Insights from the Armstrong Institute
For a moment, consider that you work at a primary care clinic, and your team needs to improve performance on annual foot exams on patients with diabetes — a critical step to prevent foot ulcers and amputations. At your monthly meeting, staff members enthusiastically suggest solutions, such as using robocalls to urge patients to schedule appointments(...)
Imagine you were seeking major surgery, and the hospital's consent form contained this surprise statement, which you were asked to initial: "I understand that this surgeon and hospital have not performed this procedure in the last 12 months. As such, I accept the greater risk of complications and even death." It's hard to believe that(...)
When you stay at a five-star hotel — if you are so lucky — you might expect a bowl of fresh fruit in your room every morning, gourmet restaurants on-site, and staff members who know your name and anticipate your needs. At a one-star hotel, you may just hope for value, cleanliness and decent water pressure. The(...)
Some measures of health care quality and patient safety should be taken with a grain of salt. A few need a spoonful. In April, a team of Johns Hopkins researchers published an article examining how well a state of Maryland pay-for-performance program measure for dangerous blood clots identified cases that were potentially preventable. In reviewing(...)
Consider, for a moment, that you are a new physician. A patient, who is a lifelong smoker, comes to your clinic complaining of shortness of breath, and after conducting several tests you diagnose him with chronic obstructive pulmonary disease (COPD). Relying on your training, you prescribe medications, arrange for follow-up visits and describe activities that can(...)
Years ago, I felt firsthand what it was like to be the helpless family member of a hospitalized patient. My mother had undergone surgery in a hospital nearly three hours away, and things had not gone well. She was unconscious when I arrived in the intensive care unit. One of the first things I noticed(...)
More than a decade ago, a team of Johns Hopkins safety and quality scholars began meeting in a small office building along the Baltimore waterfront to discuss their research ideas. Physicians, nurses, a psychologist, economists, public health researchers and others would describe their goals, and then see how they could help one another to achieve(...)
When you are a patient at a hospital, you want to know that the executives who run that facility put the safety and quality of care above all other concerns. Encouragingly, more of them are saying that safety is indeed their number-one priority—a fitting answer given that preventable patient harm may claim more than 400,000(...)
As standardized exam scores increasingly define success for students, teachers and schools, parents worry about the dangers of “teaching to the test”—and of their children being judged by tests with low or unknown validity. We want our children to perform well on tests, of course, yet only if they measure something that students, patients and(...)
Often, when giving talks to health care professionals about the urgent need to improve patient safety and quality, I ask them to do an exercise. At the beginning of the talk, they write down “I will…” on a piece of paper. As the talk comes to a close, the audience is urged to complete that(...)