Finishing Reading: Safe Patients, Smart Hospitals By Peter Pronovost And Eric Vohr

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I am finishing this up this weekend and I am trying to get my hands around how with such a simple thing as a checklist can so many lives be saved. This excerpt from page 223:

“Within three months of implementing the interventions (in the state of Michigan), we nearly eliminated these infections in all of the 103 participating ICU’s; it has stayed that way for four years. The work was not easy; it required hospital leaders, doctors, and nurses to implement interventions, improve teamwork and monitor performance.”

You would not call this book a nonfiction masterpiece, however, from the standpoint of giving this reader something to mull over in how to use checklists in improving my performance in my occupation, it is a very thought-provoking book.



More From Safe Patients, Smart Hospitals From Peter Pronovost and Eric Vohr


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I am currently about two-thirds of the way through on this book and I am coming to the conclusion that it is not that difficult for organizations and especially units of organizations to figure out what problems they are facing and most of all to come up with a plan to fix these problems. However, the stumbling block to me, is the ability of the organization to change the culture in order to make these necessary changes. I know personally that it is very easy for me to rationalize in order to avoid changes to improve my life, and I can imagine that for an organization to make changes is difficult at best.

I was talking to my brother-in-law about changes in our county government and how slow it can be. People want change but they do not want to change themselves. This excerpt from page 83 shows the challenges that are faced in hospitals when doctors expect and believe that they are god:

“Yet many surgical teams don’t even know the names or roles of their colleagues, even after working together for years. I remember speaking to a nurse who had been working with a surgeon for two decades. The surgeon had just left the room and she had tears in her eyes. I asked her what was the matter and if I could help. She said, ‘I have worked for twenty years with him, I have bent over backward to make this place work and his life better, and he does not even know my name.'”

My question to our readers is this: What industries or organizations are the least resistant to change primarily because of culture? I would appreciate your comments.

Excerpt About Loss From Safe Patients, Smart Hospitals By Peter Pronovost and Eric Vohr

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I ran across this excerpt on page 72 and wanted to share it with our readers:

“People don’t fear change, they fear loss. And loss has two components, a real component and a perceived component, and the perceived is generally larger and more powerful. Yet it is often unproven, generally false, and grossly exaggerated. What leaders of change need to do is minimize real losses and demonstrate that perceived losses are mythical. Only then can they successfully implement change.”

If you are in a culture battle in your workplace, this is one of the best paragraphs I have ever read on loss and needs to be put into place wherever change needs to take place.

More On Safe Patients, Smart Hospitals By Peter Pronovost and Eric Vohr

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I am at around page 50 and it is astounding to me the culture of a hospital. Doctors are held as gods and subordinates such as nurses are afraid to speak due to getting their heads chopped off. A blurb from page 39 about improving health care is an excellent example:

“To improve health care, we need to examine how culture affects the systems and structures within which we do our work. Culture influences how we deliver care, how we interrelated with our colleagues, and how we treat our patients. Similarly, the systems in which we work and live, in turn, affect culture—they are interconnected. Whether in a clinic in Africa or in the halls of an American hospital, culture and systems must be reevaluated in order for patient safety to be achieved.

This paragraph burned in my mind about culture changes that need to be made in areas that I work in such as county government and K-12 education. The culture issues are similar, I am sure, due to the fact that they have always been done that way. I am currently starting a consulting business in helping local and county governments tighten their budgets by improving their process. I must say that is much easier said than done.

Another example of toxic hospital culture, is the myth of how doctors cannot make mistakes. On page 47, this myth is brought to life:

“An estimated 750,000 people each year suffer a cardiac arrest in the hospital. Cardiac arrest is almost always treated with a defibrillator. Yet roughly 30 percent of the time, physicians operate those machines incorrectly. So why not redesign them so they are easier to use, or print clear instructions on the machine? Because no doctor wants to admit that he or she doesn’t know how to use it correctly. No one wants to admit doctors are human, they are flawed, and they can make mistakes.”

One of the most interesting points the author makes is that it is imperative to understand that it is culture and systems, not the doctors themselves or the nurses, that are the cause of these mistakes and they do not have to be perfect.

Currently Reading: Safe Patients, Smart Hospitals By Peter Pronovost and Eric Vohr

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I started this book over the weekend and I must say by reading only the introduction I was hooked. Safe Patients, Smart Hospitals, thus far, is a book that brings out a torrent of emotions and the pain that families endure because of medical errors. An excerpt from the introduction:

“After the children left the room, Josie’s family stood around the small dying child hooked up to a myriad of bleeping, buzzing machines. Speers (the pastor) read from the Bible as doctors placed the near-lifeless child into her parents’ arms.

‘We held her and they switched off the machines. We held her and we held her. Her heart was still beating and the doctor came up and put the stethoscope on her heart and then he nodded, which meant her heart had stopped, she was dead,’ recalls Sorrel (the mother).

The grief-stricken parents each held their precious child for the last time, rocking her and singing to her through their tears as light flakes of snow softly fell outside the window.”

This book is about improving healthcare and all the problems associated with it such as egotism of doctors and chain of command. Thus far, this is an excellent book and has brought out a myriad of emotions.