Safe Patients, Smart Hospitals

If you are concerned about the quality of health care and rising costs, read this book.

If you are responsible for change management in a corporation, read this book.

If your are working on an electronic medical records system, read this book.

Peter Pronovost, M.D. and Ph.D. took on change management as a process to reduce the costs, and more important, the risks of serious illness or death associated with the practice of medicine. This book is not just about a good idea. It is about having a good idea and then doing what needs to be done to realize the benefits of that idea.

“We knew our success would depend on three key elements: Developing and unambiguous checklist that would encapsulate as much evidence or knowledge as we could capture on a particular procedure; changing the culture and associated broken systems to remove any barriers to implementing that checklist; and measuring results so we could gauge the checklist’s efficacy and provide feedback to provide whatever changes are necessary to improve it.”

“What was striking was that nobody debated the evidence, nobody challenged the items on the checklist, and nobody questioned whether we should do them. But everyone objected to the change in culture. … Perhaps the most radical step we took was to promote the checklist was we gave it to family members of patients. We explained how it worked and why it worked and encouraged these nonclinicians to observe and ask nurses and doctors if the procedures were not being followed. … Now that family members were aware of the checklist, they were asking useful questions that actually helped the nurses and doctors do their job.”

Great move, but one that requires clear support from the people responsible for performance in accordance with the checklist – doctors and nurses – and senior management. For a number of reasons that are covered in the book Dr. Pronovost and his various teams had outstanding support from the senior management of John Hopkins Hospital.

As a business analyst for process improvement and systems development, I find that good ideas are relatively common. Particularly those that include the results of shared experience and thoughtful consideration. “… changing the culture and associate broken systems. …” is the hard part and the part that is least understood by most champions of change. The way Dr. Pronovost and his various teams dealt with those issues is some of the most interesting material in the book.

By the way, very well written.

Safe Patients, Smart Hospitals
By Peter Pronovost and Eric Vohr
Hudson Street Press, 282 pages, $25.95

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