One night, a woman is examined in the emergency department complaining of vertigo. Her physician orders a CT scan, and when the tests come back negative, he diagnoses her with a benign inner ear condition and sends her home. He never sees her again. What he never learns is that her dizziness was far from(...)
Measurement of Safety and Quality
Blockbuster Data: How Reporting Surgical Volumes Could Save Lives
Posted by | Measurement of Safety and Quality, Preventing Patient HarmIf there was a wonder drug to save the lives of infants with serious heart abnormalities, doctors would be sure to prescribe it. Parents would insist that their children get it. The company that invented it would get rich. But there already is something that can have as dramatic an impact on these young lives(...)
A Clear-Eyed Approach to Reducing Costly Health Care Regulations
Posted by | Measurement of Safety and QualityJohns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country's health-care bill, with no negative effect on patient health. The only thing standing in the way is a stubborn government requirement. Seventeen years ago, Dr. Schein and colleagues published a study finding that(...)
Why Surgical Volumes Should Be Public
Posted by | Measurement of Safety and QualityHer voice cracked with strain. I could imagine the woman at the other end of the line shaking, overcome with remorse about the hospital where her husband had had esophageal surgery. Might he still be alive, she asked me, if they had chosen a different hospital? The couple had initially planned to have the procedure(...)
More Science, Less Sausage-Making Needed for Hospital Quality Measures
Posted by | Measurement of Safety and QualityIf you understand statistics and possess the intestinal fortitude to examine a ranking methodology, you will recognize that it involves ingredients that have to be recombined, repackaged and renamed. It's messy, like sausage-making. This is not to say that the end product — hospital rankings — are distasteful. Patients deserve valid, transparent and timely information(...)
5 Lessons for Creating Health Care Performance Dashboards
Posted by | Measurement of Safety and QualityIn recent years, Johns Hopkins Medicine has grown increasingly sophisticated in its use of patient safety and quality dashboards, not just to spur internal improvement efforts but also to increase transparency with the public about our performance. In 2013, we launched an internal dashboard for our health system’s 41,000 employees, sharing our performance data on(...)
Why It’s So Hard to Pick the Right Hospital
Posted by | Measurement of Safety and QualitySelecting the right hospital to receive care can save your life, lower your risks of getting a complication, or even reduce your financial hardship. The problem is that it's extremely hard for patients to make that judgment. Sometimes, the data they need to select the best hospital for their care doesn't exist. In other cases(...)
Seeking the Right Stuff for Teams: In the Hospital or Distant Space
Posted by | Designing Safer Systems, Measurement of Safety and Quality, Organizational and Cultural ChangeWanted: Talented, highly driven individuals to take on multiyear work assignment with potential for benefiting humankind. Requires the highest levels of technical skill, teamwork and adaptability. Must be able to tolerate social isolation, mental and physical fatigue, demanding and uneven work schedules, days and nights away from home. Risk of depression and burnout. Must be(...)
Patient Safety at 15: How Much Have We Grown?
Posted by | Designing Safer Systems, Measurement of Safety and Quality, Organizational and Cultural Change, Preventing Patient HarmFifteen-year anniversaries often come and go without fuss, overlooked in favor of those we can mark in full decades. Yet recently, at Johns Hopkins and nationally, we've crossed that mark for a couple of events in patient safety that merit both celebration and reflection. In January 2001, a series of lapses at Johns Hopkins led(...)
Potential Bias in U.S. News Patient Safety Scores
Posted by | Measurement of Safety and Quality, Preventing Patient HarmIn this post, I present the case that U.S. News & World Report’s patient safety score, a component of its annual Best Hospitals rankings, has a bias against Maryland hospitals. Two editors at U.S. News respond to my position at the bottom of the post. Hospitals can get overwhelmed by the array of ratings, rankings(...)