After building a domestic reputation, Peter Pronovost and his group of experts now eye distant shores.
About three years ago, a team of Hopkins patient-safety experts introduced a program for reducing catheter-related bloodstream infections to more than 100 intensive care units in
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Michigan. They wanted to see if the protocols, which had already proven successful in ICUs here, could work in a wide range of hospital settings—urban and rural, academic and private. The results, published in the Dec. 28 issue of the New England Journal of Medicine, show a drastic drop in these infections across the state.
Now, with help from the World Health Organization, Hopkins may have the chance to take an even bolder step: replicating such safety programs in entire countries. The University, led by critical care specialist Peter Pronovost, is working on a partnership with WHO in which Hopkins would design projects, provide oversight and measure results.
The fact that WHO is interested in expanding Hopkins’ groundbreaking work in this field, Pronovost stresses, shows the need for safety programs that are done with scientific rigor and evaluation and are also feasible on a large scale. “In our view, it’s very much in keeping with the Hopkins mission of bringing knowledge to the world.”
Talk of a partnership began last spring after Sir Liam Donaldson, the United Kingdom’s chief medical officer and chair of WHO’s World Alliance for Patient Safety, visited the University’s Quality and Safety Research Group offices in Fells Point. That led to several trips by Pronovost to the United Kingdom and WHO headquarters in Geneva to discuss a collaboration.
Although the agreement hasn’t been finalized (Pronovost returned to Geneva in mid-January to discuss its details), the proposed partnership would integrate safety researchers from the schools of Medicine, Public Health and Nursing and could put Hopkins in a unique position. Pronovost plans to visit Spain in March to explore a possible WHO-affiliated project there.
Aside from the international safety projects, the partnership would have two other components, Pronovost says. First, under a new WHO program, “safety scholars” would attend Hopkins for a year to get a master’s degree in public health with a concentration in quality and safety. They would spend their second year doing patient-safety projects or high-level policy research at WHO, Hopkins, the United Kingdom, or in the U.S. government, such as at the Agency for Healthcare Research and Quality. Scholars would then return to their home countries to work on safety improvement efforts while continuing to receive support from the Hopkins team.
The first five scholars would start this July, taking such courses as epidemiology and working with a Hopkins mentor. Beginning in July 2008, the program would enroll 10 students per year. One space would be reserved for a Hopkins student.
The proposed partnership also calls for a new evidence and evaluation center, based in Baltimore, to assess the global projects of the WHO World Alliance for Patient Safety, such as in perioperative safety and hand hygiene. The center would also evaluate strategies to broadly eliminate specific types of hazards.
Pronovost, who would co-direct the center with public health professor Laura Morlock, says the new partnership could make a difference in the lives of millions of patients. He observes that many countries are struggling with some of the basics of patient safety, including the availability of standard protocols for care. “At Hopkins we sometimes spend hundreds of hours developing protocols, with great intellectual input,” he says. “These hospitals often don’t have the resources to do that.”
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, January 2007
