Do More of What Already Works: Power Consistency
When we are trying to improve our workflow or increase productivity, people often tend to lose sight of the skills they already know in favor of exploring new tactics. But old solutions you already know are often best practices, and consistency is what’s missing.
This post originally appeared on James Clear’s blog .
In 2004, nine hospitals in Michigan began implementing the new procedure in their intensive care units (ICUs). Almost immediately, health professionals were overwhelmed by his success.
Three months after starting, the procedure reduced the infection rate of patients in the intensive care unit by sixty-six percent. In 18 months, this single method saved $ 75 million in medical costs. Best of all, this single intervention saved the lives of over 1,500 people in just a year and a half. The strategy was immediately published in a blockbuster for the New England Journal of Medicine .
This medical miracle turned out to be easier than you might have imagined. It was a checklist.
The power to never skip steps
The checklist strategy implemented in Michigan hospitals has been dubbed the Keystone ICU Project. It was led by a physician named Peter Pronovost and later popularized by the writer Atul Gawande.
In Gawande’s best-selling book The Checklist Manifesto, he describes how Pronovost’s simple checklist can produce such impressive results. In the following quote, Gawande explains one of the checklists that were used to reduce the risk of infection when setting a center line in a patient (a relatively common procedure):
On a piece of plain paper, [Pronovost] outlined the steps to be taken to avoid infections while installing the line. Physicians should (1) wash their hands with soap, (2) cleanse the patient’s skin with chlorhexidine antiseptic. , (3) put on a sterile sheet over the entire patient, (4) put on a sterile mask, hat, gown and gloves, and (5) put on a sterile dressing over the catheter site after the line has been inserted. Check, check, check, check, check.
The steps are simple; they have been known and taught for years. So it was foolish to make a checklist just for them. Nonetheless, Pronovost asked the nurses in his ICU for a month to watch doctors as they lined up patients and record how often they performed each step. In more than a third of patients, they missed at least one.
This five-step checklist was a simple solution that Michigan hospitals used to save 1,500 lives. Think about this for a moment. No technical innovations. There were no pharmaceutical discoveries or advanced procedures. Doctors just stopped skipping steps. They applied the answers they already had in a more consistent manner.
New solutions versus old solutions
We tend to underestimate the answers we’ve already found. We don’t make enough use of old solutions – even if they are best practices – because they seem like what we’ve already covered.
Here’s the problem: “Everyone already knows this” is very different from “Everyone already does it.” Knowing a solution does not mean that it is being used.
More importantly, just because a solution is implemented from time to time does not mean that it is being implemented consistently. Every doctor knew the five steps from Peter Pronovost’s checklist, but very few completed all five steps flawlessly each time.
We assume that new solutions are needed if we are to make real progress, but this is not always the case.
Use what you already have
This pattern is as common in our personal lives as it is in corporations and governments. We spend resources and ideas at our fingertips because they don’t seem new and exciting.
There are many examples of behaviors, large and small, that can make progress in our lives if we simply do them with more consistency. Flossing every day. I never miss a workout. Complete basic business tasks every day, not just when you have time. I apologize more often. Writing thank you notes every week.
Of course, these answers are boring. Mastering the basics isn’t sexy, but it works. No matter what task you are working on, there is a simple checklist of steps you can follow right now – the basic basics that you have known for years – that can give immediate results if you just practice them more consistently. …
Progress is often hidden behind boring solutions and underutilized ideas. You don’t need more information. You don’t need a better strategy. You just need to do more of what is already working.
Do More Of What Already Works | James Clear