Thinking Inside the (Check)box: Simple Solutions to Thorny Safety Problems


Photo credit: Aircraft Checklist History/atchistory.org

Photo credit: Aircraft Checklist History/atchistory.org

It was October 30, 1935. A small crowd of senior army officers and industry executives gathered at Wright Field in Dayton, Ohio. They were there to watch Boeing demonstrate their new state-of-the-art bomber prototype, the Model 299, being flown by one of the army’s top test pilots.

The crowd watched as the airplane roared to life, taking flight and climbing confidently to several hundred feet. Without warning, the airplane slowed into a stall, turning sharply on one wing and falling to the ground. Both pilots were killed. An investigation revealed a tragically simple cause: the highly-experienced test pilot had left a simple locking mechanism on the airplane’s flight controls engaged. Newspapers declared the aircraft too complex for human pilots.

From the ashes, a simple idea was born: the checklist. Pilots began to use simple checklists to remember the dozens of steps required to takeoff and land the airplane, dramatically reducing the incidence of accidents. The Model 299 was tamed, eventually becoming the venerable B-17 of World War II.

When thinking about improvements to prevention and safety standards in the Boston Fire Department, we didn’t begin our brainstorming session with the Model 299 in mind. Our Harvard student team was continuing our work with the department to improve the reporting of exposures to carcinogenic materials and, ultimately, to reduce firefighters’ risk of cancer.

Our research had given us valuable insights, such as the “dirty helmet” culture of the Boston Fire Department. Individuals often keep their helmets dirty as a badge of honor, even though the “dirt” on the helmet can be carcinogenic, increasing their risk of cancer. We now had to turn these insights into a concrete prototype idea.

We kicked off a prototype brainstorming session with the ”Yes, and exercise. Participants can share absolutely any idea, with only one rule: the idea must start with the phrase “Yes, and.” This exercise’s goal is to promote creativity and to avoid shutting down someone’s contribution. As one of our mentors, Dana Chisnell of the U.S. Digital Service, told us, “Yes, and” exercises should end up with a least one idea that involves outer space.

We did not quite reach outer space, but our “Yes, and” exercise led us to some important realizations:

  1. Carcinogen exposure will not be solved through an improved form or higher rates of completion. No form can protect the well-being of a firefighter if they aren’t taking the necessary precautions to prevent exposure to carcinogenic material in the first place.

  2. There are many small tasks that can reduce a firefighter’s lifetime carcinogen exposure, such as washing one’s hand tools or wiping one’s face after a fire. Keeping track of all these steps can be cumbersome, an area where automation could help.

We quickly realized that self-cleaning suits and carcinogen-scanning apps were not going to be feasible. But we soon settled on a dramatically cheaper and simpler solution to automate the process of reducing carcinogen exposure: a checklist. The idea came from Sean, who as a helicopter pilot in the U.S. Army, uses checklists before taking off or landing. In the eighty years since the Model 299 crash, checklists have made a once dangerous pursuit remarkably safe. In the last ten years, fields as disparate as surgery and construction have been adopting checklists to dramatically improve safety. Checklists have grown significantly in popularity due to these successes and the New York Times Bestseller, The Checklist Manifesto.

The more we thought about a checklist for firefighters, the more promise we saw in the idea. By creating an online checklist and integrating the data currently gathered on paper exposure reports, we could directly improve firefighters’ health by reducing their exposure while also creating a seamless path for reporting.

Our checklist prototype, available at http://is.gd/bfdchecklistdraft.

Our checklist prototype, available at http://is.gd/bfdchecklistdraft.

With our ideas clearly focused by our brainstorming session, we rapidly developed a low-fidelity version of the prototype to test with firefighters. Over the next several weeks, we will iterate upon and improve our ideas as we receive feedback from users and the Boston Fire Department Leadership.

Sean Cochran, Neel Mehta, Algirde Pipikaite, Charlie Sellew, Chanteclaire Swett