- Less paper. Paper checklists usually must be kept for at least seven years for state and federal audits. When the bosses see a room full of old paper, they see dollar signs.
- Reduced exposure. Even worse, that paper could be a ticking time bomb because no one is sure of what is really in those records. Do they expose the department to an unfavorable ISO audit? Might a lawyer find some damning evidence in there that the chief never knew about?
- Accountability: Nothing falls between the cracks. It’s very hard to know everything that goes on day-to-day at the station, and that’s a scary thought. The people releasing the funding will want to know that reliable procedures are being diligently followed, and that identified problems are being promptly addressed.
- Acceptance: The team will love it. Unlike many computer systems imposed on the workforce in the past, this one is actually easier to use – and even fun. It’s touch screen based and runs on a tablet or cell phone.
- Lawsuit defense. In the dangerous world of first responders people get injured and sometimes die. Regardless of intentions and effort, this can draw lawsuits. Vital to the department’s defense is to show that there was no contributory negligence – that is that all reasonable precautions were taken and documented. This results in smaller awards.
- Faster turnaround on broken equipment and out-of-service vehicles. Given the demands of the typical 24/48 shift and that almost 90% of all U.S. departments employ volunteers, it can often take days or even weeks to assign follow up work once a problem has been identified. Station Check reduces that to minutes or hours, resulting in more equipment being ready at any given point with fewer dollars spent.
- Identify problems before failure. This system provides trend data on wear and repair patterns that are very difficult to harvest using paper forms. This allows better preventative maintenance regimens and informs equipment purchase decisions.
- More successful funding requests. With accurate reliable data – including no negative ISO audit results – the city, county, state and even federal funding sources will be more confident about sending money to your organization.
- Professionalism and leadership. People want to work for well-run departments. It gives them pride and camaraderie. It fosters job security and the sense of upward mobility.
- Better serve the mission. This is the reason most people chose to become first responders – to serve the community by preventing injury, protecting property and saving lives. With Station Check, the bosses can be assured they are affordably providing the best service possible to the people they serve.
Review of The Checklist Manifesto by Atul Gawande
“It seems silly to make checklists for something that is so obvious.”
In his eye-opening book, The Checklist Manifesto, author Atul Gawande documented this sentiment in industry after industry – among doctors, nurses, firefighters, police, lawyers, financial managers, pilots, EMS teams, and sometimes even our military. But when checklists are employed and adhered to, the results are astounding.
Checklist Manifesto digs into why this process is so important.
In a complex environment, [there are] two main difficulties. The first is the fallibility of human memory and attention, especially when it comes to mundane, routine matters that are easily overlooked under the strain of more pressing events.
… Just as insidious, is that people can lull themselves into skipping steps even when they remember them … Perhaps the elevator controls on airplanes are usually unlocked and a check is pointless most of the time … “This has never been a problem before,” people say. Until one day it is.
Checklists seem to provide protection against such failures. They remind us of the minimum necessary steps and make them explicit. They not only offer the possibility of verification but also instill a kind of discipline of higher performance.
One of the impressive cases early in Manifesto that Gawande reports was from a Johns Hopkins Hospital, where a critical care specialist decided to give a doctor checklist a try after he witnessed several tragedies. It was simple stuff.
On a sheet of plain paper, [the critical care specialist] plotted out the steps to take to avoid infections when putting in a central line [into an artery or vein]. Doctors are supposed to (1) wash their hands with soap, (2) clean the patient’s skin with chlorhexidine antiseptic, (3) put sterile drapes over the entire patient, (4) wear a mask, hat, sterile gown, and gloves, and (5) put a sterile dressing over the insertion site once the line is in … These steps are no-brainers; they have been known and taught for years.
Anybody with some common sense knows to follow these steps, but Gawande reported on how often they were not implemented, for a variety of reasons that involved human nature and short-sighted budgeting. By using a checklist – and having the necessary conversations brought on by their insights — compliance increased and …
The results were so dramatic that they weren’t sure whether to believe them: the ten-day line-infection rate went from 11 percent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. They calculated that, in this one hospital, the checklist had prevented forty-three infections, eight deaths and saved two million dollars in costs [and other similar measures]. It reduced from 41 percent to 3 percent the likelihood of a patient’s enduring untreated pain. They tested a checklist for patients on mechanical ventilation, making sure, for instance, that doctors prescribed antacid medication to prevent stomach ulcers. The list included a check that the head of each patient’s bed was propped up at least thirty degrees to stop oral secretions from going into the windpipe. The proportion of patients not receiving the recommended care dropped from 70 percent to 4 percent, the occurrence of pneumonias fell by a quarter, and twenty-one fewer patients died than in the previous year.
I am left with one resounding lesson after reading this memorable book – checks save lives.
Do better checks.
Most everything burns, and when it does, disaster can ensue. Historically, there have been some big ones: Rome nearly burned to the ground. The London burnings were a catastrophe, and last century the Great Chicago Fire destroyed many homes and businesses.
Firefighter technology has come a long way. We now have dedicated fire brigades, but when they got started a few hundred years ago, they were mostly volunteers, and unlike today, those volunteers were unpaid, untrained civilians carrying around buckets of water.
Improved Water Pumps
We think the first water pump was invented in Alexandria around 200 AD, but when that civilization was lost, we didn’t see “modern” water pumps introduced until around 1600. Until then, water used to combat fire was carried by men and horses.
Heavy Duty Fabric
Even after we started getting trained firefighters in place, they didn’t initially wear protective clothing, which meant they had to fight the blaze from afar. After a few decades, they realized they could be far more effective by getting closer to the fire – they could put it out faster and actually go into burnings building for sweeps and rescues.
The first firefighter uniform was basically a leather trench coat with a wool liner. As rubber products became commercialized, one of the first uses was fire gear. Boy, they must have been hot!
One of the spin-off benefits of the space program that helped firefighters immensely in the 1970’s occurred when NASA developed durable fabrics designed for the harsh environment of space. The US Fire Administration teamed up with NASA and created a high-end fire-resistant fabric that was the precursor of what is being used today.
More breakthroughs in synthetic fibers followed, including materials that can protect against radiant heat while still being breathable and reasonably comfortable. These materials significantly reduce the dangerous threat of heat stress.
Self-Contained Breathing Apparatus (SCBA)
Most of the firefighters tell us that their SCBA kit is one of their most important pieces of equipment. Various forms of SCBA gear go back to 1863 when James Braidwood put two canvas bags together lined with rubber, but tanks work better than canvas bags, and they were developed during WWII becoming a common piece of equipment by the 1970’s.
Any firefighter will tell you that SCBA kits protect in IDLH (Immediate Danger of Life and Health) environments, but they also help prevent long-term damage that may be caused by chemicals and carcinogens which are prevalent in the smoke.
Thermal Imaging Cameras
Thermal imaging cameras (TICs) were originally developed by the military and quickly found application in local fire departments. Being able to see where a fire is (and isn’t) before jumping into a dangerous situation is crucial to put out a blaze quickly and that it doesn’t spread too fast. Also, TICs help find victims trapped inside a burning building.
Computer-Based Readiness Systems
While much attention has been placed on giving firefighters better tools to fight fires, recently more focus has been placed on making sure all these tools are ready to use and that the firefighters are properly trained to use them. Instead of using paper forms and clipboards, firefighters can perform checks using their cell-phones, tablets or any device with internet access. Tens of thousands of firefighters are already using this service. It reduces paperwork, gives an audit trail on checks, and gets faults fixed faster.
Why didn’t somebody think of that years ago?