One Doctor’s Fight for Patient Safety

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Dr. Peter Pronovost, a Johns Hopkins anesthesiologist, is waging a war on what he calls “the secrecy, shame and lack of communication within health care”. According to Pronovost, the war must be waged to protect patients from unsafe hospital practices that lead to dangerous medical errors. Pronovost has already designed a checklist to reduce catheter-related infections in ICU’s.
Now, he’s published a book entitled, “Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out.” Pronovost’s two-pronged approach involves creating safe practice checklists as well creating hospital cultures in which nurses and other healthcare workers are unafraid to challenge doctors who are making errors.
Dr. Pronovost decided to act after witnessing a toddler, 18 month old Josie King, who had been brought to Johns Hopkins Hospital for burn treatment. Josie died from substandard care resulting from a medical error.
In the book, Pronovost writes, doctors “think they are infallible, communication between nurses and doctors is poor and accountability is virtually non-existent. . . Medicine operates like a private club of self-styled deities where the entrance requirement is an M.D.”
In her February 16, 2010 book review of Dr. Pronovost’s work, Wall St. Journal writer Laura Landro mentions two scenes which Dr. Pronovost cites as examples of this egregious behavior.
“In the course of advancing his argument, Dr. Pronovost offers glimpses into the harrowing world of intensive care, such as a patient accidentally left to overdose on narcotics—saved, ironically, because he was a heroin addict and could tolerate the excess of drugs. In one heart-stopping scene, Dr. Pronovost faces off with a surgeon who refuses to admit that the patient on the operating table is having a deadly allergic reaction to the latex gloves that the surgeon is wearing.”
I salute this young doctor’s courage and willingness to stand up for patient safety. Medical errors and patient safety are intimately related to the institutional culture as well as a profession’s willingness to change and adopt safe practices of medicine.

Kevin Dugan
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