Lessons from a lifetime thinker and doer At just 7 years old, Story Musgrave faced a crisis that tested his critical thinking. While pretending to drive his father’s red farm tractor, he unlocked the brake, sending himself and the tractor down the hill into the river. He didn’t want to admit he was at fault,(...)
Designing Safer Systems
36 hours. Unlimited possibilities to transform health care.
Posted by | Designing Safer Systems, Organizational and Cultural ChangeImagine this. You are locked in Turner Concourse for 36 hours with relative strangers, tasked with creating a project that will revolutionize health care. Now what? If you are one of this year’s MedHacks participants, you are out of the gate running, ready to innovate and transform health care. MedHacks, run by Johns Hopkins University(...)
Radiology’s Quality Improvement Committee: A Formula for Success
Posted by | Designing Safer Systems, Organizational and Cultural Change"That’s how it’s always been done" is a phrase you will not hear uttered in the Department of Radiology and Radiological Science at The Johns Hopkins Hospital or at Johns Hopkins Medical Imaging. Organizations often cite historical precedent for why “option A” is being implemented instead of trying “option B.” The radiology department has seen(...)
“War Gaming” for Patient Safety
Posted by | Designing Safer Systems, Organizational and Cultural ChangeOver 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(...)
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(...)
How the Flint Water Crisis Is a Cautionary Tale for Health Care
Posted by | Designing Safer Systems, Organizational and Cultural Change, Preventing Patient HarmThere 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(...)
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(...)
Five Steps to Innovative Solutions for Health Care Improvement
Posted by | Designing Safer SystemsIn my role as the patient safety innovation coordinator for the Armstrong Institute, I spend a lot of time helping clinicians improve processes in health care delivery. Oftentimes I've found that when faced with a challenge we all have a tendency to go right to solutions we're comfortable with. Especially in health care, we’re used(...)
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