Book: Safe Patients, Smart Hospitals

Okay this book is actually really good. You just have to get over the feeling of repetition.

He tells a lot of different stories, but they are all about the same basic thing it feels like at a lot of times.

This next portion is a paper I had to write about the book. It includes a rough overview of the book, but it's well worth reading with the improvements that this simple checklist caused not only Hopkins, but the country, and even the world.

The book that I chose to read was Safe Patients, Smart Hospitals by Peter Pronovost and Eric Vohr. Medical errors happen every day and fairly often in hospitals. As healthcare providers, we are meant to help our patients and not harm them; however, we are human and humans do make mistakes. So how are we meant to reduce the errors in hospitals that are caused by human nature? Peter Pronovost took up this exact question of patient safety and what healthcare providers can do to make hospitals safer; he made a checklist that was most successful when all members of the team came together and worked together.
Johns Hopkins Hospital (JHH) is known worldwide for its top class doctors and care; however, even Hopkins makes medical errors. After the Josie case became known, Peter Pronovost went to Sorrel and asked that she work with him to improve health to reduce medical errors that result in so many lost lives every year. Sorrel came to talk at JHH and tell her story which helped lead the changes that Peter Pronovost and his team worked to implement in not on Hopkins, but hospitals around the nation (p. 13-17). One of the implementations was the use of a checklist for procedures done in different units; this checklist is different depending on the procedure but limits the amount of steps to five (Pronovost, 2010, p. 25-27).  These checklists were the start of change in hospitals, but many problems came about when implementing them and one of those problems was teamwork.
Each unit was also different when these checklists were implanted. On the SICU, where Peter Pronovost first started his work and research, the team knew each other and were willing to make changes, as challenging as that was. Nurses, doctors, techs, patients, family members, everyone needed to come together and perform checks and balances (Pronovost, 2010, p. 27-32). After tackling central line infections in the SICU, Pronovost went to other areas, one ended up being the operating rooms itself. This proved to be a much larger problem than he anticipated; the teamwork that was in other units was not as strong in the operating room. Surgeons often were more arrogant and did not want to take the advice from the other people in the room, Pronovost stated a time when he (as an anesthesiologist) tried to tell a Surgeon he was doing wrong and potentially killing a patient and how grounded the surgeon was to no change his ways (p.73-78). One of the reasons Pronovost said his model did not work in operating rooms was because it was not a consistent team, surgical teams are always changing based on need and doctors often did not know the names of the nurses with whom they were working.
I think that it is crucial that portions of healthcare, be it nurses, techs, pharmacists, doctor, learn as a part of their education, the importance of teamwork. Pronovost says himself that doctors are trained to think as the smartest and the best. As a nursing student, I do not always feel relied upon or looked upon highly by some other aspects in healthcare, but I feel the patient’s ability to trust me. That means, to me, that it is my job to help advocate for my patient; what good will advocating do if doctors refuse to listen to my opinion? If we learned in school what the other professions learn and how they work, it may help us relate more to them, and I do see this happening through Interprofessional nights, but once a year is just simply not enough. There needs to be more time incorporated for professions to learn to work together as a team.
The work that Peter Pronovost and Eric Vohr performed and wrote about in Safe Patients, Smart Hospitals, will help lead hospitals to make less medical errors. Although the staff may still make human errors, the other members of their team will catch them and help them change their action before it leads to an error. By creating checklists and advocating for teamwork and voices for all members of the team, Pronovost has helped hospitals learn where they can decrease the time and money wasted on mistakes hospitals make each day.  The best way to get a team to work properly is for them to learn how to while in school, before their opinions and decisions affect patients.