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(...)
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(...)
It’s Not All About the Checklist: The Power of Believing and Belonging
Posted by | Organizational and Cultural Change, Preventing Patient HarmTrine 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(...)
5 Lessons for Creating Health Care Performance Dashboards
Posted by | Measurement of Safety and QualityIn 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(...)
Why It’s So Hard to Pick the Right Hospital
Posted by | Measurement of Safety and QualitySelecting the right hospital to receive care can save your life, lower your risks of getting a complication, or even reduce your financial hardship. The problem is that it's extremely hard for patients to make that judgment. Sometimes, the data they need to select the best hospital for their care doesn't exist. In other cases(...)
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?(...)
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(...)
Why White Coats Should Be Optional
Posted by | Preventing Patient HarmWould 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(...)
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(...)