Check Sheet

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Definition: A simple data collection form consisting of multiple categories with definitions. Data are entered on the form with a simple tally mark each time one of the categories occurs.

Purpose: To facilitate the collection and analysis of data.

A check sheet is a simple means of data collection. The most straightforward check sheet is simply to make a list of items that you expect will appear in a process and to mark a check beside each item when it does appear. This type of data collection can be used for almost anything, from checking off the occurrence of particular types of defects to the counting of expected items (e.g., the number of times the telephone rings before being answered).

How to Construct:

1. Clearly define the objective of the data collection.
2. Determine other information about the source of the data that should be recorded, such as shift, date, or machine.
3. Determine and define all categories of data to be collected.
4. Determine the time period for data collection and who will collect the data.
5. Determine how instructions will be given to those involved in data collection.
6. Design a check sheet by listing categories to be counted.
7. Pilot the check sheet to determine ease of use and reliability of results.
8. Modify the check sheet based on results of the pilot.

Tips:

 Use Ishikawa diagrams or Brainstorming to determine categories to be used on the check sheet.
 Construct an operational definition of each category to ensure data collected is consistent.
 Make check sheet as clear and easy to use as possible.
 Spend adequate time explaining the objective of the data collection to those involved in recording the data to ensure the data will be reliable.
 Data collected in this format facilitates easy Pareto analysis.

Here is an example of a check sheet:

DATE: 1/13/89 -1/19/89 FLOOR: 4 EAST SHIFT: 7-3					Tray Delivery Process
CHECKSHEET	MON	TUE	WED	THU	FRI	SAT	SUN	TOTAL
Tray Disabled				1	1	1		3
Production Sheet Inaccurate	1		1			1		3
Menu Incorrect	1		1		11		1	5
Diet Order Changed	1				1		1	3
Wrong Order Delivered	1		1		1	1		4
Patient Asleep	111	1	11111	1	11	111	1	16
Patient Out of Room	11111	111	11	1	1	11	11	16
Doctor Making Rounds		11	1111	1	1	1	1	11
Patient Not Hungry	1	1	11	1	111	1	11111	14
Cart Faulty					1	1	1	3
Plate Warmer Broken	11	11	111	11	1111	1	11	16
Heating Unit Broken	1	1			1		1	4
Thermometer Miscalibrated	1					1		2
Nursing Unavailable	111	11	111	1111	11	111	111	20
Cart Unavailable	11	111	11		11		11	11
Elevator Malfunction			11	111		1		6
TOTAL	22	16	25	13	21	17	20	134

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