ideas for how checklists might help you:
Goods-in: if you don't get this absolutely right, then you create errors all the way through your operation. So why not have a checklist to make sure everything you need to check is checked, and all the information you need to capture is captured?
Stock shortages: if you're short of stock when you come to pick, lots of different people in the organisation need to know, systems need to be updated, and remedial action needs to be taken. Don't rely on experience and common sense - have a checklist.
Delivery vehicle breakdown: do your drivers know what to do if they break down? How can you be sure they'll make the right checks, and contact the right people? Even if you've explained what to do when you put them through their induction course, they'll have half-forgotten by now. A checklist in the cab could be the answer.
So here's this month's message. If you don't use checklists in your operations, almost certainly you're missing an opportunity to improve service and quality - at no cost. What are you waiting for?
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