Date: June 1, 2012
An overriding theme in this issue is the concept of clinical communities, a model for improving patient safety by gathering multidisciplinary groups to brainstorm effective solutions.
A pioneering researcher in clinical communities, medical sociologist Mary Dixon-Woods of the University of Leicester in England found that one size does not fit all when it comes to effective patient care. Her research has shown that patient outcomes vary from hospital to hospital across Great Britain despite standard protocols and procedures. She theorized that the best strategies for quality care are cultivated on a local level, through discussion, debate and ultimately consensus among peers motivated by a collective concern for patients’ welfare.
While reviewing the Michigan Keystone Project, a successful initiative to reduce central line-associated bloodstream infections in ICUs across the state, Dixon-Woods recognized the same strategies. That project was spearheaded by Peter Pronovost, director of Hopkins’ Armstrong Institute for Patient Safety and Quality, and Chris Goeschel, director of strategic development and research initiatives for the Quality and Safety Research Group in Hopkins’ School of Medicine, who at the time were unfamiliar with the clinical community model but gravitated instinctively toward peer-to-peer approaches to infection prevention.
Now the Armstong Institute so far is guiding four formal clinical communities to tackle ongoing challenges in areas like improving medication safety and caring for patients in postanesthesia care units. I’m excited to see their results.
But beyond formalities, Hopkins for years has been the kind of environment where health care team members join together to find innovative solutions. At Suburban Hospital, nursing staff formed the multidisciplinary Morse Team to better prevent patient falls. If a patient falls, the Morse Team is immediately on the case, evaluating factors like the physical environment and the patient’s medications. And Howard County General Hospital is participating in the Acute Care for Elders program, an effort to keep older patients physically and mentally active during their hospitalizations to improve outcomes and prevent decline.
As you’ll see in our cover story, some practices developed by our clinical communities are now being marketed to outside hospitals and health systems so they too can benefit from our solutions. We’re sharing knowledge not just with each other but with the world.
President, Johns Hopkins HealthCare