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Managed Care Partners - Taking patient safety to the next level

Managed Care Partners Winter 2012

Taking patient safety to the next level

Date: January 3, 2012

“When good science is applied to patient safety,” says Peter Pronovost, “the results can be breathtaking.”
“When good science is applied to patient safety,” says Peter Pronovost, “the results can be breathtaking.”

A recent gift from the chairman of Johns Hopkins Medicine’s board of trustees will help Hopkins patient safety experts improve health care quality and reduce preventable patient harm, improve patient outcomes and reduce health care costs everywhere.

In May, Hopkins leaders announced a pledge of $10 million from C. Michael Armstrong to create an institute to advance the science of reducing preventable harm and improve health care quality. Shortly after, they tapped patient safety guru Peter Pronovost, a professor of anesthesiology and critical care medicine, to direct it. Pronovost, winner of a 2008 MacArthur Fellowship “genius grant” in recognition of his contributions to patient safety, also has been named Johns Hopkins Medicine’s senior vice president for patient safety and quality.

The new Armstrong Institute for Patient Safety and Quality “allows us to really merge the research with the operational side and infuse the science with the daily practice of patient safety,” Pronovost says. “The literature suggests that despite a lot of talk, there’s been little data showing that patient safety is improving. The field has run away from science rather than embrace it. One bright spot is the national reduction in bloodstream infections in intensive care units.”

The Armstrong Institute now oversees all patient safety and quality efforts throughout Johns Hopkins Medicine, enveloping Hopkins’ Quality and Safety Research Group and the Center for Innovation in Quality Patient Care. It is designed to rigorously apply scientific principles to the study of safety for the benefit of all patients, not just those at Hopkins. The focus will be on eliminating preventable harm for patients, eliminating health disparities, ensuring clinical excellence and creating a culture that values collaboration, accountability and organizational learning. Johns Hopkins will serve as a learning laboratory to test the best that its researchers have to offer in the fields of patient safety and quality improvement.

Pronovost is known internationally for his work using a simple, five-step checklist coupled with a program of culture change to dramatically reduce central-line-associated bloodstream infections in intensive care units, virtually eliminating them at The Johns Hopkins Hospital and throughout the state of Michigan. His program, now adopted by nearly every state, the District of Columbia, Puerto Rico and many nations around the world, is believed to have saved thousands of lives and millions of health care dollars.

The infections, which kill more than 30,000 Americans each year, are down 58 percent across the country in recent years, according to the U.S. Centers for Disease Control and Prevention.

Building on that success, Pronovost and colleagues are working with the American College of Surgeons to launch a program in 10 states to try to reduce surgical-site infections. The Agency for Healthcare Research and Quality awarded $10 million for this project and an additional $700,000 for an 18-month program to develop and implement the checklist system in two states to prevent ventilator-associated pneumonia.

“Peter Pronovost has exemplified excellence at Hopkins and throughout the country through his patient safety research, implementation and results,” says Armstrong, retired chairman of Comcast, AT&T, Hughes Electronics and IBM World Trade Corp. “He is the right leader for the Armstrong Institute and will take patient safety to its next level.”

Pronovost says he expects to bring a multidisciplinary approach to the new Armstrong Institute, noting there are different types of safety problems requiring different theories and methods to solve. He plans to call on psychologists to assist in improving teamwork, sociologists to help with organizational culture and human factors, and systems engineers to improve the interaction between staff members and new hospital technologies.

The Institute also will maintain a website featuring training materials and Pronovost’s blog about patient safety. It can be found at