BY L. GARY BOOMER
Driven by checklists,
or professional judgement?
Complexity and the volume of knowl- edge have exceeded the individual’s ability to deliver the benefits of that
knowledge correctly, safely and reliably. The
accounting profession is no exception, but
lessons can be learned from other professions like medicine and the airline industry.
In The Checklist Manifesto: How to Get
Things Done, Atul Gawande provides several
lessons from both the airline industry and
medical profession that can be applied to the
accounting profession. Humans are fallible
and lose attention when it comes to routine
matters that can easily be overlooked under
the stress of deadlines and fatigue. People can
skip steps even when they remember them.
In complex processes, like the preparation of
a tax return, certain steps don’t always matter. Checklists seem to help provide protection against failures and instill a discipline
that leads to higher performance.
The problem comes when checklists attempt to become all-encompassing. Gawande points out that checklists can be boring to
doctors who may feel above the routine steps,
yet his research proved that a simple checklist
of five steps significantly reduced infections
in hospitals when putting a central line into a
patient’s body. Doctors are supposed to:
1. Wash their hands with soap;
2. Clean the patient’s skin with chlorhexi-dine antiseptic;
3. Put sterile drapes over the patient;
4. Wear a mask, hat, gown and gloves;
5. Put a sterile dressing over the insertion
site once the line is in.
These steps are no-brainers, yet in a test,
more than one step was skipped in a third of
the cases. The line infection rate went from 11
percent to 0 when the nurses were instructed
to stop the doctors when they skipped a step.
Checklists do establish a higher standard of
baseline performance, yet resistance remains
in all professions.
Technology can be both a blessing and a
curse in all professions. The complexity and
number of procedures and services have
grown exponentially. Technology enables
professionals to track steps and procedures
even when irrelevant and redundant. If
checklists become too long, people will not
pay attention or lose focus. Thus, professional
judgment and updating are required. This is
where technology can be useful if properly
utilized. If not, the result is often extremely
long checklists that waste time and do not
improve performance and results.
Gary Boomer, CPA, is the president of
Boomer Consulting, in Manhattan, Kan.
AUTONOMY AND DISCIPLINE
Each profession has a code of conduct that
typically includes selflessness, skill and trustworthiness. Gawande points out that aviators have a fourth expectation: discipline. The
medical profession cherishes autonomy. To
me, discipline is the most difficult in that it requires accountability. The accounting profession requires both autonomy and discipline,
which can be direct opposites depending
upon the service and client relationship. Discipline is something that requires constant
learning and work. So the question becomes,
how can the profession better use judgment
and improved checklists?
In my accounting experience, I have seen
several trends that are understandable, but
alarming. First, firms tend to allow people
with departmental perspectives to make
technology and procedural decisions, which
often result in lack of integration, redundancy
and complexity. A good example is the number of databases that firms utilize that contain
duplicate data requiring continual updating
in many locations and reconciliation. Trust in
the accuracy of the data quickly diminishes.
An example that Gawande uses is the attempt to build the world’s greatest car. He
gives the example of connecting a Ferrari
engine, the brakes of a Porsche, a BMW suspension and a Volvo body. What do you get?
A pile of expensive junk! I am confident many
of you can relate to the analogy.
In order to break through the ceiling of
complexity, you must simplify. This is precisely what the medical profession has done
by shortening checklists and consistently
using professional judgment to focus on the
items of highest risk and importance.
Captain Sully Sullenberger, the pilot of the
US Airways flight that landed in the Hudson
after the plane ingested geese into its en-
gines, credits the success of the landing to
the crew effort and its teamwork and adher-
ence to procedures. This required discipline
and accountability. The two pilots had never
flown together before that day. Through the
use of checklists and a few short minutes
prior to leaving the gate, they transformed
themselves into a team. Part of the checklist
was to introduce themselves and the crew.
They considered the odds of anything going
wrong extremely low, far lower than we do in
other professions. But they ran through their
checklists anyway (discipline).
ENSURE A PERFORMANCE BASELINE
The fear most people have about protocol
is rigidity. But what happens is just the opposite. Taking the time in advance gets the
“dumb stuff” out of the way and clears the
mind to focus on the harder stuff.
You may say that the accounting profession is different from the medical profession
or the airline industry. My response is ... not
so quick! We can learn some lessons.
First, checklists are important and must
continually be revised to reflect the most important steps in reducing risks and ensuring
a higher baseline of performance. This can
only be accomplished when checklists are
integrated with professional judgment. In my
opinion, too many CPAs have relied on published checklists as the Holy Grail, without
incorporating the proper amount of professional judgment.
The second lesson is that training and dis-cipline/accountability are paramount. I also
believe that too little training time is focused
on management, processes and the use of
In the case of the landing on the Hudson,
all of the team knew their roles. Sullenberger
took over the controls and looked for a place
to safely land, while Skiles, the co-pilot,
went to the engine failure checklist to see if
he could relight the engines. The rest of the
crew was preparing the main cabin for a crash
landing. Does your team know their roles, or
is it simply left to skills and hope?
Hope is not a strategy! AT