Voices for Safer Care

Insights from the Armstrong Institute

stroke_goggles

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

Posted by David Newman-Toker | Preventing Patient Harm

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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Nov 3, 2016 4 comments

Measuring blood pressure

Reinventing the Physical Exam

Posted by Peter Pronovost | Designing Safer Systems, Patient-Centered Care

In 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 […]

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Oct 6, 2016 3 comments

Blood glucose test

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

Posted by Nisa Maruthur and Melinda Sawyer | Patient-Centered Care, Preventing Patient Harm

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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Sep 20, 2016 7 comments

How Teamwork Can Reduce Missed Diagnoses

Posted by David Newman-Toker | Organizational and Cultural Change, Preventing Patient Harm

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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Jul 6, 2016 6 comments

Flint Water Plant

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

Posted by Lori Paine | Designing Safer Systems, Organizational and Cultural Change, Preventing Patient Harm

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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Jun 23, 2016 6 comments

teenage hospital patient

What Teenage Patients — and Their Parents — Want from Their Care Team

Posted by Peter Pronovost | Patient-Centered Care

For 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 […]

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Jun 16, 2016 10 comments

ECMO

Improving the Odds for a Chance at Life

Posted by Melania Bembea | Preventing Patient Harm

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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Jun 9, 2016 No comments

doctor speaking with patient

The Risks of the 15-Minute Doctor’s Appointment

Posted by Peter Pronovost | Patient-Centered Care

How 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 […]

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Apr 21, 2016 10 comments

Positive thinking

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

Posted by Peter Pronovost | Organizational and Cultural Change, Preventing Patient Harm

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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Apr 8, 2016 4 comments

hospital dashboard

5 Lessons for Creating Health Care Performance Dashboards

Posted by Matt Austin | Measurement of Safety and Quality

In 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 […]

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Mar 10, 2016 No comments

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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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