Monday, March 15, 2010
Safe Patients, Smart Hospitals
I had some beach time last week so I read Peter Pronovost's new book, Safe Patient, Smart Hospitals. It's the story of his journey in patient safety, which starts with his father's death, likely hastened by a medical error. Parts of the story are probably familiar to those who work in infection prevention, but I think it's worth reading.
One of the major points he makes is that the checklist, while important, can really only work when the hospital unit embraces a culture of safety. An aspect of the book that I particularly liked is his criticism of some of the work in quality improvement because measurements lack validity. Like Pronovost, I've been accused of trying to do research by QI folks, when all I was asking was to measure a process or outcome accurately and precisely. He also points out how often ego gets in the way of doing the right thing. Over and over, I kept wondering why change is so difficult in hospitals even when the data for a new intervention are compelling. And he reinforced my belief that infection prevention, like many other aspects of patient safety, is all about high levels of compliance with simple practices.
Unfortunately, I suspect that Dr. Pronovost is preaching to the choir. Those who might benefit most from his words are least likely to turn the pages of this book.