Develop a practical, high-value resource to support hospital implementation of a surgical safety checklist


In 2010, Ariadne Labs — a Joint Center of Innovation at Brigham and Women’s Hospital and the T.H. Chan Harvard School of Pubic Health — launched SafeSurgery 2015, a program dedicated to bring the World Health Organization (WHO) Surgical Safety Checklist into use in every hospital in the United States. 

The team began in South Carolina, working closely with the South Carolina Hospital Association and hospitals around the state to implement the checklist. 

By 2013, good training materials had been developed, but content was buried in webinars and was often specific to South Carolina cohorts. Meanwhile, the team was beginning to expand the program to other states and large systems, and recognized the need for change in order to support a broader national reach.

How we helped

We were first hired to explore development of an automated system for checklist modification, but analysis and user research revealed that it would be more impactful to give facilities better tools for understanding and executing the implementation process.

We pivoted: auditing existing content and conducting additional user/stakeholder research. We created a new conceptual framework to describe the quality improvement process and to explain and present best practices for checklist implementation.

We then used that framework to validate existing content, identify and address gaps, develop new tools, and organize the material into a comprehensive system. Although the budget did not enable us to build the website originally envisioned as ideal for users, we wrote and structured the materials with web deployment in mind, delivering content that is concise, direct, and easy to navigate.


  • Improved user access to critical content and tools
  • Improved consistency and usability of materials
  • Established a process model that can help guide other programs and quality improvement efforts.

Services provided

  • Design strategy
  • User and stakeholder research
  • Content analysis and instructional design
  • Information architecture
  • Content development, writing, and editing
  • Brand audit and consulting
  • Visual design and production

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