Fifteen years ago, if you wanted to carve out a career niche in patient safety, you had to be resourceful — and a tad lucky. I was a bedside nurse at Johns Hopkins then, and my manager was helping me find a track for promotion. Noting that I submitted far more adverse-event reports than anyone else,(...)
Patient-Centered Care
Seeing It Through: Confronting the Danger of Missed Blood Clot Prophylaxis
Posted by | Patient-Centered Care, Preventing Patient Harm- By Elliott Haut and Brandyn Lau on behalf of the Johns Hopkins Venous Thromboembolism Collaborative You pack a healthy lunch for your child, but the carrot sticks and apple come home untouched. You donate to disaster relief, but the supplies sit unused in a shipping container. You mail a birthday gift to a friend,(...)
Breaking Down the Barriers to a Second Opinion
Posted by | Patient-Centered CareWhen patients receive life-altering diagnoses, face aggressive treatments, or have misgivings about a provider’s conclusions, they may wonder if they should seek a second opinion. A recent study by Mayo Clinic researchers suggests that patients who do get second opinions frequently end up with different diagnoses. Of 286 cases referred by primary care practices to(...)
How We Can Engineer a Less Costly Health Care System
Posted by | Designing Safer Systems, Patient-Centered Care, Preventing Patient HarmIf we want to rein in the costs of the U.S. health-care system — now equal to nearly 18 percent of the nation's gross domestic product — we cannot ignore the fragmented technologies used to help heal and save lives. At first glance, the devices, monitors, electronic health records and machines found in today's hospitals(...)
Reinventing the Physical Exam
Posted by | Designing Safer Systems, Patient-Centered CareIn the technology-thick landscape of modern health care, the physical exam remains in a backwoods. Sure, there have been advances — blood-pressure cuffs, for example, now inflate themselves — but on the whole the exam has barely changed in the past century. Patients still open up and say "ah," take deep breaths and gaze at(...)
Thinking Outside the Hospital: A Call to Action for Outpatient Safety
Posted by | Patient-Centered Care, Preventing Patient HarmHealth care has been thinking about medical errors for nearly 20 years, starting with the Institute of Medicine’s 1999 report “To Err is Human.” This and other work across the country have correctly shed light upon such medical errors as amputation of the wrong limb, inpatient adverse drug events and hospital-acquired infections, and we have(...)
What Teenage Patients — and Their Parents — Want from Their Care Team
Posted by | Patient-Centered CareFor anyone with a serious medical condition, frequent hospitalizations and clinic visits can have a profoundly disruptive impact. Yet adolescent and teenage patients have a uniquely challenging experience. A boy who would otherwise be playing on a soccer team or performing in a play may be undergoing chemotherapy. A girl who had expected to be(...)
The Risks of the 15-Minute Doctor’s Appointment
Posted by | Patient-Centered CareHow would you react if you sent your sputtering car to the auto mechanic, and they stopped trying to diagnose the problem after 15 minutes? You would probably revolt if they told you that your time was up and gave back the keys. Yet in medicine, it's common for practices to schedule patient visits in(...)
Patient Care: What’s Love Got to Do with It?
Posted by | Organizational and Cultural Change, Patient-Centered CareTalking to health care professionals about the importance of loving your patients and colleagues — as I often do — might raise eyebrows. How can we be expected to love our patients during a 15-minute clinic visit? How can love form among hospital teams coming together for a surgical procedure but then moving on to other work?(...)
The Patient Wish List
Posted by | Patient-Centered CareSince undergoing a double-lung transplant at The Johns Hopkins Hospital in December 2011, Podge Reed Jr. has had four medical admissions, two surgical admissions, eight outpatient procedures requiring anesthesia, more than 100 outpatient appointments, and 700 labs and other tests. He's amassed enough experiences with the health care system to write a book. So far,(...)