In the past 10 years there has been a huge increase in interest in ways to improve patient safety and reduce iatrogenic injury. The development of checklists in medicine is one such way. In the USA in 1999 the Institute of Medicine (a non-governmental organization whose purpose is to provide national advice on issues relating to health and medicine) published ‘To Err is Human: Building a Safer Health System’. This report looked at medical errors in the USA. This was followed in 2001 by ‘Crossing the Quality Chasm’, which investigated further elements of the 1999 report. These reports were the inspiration for the widely publicized ‘100,000 lives campaign’ in the USA, aimed at reducing hospital morbidity and mortality in a number of key areas, e.g. the prevention of central line infections and surgical site infections.

Enthusiasm for checklists grew following the publication of the ‘Michigan’ or ‘Keystone’ paper. Peter Pronovost, an American intensivist at Johns Hopkins, devised a simple five-point checklist to accompany central line cannulation in an intensive care unit. He created the list after extensive literature review and he chose for the checklist the five points that were most likely to be effective in reducing line-associated infection. The checklist was therefore a standardized, evidenced-based tool. The use of the checklist was associated with a dramatic reduction in infection in the intensive care unit.