Voices for Safer Care

Insights from the Armstrong Institute

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How We Can Engineer a Less Costly Health Care System

If 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 […]

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stroke_goggles

Common Symptoms, Uncommon Causes: Reducing Misdiagnosis on the Front Lines

In 2013, a 52-year-old man went to an emergency department complaining of dizziness. Physicians evaluated him, decided that it was a benign condition — as it usually is — and sent him home. Days later, it became apparent that this was no harmless event. He suffered a significant stroke, with permanent disability as the result. […]

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Blood glucose test

Thinking Outside the Hospital: A Call to Action for Outpatient Safety

Health 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 […]

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How Teamwork Can Reduce Missed Diagnoses

How Teamwork Can Reduce Missed Diagnoses

Every American will experience a missed or delayed diagnosis at some point in his or her lifetime. Saying that is not a scare tactic — it's a reality, according to a 2015 National Academy of Medicine report titled "Improving Diagnosis in Health Care." Yet we have not made effective use of a simple solution: teamwork. […]

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Flint Water Plant

How the Flint Water Crisis Is a Cautionary Tale for Health Care

There has been no shortage of blame for the poisoning of Flint, Michigan's water supply. In March, a governor-appointed task force issued a report that rebuked local, state and federal authorities for their actions — and inactions — that created the public health crisis. Then, in late April, state prosecutors announced the first charges in the […]

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ECMO

Improving the Odds for a Chance at Life

Tens of thousands of people owe their lives to extracorporeal life support (ECLS) — a treatment that uses mechanical devices to perform the work of the heart and lungs for days, weeks or even months when those organs cannot function on their own. With ECLS, we can give newborns with major congenital defects a fighting […]

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Positive thinking

It’s Not All About the Checklist: The Power of Believing and Belonging

Trine Engebretsen was clinging to life. It was the early 1980s, and the girl had a genetic liver disorder that would kill her if she did not get a transplant. Yet, as she waited for a matching liver, some providers called her parents and urged them not to allow the surgery. They cautioned them that […]

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Growth chart

Patient Safety at 15: How Much Have We Grown?

Fifteen-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 […]

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White Lab Coat with Stethoscope

Why White Coats Should Be Optional

Would my white lab coat be better put to use when I carve the Christmas roast than when seeing patients? After all, we know that these coats can be covered with pathogens, including drug-resistant ones, which may be transmitted to patients. They are cleaned infrequently: In a survey of physicians, nearly 58 percent said they […]

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yardstick

Potential Bias in U.S. News Patient Safety Scores

In 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 […]

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About the Armstrong Institute Blog

Voices for Safer Care serves as a forum for health care professionals, patients and others who are committed to ending preventable harm, improving patients’ outcomes and experiences, and reducing waste in health care. The “voices” are those of the buy modafinil clinicians, researchers and staff experts of the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, as well as anyone who joins the dialogue.

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Categories

  • Designing Safer Systems
  • Measurement of Safety and Quality
  • Organizational and Cultural Change
  • Patient-Centered Care
  • Preventing Patient Harm