The last century of scientific research has driven incredible breakthroughs in medical knowledge and capability. However, all too often our health systems fail to deliver those breakthroughs to patients at the critical moment of care.

Ariadne Labs develops simple, scalable solutions that dramatically improve the delivery of health care to save lives and reduce suffering. Ariadne Labs is widely recognized for pioneering an innovation pathway that produces transformative, globally scalable solutions. We call it the Ariadne Labs Arc. Inspired by best practices from a range of industries and adapted for public health, the Ariadne Labs Arc ensures our solutions meet the highest standards of science and are designed for global spread.

Stages of the Arc

The Ariadne Labs Arc represents a process of continual learning and collaboration. As our solutions advance through the three stages of the Ariadne Labs Arc—Design, Test, Spread—we collaborate with partners worldwide, iterate as new knowledge is discovered, and refine our approaches. Our stakeholders in innovation include health system leaders, frontline clinicians, implementation organizations, global public health organizations and NGOs, donors and grant agencies, local and national governments, public health researchers, and patients and their families.


  • Define the problem, desired outcomes, and the best bet on how to change the key outcomes based on prior research, analysis, and experience.
  • Build a diverse coalition of committed stakeholders to advise your solution development.
  • Select stakeholders who can later act as champions to support spread.
  • Solicit feedback from end users on usability and feasibility of draft tools and implementation guidance, and iterate accordingly.
  • Develop guidance and materials for implementation.


  • Test whether the solution drives process and behavior change and shows at least leading indications of  changing outcomes.
  • Test whether the solution drives changes in selected health outcomes.
  • Test whether the solution can be scaled across diverse facilities and contexts.


  • Distribute implementation tools and support materials broadly.
  • Provide direct implementation support to a select group of implementers to continue to learn what works and what needs improvement.
  • Develop an education strategy and associated courses and materials.
  • Create and support Communities of Practice where practitioners can share implementation learnings and can guide each other.
  • Disseminate and promote key ideas through publications, coalition-building, and other media.
  • Incorporate feedback and adapt.
  • Measure impact.

The Ariadne Labs Arc in Practice: The WHO Surgical Safety Checklist

The development of the WHO Surgical Safety Checklist provided the template for the arc of innovation. The first phase of the work was a comprehensive review of previous work in patient safety and quality improvement in surgery, as well as an assessment of the burden of the problem. Next, the WHO convened global leaders in surgery, anesthesia, perioperative nursing, and others involved in surgical care to develop a plan to make surgery safer worldwide based on the review of past work and the group’s own expertise.

Out of this series of convenings, the first iteration of the WHO Surgical Safety checklist was developed. After small scale field experience and iteration, a formal pilot study in eight diverse sites around the world was launched, evaluating both behavior change among surgical team and outcomes of patients undergoing inpatient surgery.

This pilot demonstrated significant change in processes of care, as well as a more than 40% reduction in postoperative mortality. Since that time, many different health systems have tested and implemented the checklist in diverse settings. In addition, the message of the value of teamwork in the operating room and the checklist is now used in 100 million of 300 million operations worldwide.