If the quality of a referral is measured by the presence or absence of certain variables, then there should be no surprise that the proforma leads to better quality referrals. Checklists have been shown to reduce human error when it comes to high intensity work fields suchas the military and the airline industry where the consequences of a mistake involves people's lives''"'^'. Checklists in medicine are often used in emergency medicine and intensive care and have been shown to be effective in improving the quality of patient care"'".