In the July 14th issue of the Journal of the American Medical Association (JAMA), Dr. Peter J. Pronovost looks at the role of physicians and hospital leadership in improving health care quality. He writes that teamwork failures are often contributors to negative patient outcomes.
Pronovost explains that there is not a lot of empirical evidence in the effort to improve patient safety, but he looks at one exception to this rule – central line-associated bloodstream infection (CLABSI.) He uses CLABSI as example of an infection that can be prevented with interventions that include checklists of prevention practices, measurement of infection rates, and tools to improve teamwork in a hospital. However, hospitals across the country have been slow to adopt these interventions for a variety of reasons.
Pronovost concludes that CLABSI and other negative patient outcomes can be reduced if clinicians and hospital leaders work together as a team and hold themselves accountable. Pronovost also emphasizes the need for public reporting of infection rates, financial incentives from insurers, and sanctions from hospitals in order to hold physicians accountable for patient outcomes.
Massachusetts is already taking some of these steps toward reducing infections: the first statewide hospital-specific public report on infections came out in April (this will be an annual report), a section of last year’s state budget mandated that hospitals not be reimbursed for care needed following the occurrence of a preventable infection (the regulations for implementation still need to be written and approved), and a number of Massachusetts hospitals are currently participating in statewide initiatives, under the leadership of the MA Coalition for the Prevention of Medical Errors, the MA Hospital Association, and the MA Department of Public Health, to reduce CLABSI and other infections, using the tools that Dr. Pronovost describes in the article.
Read more about Dr. Pronovost’s article and his work on the Running a Hospital blog.
-Emma Smizik
