The Checklist That Cut ICU Infections

ficklestudio26 · Facts checked October 15, 2026

Checklists can seem too simple to matter. A well-known study in hospitals is the usual example of why they sometimes do.

Make a checklist
Daily, weekly, packing and shopping lists with your own items.
Open the tool →

The study

In 2006 Peter Pronovost and colleagues reported the results of a program in intensive care units across Michigan in the New England Journal of Medicine. The aim was to reduce bloodstream infections linked to central venous catheters, the thin tubes put into large veins. Reports of the study give different numbers of participating units, at around one hundred, so we will not give an exact number.

What they did

The program built on guidelines from the US Centers for Disease Control and Prevention. Staff followed a short list of steps for placing a catheter: washing hands, using full-barrier precautions, cleaning the skin with chlorhexidine, avoiding the femoral site where possible, and removing catheters that are no longer needed. Each unit named a physician and a nurse as team leaders. The researchers reported that the program required no new staff or technology.

What happened

The median infection rate across the units fell from 2.7 per 1,000 catheter-days at the start to zero. Mean rates also fell substantially. One summary describes a reduction of up to 66%, and the exact figure depends on which comparison you use.

What it does not prove

This was a before-and-after study without a separate comparison group, so we cannot be sure how much of the change was due to the checklist and how much to the wider program, such as the team training and attention to the issue. A median of zero is also sensitive to small counts. The study is best read as a strong example of what a simple, shared routine can do in a high-stakes setting, not as proof that every checklist works.

For everyday lists

Most of our lists are lower stakes: groceries, packing, a morning routine. The idea carries over in a modest way. Writing steps down once means you do not rely on memory each time.