Create a comprehensive resource to guide hospitals through implementation of the Safe Surgery Checklist

Transform lessons learned into a practical high-value system of content and tools


  • Design strategy

  • Content analysis and instructional design

  • Information architecture

  • Content development, writing, and editing

  • User and stakeholder research

  • Brand audit and consulting

  • Visual design and production


  • Translated years of work and experience into a practical system of content that facilities anywhere can use

  • Established a process model that can help guide other programs and quality improvement efforts


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. Good training materials had been developed, but much of the advice was only available in videos of 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 initially asked to explore the idea of an automated system for checklist modification, but analysis and user research revealed that it would be more helpful to give facilities better tools for understanding and executing the implementation process.

So we pivoted. After auditing existing content and conducting additional user/stakeholder research, we helped the team create 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 content and 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 future web deployment in mind, delivering content that is concise, practical, and easy to navigate.

The solution: an integrated system of content

Over the course of many months, the project evolved to include:

  • 15 chapters of concise, practical information and advice on origin, development, and implementation of the Safe Surgery Checklist
  • 3 Quick-Reference Guides
  • 5 Checklist Templates (modifiable by users)
  • 9 Action Guides (one-page job aids to support specific tasks)
  • 3 Fact Sheets
  • 2 Practice Script samples
  • 2 Observation Tools
  • 2 Culture Surveys
  • 1 Implementation Lead Spreadsheet (project management tool for tracking and managing component tasks)

The Implementation Guide was delivered as a printed book and a fully hyperlinked interactive PDF, and all of the chapters and component tools were also delivered as individual PDFs that users can download separately.

Links and resources