What's a ‘Smart’ Checklist for Clinical Environments?


“Why would you start a business based on a checklist?” 

That is a question I get sometimes from people who are first learning about my company, ReadyList.

ReadyList is not just any old checklist. ReadyList is a smart checklist that can transform the way your teams operate. 

So, what is a smart checklist? A smart checklist uses data analysis to prescribe best practices in line with operational goals. 

It allows teams to complete a set of activities perfectly and efficiently.

In other words: smart checklists can help users do much more than paper lists or even standard e-checklists could ever do.


Let me paint a picture.

Today, many environmental services (ES) teams, for example, work from memory or at best a paper checklist. 

The workers apply that same mental or paper checklist to every patient room, regardless of whether it is in the ICU, in labor and delivery or on a medical/surgical unit. 

Did they do the tasks well? Not sure--they are not capturing data. And if there are problems, they are often not reported at all. That is, unless supervisors catch the issues. 

But most supervisors may only be able to make a couple rounds at best around the hospital in a regular shift, and do so in a routine matter, which means they can miss things. 


Now let us consider what a smart checklist could do for the same ES team.

On a mobile device, a team member follows a checklist of room turnover tasks that is specific to rooms in the ICU, labor and delivery and so on.

Not only is the checklist configurable to the room, but it is also tailored to the individual team member.

The smart checklist adjusts over time and advises the worker where to take extra measures and what to double check based on past performance. 

The worker then captures a picture from his phone to show completion of his work. This data is logged and proficiency is easily assessed by supervisors.

At the end of the day, the smart checklist guides the team member through repeatable best practices in pursuit of goals like zero hospital-acquired infections and faster room turnover. 

Having ReadyList is like having a supervisor alongside you on every clean.
-Chris H., Environmental Services Director

In the rest of this article, I will give you more insight into what our company, ReadyList, does and where we’re headed.


The Evolution of the Checklist

As technology goes through iterations to improve itself, we often wonder how we ever managed before.

Consider the paper map. Sure, we learned how to navigate with it, but can you imagine a world without Google Maps and all of its amenities?

Or how about the mobile phone--it went from being a simple device that could call someone to a smart device that is essentially a computer in your pocket.

The checklist also has gone from simple to smart thanks to technology. 


The Paper Checklist 

First came the paper checklist. It works for simple tasks, but not for more complex tasks with variable steps.

Plus, paper checklists are easy to lose, easy to mess up and are just plain inflexible.

The Electronic Checklist

You may be familiar with things like Google Keep and Wunderlist, which are popular electronic checklists. 

They work quite well for basic tasks. For example, a grocery list or a list of topics you want to write about for your blog.

They are efficient, you can take them anywhere on your mobile device or laptop, and they offer functionality beyond the paper list, like sending reminders.

The Smart Checklist

The smart checklist comes with all the basic functions of the electronic checklist, but kicks it up a notch.

This is where our company, ReadyList, shines.

We take the basic e-checklist, and add functions like:

  • Variation
  • Accountability
  • Integration
  • Descriptive analytics

Plus, we’re working on things like:

  • Predictive analytics
  • Prescriptive analytics

Next, I’ll give more examples of how we use these features at ReadyList.

1. Variation

This is the first set of features that tackles challenges many e-checklists cannot. 

For example, our smart checklist is designed to be unique to the job, clinical environment and operational workflow (e.g., the ability to order equipment at the beginning of a clean so it arrives by the time the clean is finished). 


The medical equipment list for a patient room on a Children’s Medical/Surgical unit

To understand why variable steps matter in some settings but not others, here is an example …

In a hotel, you have near-identical rooms that require roughly the same cleaning process. A simple checklist would work well for cleaning procedures.

In a hospital environment, however, you might have 20 unique units and five different cleaning protocols. 

So that could mean 100 unique variations of a cleaning checklist, which becomes too complex to manage with a simple e-checklist.

2. Accountability

A smart checklist captures data in a way that makes teams more accountable. 

For example, users might take photographic proof of the job they have done (or a visual of any problems that arise). 


Save a photo of your work to account for a job well done

This has a variety of benefits: 

  • It reduces checklist fatigue by increasing accountability. 
  • It helps workers and supervisors take control of their performance reporting. 
  • It enables on-site supervision when managers are off-site or have more pressing issues. 

Features like this offer other possibilities, like gamification of the job. (For example, Team Member A took more photos this week than Team Member B, so she gets more points toward a team goal or award).

3. Integration

A smart checklist also helps manage tasks assigned to multiple people (and teams) in a coordinated manner. 

Why is this important? In a hospital environment, turning over a patient room involves multiple parties such as ES, central supply, nursing, respiratory and often others.   

Smart checklists coordinate the work of many in one place in real time for one particular clinical environment.

Keep in mind, too, the many other processes in a hospital that are managed through many disparate systems. 

A smart checklist like ours at ReadyList can integrate with those systems to do things like:

  • Get alerts from the hospital bed board.
  • Order equipment.
  • Send texts to share inspection scores.
  • Auto-engineer service tickets.
  • Request IT help in the room.

4. Descriptive Analytics 

A smart checklist not only collects data, but also converts that data into information for management to assess and act on. 

With operational reports at-the-ready, you can review outcomes over time, and tweak future processes to improve those outcomes.

For example, say you have a business problem to solve: you have noticed that infection rates on a particular unit have increased for three days. Why? 

Reports enable you to find a root cause. You can quickly trace, to the day, that new staff were onboarded while your primary trainer went out on maternity leave. The new cleaners need retraining.

If you did not have that data readily available, you may never have been able to put the two together to figure it out.


Real time metrics enable management to target their supervisory efforts

5. Predictive Analytics

Building on descriptive analytics, this level of data processing analyzes past and present data points to make predictions about future outcomes.

This is something we are working on at ReadyList.

For example, instead of relying on a manager or supervisor to interpret the data and make changes to increase cleaning efficiency, ReadyList could make suggestions directly to the cleaner.

This might be in the form of:

1. Cleaning rooms in a different order to complete the job more quickly.
2. Recommending a terminal clean automatically after a set number of daily cleans.
3. Assigning a discharge clean to a certain cleaner who has better inspection scores on a particular high-acuity unit. 

This type of analytics allows service teams to proactively address a potential problem, before it becomes an issue. 

6. Prescriptive Analytics / Machine Learning 

Prescriptive analytics and machine learning work together in a smart checklist to advise users on the steps to take. 

This could result in automatically revising the checklist over time based on what has been learned.

For example, we know that infection prevention relies on evidence-based protocols. What if ReadyList, based on its learning over time, prescribed cleaning protocols derived from a library of data collected across hospitals all over the U.S.?

It is provocative to think that a checklist could inform infection prevention protocols, but why not? 

This is a vision we have for the future, and are working towards this in our research and development here at ReadyList.

More Than Just a Checklist

Our vision and our product is so much more than checking off a task on a list. 

Our purpose is to transform how clinical environments work, so they are better, more efficient and 100 percent ready for patient care.

I invite you to learn more by contacting me directly on LinkedIn or email at brian.herriot@readylist.com. 

Brian Herriot is a hospital operations leader and Co-Founder of ReadyList, Inc. ReadyList software ensures fully operational inpatient and surgical environments to help clinicians dedicate more time to their patients.

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