Ariadne Labs was launched in 2012 by Atul Gawande, MD, MPH, and Bill Berry, MD, MPA, MPH, as a first-of-its-kind joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. Bridging the gap between health care delivery, academic medicine, and public health, Gawande and Berry saw a disconnect between how they knew care should be delivered, and how it was being delivered in practice, what’s known as the “know-do gap.”

  • Building the foundation for Ariadne Labs

    • Dr. Atul Gawande forms research group to develop tools that improve the delivery of care for patients. By 2007 he is joined by Dr. Bill Berry.
    • Gawande and Berry lead the global effort to create the Surgical Safety Checklist as part of the World Health Organization’s Safe Surgery Saves Lives campaign.
    • Inspired by the Surgical Safety Checklist, WHO convenes global maternal health and patient safety experts led by Gawande to develop the Safe Childbirth Checklist.
    • Pilot study of the Surgical Safety Checklist in 8 hospitals around the world demonstrates a 47% decrease in deaths and a 36% reduction in complications.
    • Idea that a simple tool like a checklist can save lives in medicine goes mainstream after the TV show ER features the Surgical Safety Checklist and Gawande’s Checklist Manifesto becomes a New York Times bestseller.
    • Centers for Disease Control and Prevention consults with Gawande and his research team to create the H1N1 Checklist.
    • The South Carolina Hospital Association signs on to implement the Safe Surgery Program statewide.
    • The Safe Childbirth Checklist field tested in 17 sites in India, Kenya, Tanzania, Ghana, Nigeria, Mali, Pakistan, Egypt, and China.
    • Dr. Susan Block leads a team of palliative care experts to develop and pilot a conversation-based intervention that improves care for patients with serious illness.
    • Gawande founds Lifebox to spread the Surgical Safety Checklist, and make surgery and anaesthesia safer on a global scale.

    • Ariadne Labs launches with 13 employees after Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health sign off on creation of a first-of-its-kind joint center for health systems innovation.
    • Ariadne Labs, Stanford University, Massachusetts General Hospital, Brigham and Women’s Hospital, Kaiser Permanente, and Cooper Hospital form the Emergency Manuals Implementation Collaborative to promote use of cognitive aids during OR crises.
    • Serious Illness Care Program begins its flagship study at Dana-Farber Cancer Institute to test a system intervention that supports patient-clinician guided conversations about patient goals and values.
    • The Safe Childbirth Checklist Collaborative launches with 30+ countries to implement the checklist and share best practices.
    • Ariadne-led study demonstrates that when surgical teams use checklists during OR crises, they complete nearly 100% of lifesaving steps. Without them, they complete only 77%.

    • Obstetrician Dr. Neel Shah awarded Ariadne Labs Spark Grant to explore ways to improve childbirth in the United States.
    • Ariadne Labs grows to 50 employees and moves to Boston’s Landmark Center.

    • The BetterBirth study—one of the world’s largest maternal health trials—begins in Uttar Pradesh, India, to test whether the Safe Childbirth Checklist, paired with coaching, can improve quality of care and reduce mortality.
    • New York Times bestseller Being Mortal: Medicine and What Matters in the End, by Gawande, inspires social movement around the importance of seriously ill patients and clinicians being aligned around goals of care.
    • Brigham physician Dr. Asaf Bitton joins Ariadne Labs to begin program focused on improving primary health care globally.
    • Maternal and newborn health epidemiologist Katherine Semrau joins as director of BetterBirth.
    • CDC and Ariadne Labs release Ebola checklist.

    • The Primary Health Care Performance Initiative to strengthen global primary health care systems launches at United Nations with the Bill & Melinda Gates Foundation, WHO, World Bank, Ariadne Labs, and Results for Development.
    • Dr. Rachelle Bernacki from Serious Illness Care selected for prestigious Cambia Foundation Sojourns Scholar Leadership Program.
    • Ariadne Labs and Stanford University publish landmark study in JAMA that suggests optimal country-level C-section rate based on maternal mortality is 19%.

    • CDC and Ariadne Labs release Opioid checklist.
    • Primary Health Care team publishes core tenets for primary care improvement as part of a World Bank study to help China improve its health system.
    • Serious Illness Care announces first innovation partnerships: Baylor Scott & White in Texas, Lowell General Hospital in Massachusetts, and Clatterbridge Cancer Center NHS Foundation Trust in the United Kingdom.
    • Gawande testifies before the U.S. Senate Special Committee on Aging about improving care for seriously ill patients.
    • Serious Illness Care Program’s founding director Dr. Susan Block honored with Lifetime Achievement Award by the American Academy of Hospice and Palliative Medicine.
    • Drs. Justin Sanders and Josh Lakin from Serious Illness Care selected for the Cambia Foundation Sojourns Scholar Leadership Program.

    • Shah launches Delivery Decisions Initiative to develop an intervention that reduces unnecessary C-sections.
    • BetterBirth study in New England Journal of Medicine, co-authored by Semrau and Gawande, demonstrates large-scale broad- based improvement in facility-based care, but improvements are insufficient to reduce maternal and perinatal mortality.
    • South Carolina Safe Surgery program demonstrates a 22% reduction in postoperative deaths among hospitals that complete implementation of the program.
    • Safe Childbirth Checklist implementation in Gobabis District Hospital in Namibia reduces perinatal mortality from 22 deaths per 1,000 deliveries to 13.8 deaths and maternal mortality to zero for two years.
    • JAMA Surgery study co-authored by Shah shows women giving birth by C-section have higher risk of needing a hysterectomy later in life, and face greater risk of complications during a hysterectomy.
    • The online OR Crisis Checklists Implementation Toolkit debuts at the 2017 American Society of Anesthesiologists.
    • National patient safety leader Dr. Evan Benjamin becomes new chief medical officer.
    • Mass General surgeon Alex Haynes becomes director of Safe Surgery Program.
    • Palliative care physician Erik Fromme becomes new director of Serious Illness Care Program.
    • Serious Illness Care study demonstrates success of serious illness conversations in a high-risk primary care setting.
    • Serious Illness Care Community of Practice surpasses 1,000 members.
    • Boston innovation leader Nic Encina joins as first chief science and technology officer.
    • The Estonian Health Insurance Fund, the World Bank, and the Primary Health Care team conclude successful pilot program for enhanced care management in Estonia.
    • Ariadne Labs staff visit Costa Rica to determine how the country created a successful primary health care model. The case study, Building a Thriving Primary Health Care System: The Story of Costa Rica, is published.

    • Safe Surgery study published in Implementation Science reported benefits from implementing the Operating Room Crisis Checklists.
    • Safe System Expansion Toolkit released to help clinical leaders uncover safety considerations and mitigate harm during mergers and affiliations.
    • Gawande is named Ariadne Labs Chairman, transitioning from role as Executive Director.
    • Delivery Decisions Initiative launches a TeamBirth pilot study at four hospitals that will foster teamwork, communication, and women and family empowerment.
    • The Serious Illness Care Program launches the first wave of its implementation collaborative, training seven health systems implementing the program to initiate more, better, and earlier conversations about patient values.
    • The Declaration of Astana is endorsed during the Global Conference on Primary Health Care in Astana, Kazakhstan. Members of the Primary Health Care team attend and debut PHCPI’s first Vital Signs Profiles.

    • Better Evidence program joins Ariadne Labs. Better Evidence facilitates access to evidence-based clinical resources in low- and middle-income countries.
    • Ariadne Labs publishes the BetterBirth Study report, which highlights the role of systemness in childbirth to improve maternal and newborn health outcomes and provides global recommendations. The report is formally released at the 2019 Women Deliver Conference, the world’s largest conference on gender equality and the health, rights, and well-being of girls and women.
    • Primary health care expert Asaf Bitton MD, MPH is named Ariadne Labs Executive Director.
    • A landmark study published in the British Journal of Surgery finds WHO Surgical Safety checklist significantly reduces surgical mortality in Scotland.
    • A four-year randomized control trial of the Serious Illness Care Program published in two JAMA papers found that more, earlier, and better conversations between patients and clinicians led to significant reductions in emotional distress.
    • A BMJ Global Health special issue features 15 manuscripts that identify gaps in global knowledge of primary care. The issue sets a new research agenda to advance primary health care and achieve UHC.
    • Ariadne Labs’ Primary Health Care work with PHCPI is recognized during the UN General Assembly.
    • 15 health systems join a new cohort of the Serious Illness Collaborative to train health systems on implementing the Serious Illness Care Program.
    • The Delivery Decisions Initiative launches “Expecting More,” a campaign to elevate our shared expectations of the care and support people deserve when growing a family.
    • Atlas Initiative launches to develop context assessment tools to improve success of quality improvement implementation efforts.
    • Ariadne’s Rural Home Hospital project collaborates with University of Utah health to begin testing a model of home-based acute care with mock patient admissions.

    • A milestone report details the impact of the WHO Surgical Safety Checklist at its 10-year anniversary.
    • Ariadne Labs joins the Population Reference Bureau’s Momentum Knowledge Accelerator, supported by USAID, for maternal, neonatal and child health interventions.
    • Shortly after COVID-19 begins to spread across the U.S., Ariadne Labs Executive Director Asaf Bitton publishes his guide to social distancing, “This is Not a Snow Day”, viewed more than 7.5 million times.
    • Ariadne launches COVID-19 response efforts, addressing: Community Mitigation, Global Response: Vaccine Delivery, Global Response: Global Learning, Seniors & Vulnerable People, Obstetrics, Safe Surgery & Safe Systems, and Outpatient Care.
    • The Serious Illness Care Program rapidly develops and launches the COVID-19 toolkit to support serious illness conversations in outpatient, inpatient, and long-term care settings. Materials are shared widely, including being added to the CDC website.
    • Parabola Project launches (in collaboration with The Learning Accelerator), providing resources for school system leaders to minimize COVID-19 risks while maximizing learning opportunities for students.
    • Dr. Mary Brindle is named Director of the Safe Surgery/Safe Systems Program.
    • The Assurance Testing Alliance launches to rapidly scale COVID-19 testing in the US.
    • Ariadne Labs launches Aria platform to bring Ariadne Labs’ implementation science tools to thought leaders and front line experts doing the challenging work of improving care for every person, everywhere.

    • Ariadne Labs and Boston University School of Public Health launch Crosswalk Telehealth to develop equity-based telehealth best practices for Medicaid-enrolled patients with chronic conditions.
    • Ariadne Labs and Genomes2People launch the Precision Population Health initiative to bring cutting-edge genetic innovation to primary care.
    • The Global Mass Vaccination Site Collaborative begins to facilitate rapid exchange of information about COVID-19 vaccination efforts around the world.
    • An ad hoc committee of the National Academy of Sciences, Engineering, and Medicine, including Executive Director Asaf Bitton, published a report highlighting evidence-based recommendations for implementing high-quality primary care in the United States.
    • Ariadne Labs, Boston Children’s Hospital, and Google launch the Vaccine Equity Planner, a data-driven tool to map vaccine deserts.
    • The PACT Collaborative: Pathway to Accountability, Compassion, and Transparency launches to support health systems in responding to patient harm events.
    • Ariadne Labs forms the Home Hospital Early Adopters Accelerator with CaroNova, applying Scrum to rapidly develop tools and resources for health systems launching home hospital services.
    • Amber Weiseth, DNP, MSN, RNC-OB, is named Director of the Delivery Decisions Initiative.
    • The Conversation Project and Ariadne Labs’ Serious Illness Care Program release a free workbook to help people prepare to talk to their health care team about what is most important to them.

    • TeamBirth is implemented in 37 additional U.S. hospitals, including every birthing hospital in Tulsa, Oklahoma, bringing the total number of hospitals using TeamBirth to 57.
    • The Rural Home Hospital randomized controlled trial launches at three sites in the U.S. and Canada.
    • The Safe Surgery/Safe Systems team concludes a multi-year partnership with Singapore General Hospital to implement the Device Briefing Tool, developed in collaboration with Johnson & Johnson.
    • Ambassador Román Macaya, PhD, MBA, and John Maraganore, PhD, MS, are named to Ariadne’s Advisory Board.
    • The WHO and UNICEF jointly launch the first-ever globally normative and endorsed primary health care measurement framework and indicators, which rely heavily on work by Ariadne Labs’ Primary Health Care Program.
    • Better Evidence and Wolters Kluwer facilitate access to the latest online medical information to support physicians in Ukraine and Poland impacted by war.
    • TeamBirth is featured in the documentary “Aftershock,” which focuses on the Black maternal health crisis in the U.S. and efforts to make change.
    • The Emergency Manuals Implementation Collaborative, founded by Ariadne Labs and Stanford University, announces a collaboration with the Anesthesia Patient Safety Foundation to support patient safety in surgery.
    • BetterBirth releases an executive summary detailing findings from the Low Birthweight Infant Feeding Exploration (LIFE) study.
    • At the Clinton Global Initiative meeting in New York City, President Bill Clinton announces a Commitment to Action for Ariadne Labs to develop open access humanitarian health education videos.
    • Better Evidence reaches the milestone of 100,000 UpToDate® subscriptions donated to health care workers in low-resource settings across 154 countries.
    • Genomes2People hosts the inaugural International Conference on Newborn Sequencing (ICONS) at Boston’s Museum of Science.

Our Story

Ariadne Labs was launched in 2012 by Atul Gawande, MD, MPH, and Bill Berry, MD, MPA, MPH, as a first-of-its-kind joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. Gawande and Berry saw a disconnect between how they knew care should be delivered, and how it was being delivered in practice, what’s known as the “know-do gap.” 

Ariadne Labs builds on the foundation of work that Gawande, Berry and a small community of researchers were already doing to build simple, scalable ways to make health care better, such as the Surgical Safety Checklist, which was developed in 2008 in collaboration with the World Health Organization, and is now widely recognized as the global standard of care. In the summer of 2012, Gawande and colleagues applied a similar approach to develop the Safe Childbirth Checklist

Later that year, Ariadne Labs was launched in Boston, MA with 13 employees and a mission to expand their work to save lives and reduce suffering by creating scalable solutions that equitably improve health care delivery for every patient, everywhere. Located in Boston — which Gawande often described as the Silicon Valley of healthcare — Ariadne Labs was founded as an innovation incubator. 

Gawande and Berry believed that, positioned at the intersection of academic medicine and public health, Ariadne Labs would be able to quickly iterate and incubate innovations for not only what’s needed now, but also what’s next in health care. This unique position would also enable Ariadne Labs to build communities of partners and collaborators similarly focused on improving health care by transforming its delivery in settings everywhere.

To ensure adherence to the highest standards of science, Gawande and Berry led the development of the Ariadne Arc — a three-stage innovation pathway that uses human-centered design and rigorous testing to produce evidence-based, transformative innovations that impact populations at scale. 

In the early years, Gawande and Berry found that simple tools that used process-driven innovation —checklists, coaching, data feedback—dramatically reduced suffering and saved lives at scale. However, it soon became clear that there was a need to develop purpose-driven solutions to close communication gaps — such as the Serious Illness Conversation Guide — between and among patients and their clinicians. By guiding and facilitating conversations that were grounded in shared goals, empathy, dignity, and equity, outcomes for patients and the clinician’s experience of delivering care improved.

In the last few years—and with COVID-19 in particular—Ariadne Labs has seen a need for population-level solutions to address gaps in integration across the health care services people receive. Visualizing, measuring, and improving key functions of primary care, and connecting these to other resources that create health within communities, have proven critical to fighting the COVID-19 pandemic and building back a stronger health system. 

Since 2012, Ariadne Labs has grown to 110+ physicians, nurses, researchers, data scientists, implementation specialists, program managers and operations professionals, and 150+ associate faculty and affiliate members from across the Harvard system and beyond. Ariadne Labs’ work is strengthened by partnerships and collaboration with world-class experts at our founding and affiliate institutions. Throughout the years, we have been proud to partner with institutions such as the World Bank, the United Nations, Bill & Melinda Gates Foundation, CDC, and NIH, among others. From checklists and conversation guides to fostering international collaborations and establishing global standards of measurement, our work has been accessed in more than 170 countries, touching hundreds of millions of lives.

In 2019, health system innovation leader Asaf Bitton, MD, MPH, was named the incoming Executive Director as Dr. Gawande stepped down to assume the role of Chairman of the Ariadne Labs Governance Council. A Harvard professor and Brigham and Women’s Hospital primary care physician, Dr. Bitton had led Ariadne Labs’ Primary Health Care Program since 2014. 

In 2020, responding to the COVID-19 pandemic, Ariadne Labs drew on previous experience with Ebola and H1N1, to quickly identify several areas where we could innovate evidence-based solutions to support clinicians, patients, the general public, and public health decision makers. Our work has drawn on new research, front-line clinical experience, resources and accumulated knowledge in health systems innovations and emergent public health threats. In 2020, our COVID-19 work reached more than 7.8 million people.