In 2001 Peter Pronovost of Johns Hopkins created “a simple checklist designed to reduce line infections” in intensive care units. It had five steps: wash hands, clean the skin with chlorhexidine, cover the patient with a full sterile drape, wear full sterile gear, and put a sterile dressing over the site.
The list was then used across Michigan, in the Keystone Initiative. In three months, “the infection rate in Michigan’s I.C.U.s decreased by sixty-six per cent.” In eighteen months it saved “more than fifteen hundred lives.” The results were published in the New England Journal of Medicine in December 2006.