Design a set of checklists than can help surgical teams rapidly respond to and manage crisis events



  • Design strategy

  • Information architecture

  • Visual design

  • Writing and editing

  • Project management

  • Print production


  • Reduced variation within and between checklists to minimize cognitive load and optimize navigation

  • Created rigorous information and visual framework applicable to a variety of cognitive aids for crisis use


Surgery can be complicated and unpredictable and surgical teams are well-prepared to deal with many types of routine events. But when a uncommon or rare crisis events occur, urgent action and coordination are essential.

One challenge teams face is that crisis events occur infrequently, so even experienced teams may struggle to remember all key steps, recently updated evidence-based practices, or specific equipment settings. Another is that a patient in crises must be stabilized/treated while the team continues diagnosis: root causes are not always clear.

To address these challenges, a team at Ariadne Labs developed a set of twelve checklists to help surgical teams deal with crisis events in the operating room. Those checklists had been studied in simulation and the results were published in the New England Journal of Medicine.

How we helped

Emphatic was engaged to optimize the set of checklists for quick, efficient use in emergency rooms.

Our role was to lead the design process, analyze content and context, help the team weigh and prioritize conflicting goals, structure complex information, and craft a visual design that makes complicated information easy to navigate and use in crisis situations. 

Based on extensive content analysis and input from the team about the experience of using the checklists in the operating room, we defined explicit design objectives and began to develop, test, and revise prototypes. 

We considered cognitive load, physical handling, and workflow compatibility, plus the down-stream implications that our choices would have for local modification, possible use as a digital product, and cost of production.

The design system that emerged from that process transformed a set of twelve individual checklists into a single cohesive tool with rigorous consistency in language, organization, and presentation. We produced and delivered the Operating Room Crisis Checklists in several forms including a printed and bound set, an interactive PDF version, a downloadable PDF for local printing, and a content-only version for local design or incorporation into electronic systems. To help people make informed choices when making local changes, we created a resource that describes key elements of the design and why they matter.

We also worked with teams at Kaiser Permanente and Brigham and Women's Hospital to tailor the checklist sets for their unique environments and produced a version for translation and use in Moldova. Later, we helped the Ariadne Labs team revise the content and in May 2017 an updated set of Operating Room Crisis Checklists was released

Links and resources