Insights from the Armstrong Institute
Over a decade ago, I consulted on a project for the U.S. Air Force involving very large-scale simulations. These "war games" involved more than 1,500 participants around the world — some in simulators and some using real equipment in training mode. In a warehouse-sized building, a wall of gigantic screens captured the mock battle, as a(...)
The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the(...)
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.(...)
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(...)
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(...)
Talking 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?(...)
Wanted: 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(...)
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(...)
Maybe you've had this experience: You attend a workshop or conference to build your skill set, you pick up new strategies and tools, and you leave energized and excited to put them to use in your hospital or clinic. Yet when you return to work, you find it hard to get the ball rolling. Colleagues(...)
Like a pro golfer swears by a certain brand of clubs or a marathon runner has a chosen make of shoes, surgeons can form strong loyalties to the tools of their craft. Preferences for these items — such as artificial hips and knees, surgical screws, stents, pacemakers and other implants — develop over time, perhaps out of habit(...)