A new Johns Hopkins study has found that when it comes to keeping patients safe, a health system must have clear goals, strong leadership and infrastructure, staff engagement, and transparent reporting methods. The study, led by Peter Pronovost, was published in Academic Medicine in December 2014.
Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine and director of the Armstrong Institute for Patient Safety and Quality, worked with colleagues to review the model used by the Johns Hopkins Health System to improve the use of core measures. According to the January 5, 2014 news release these are, “recommended, well-researched processes for treating patients who require surgery or suffer heart attacks, heart failure, pneumonia or serious conditions.”
The researchers found that while the goal of the health system was to achieve 96% compliance on seven best practice measures at five of its member hospitals, after two years these hospitals had obtained 96% compliance on six of the seven targeted measures.
Pronovost and his colleagues found that a critical part of meeting a patient safety improvement goal is ensuring that an organization first has a “commitment from leadership to invest in organizational structures and governance to hold member institutions accountable. Leaders from Johns Hopkins Medicine formed the Armstrong Institute to coordinate research, training and operations for quality improvement efforts across the organization. Clinical work groups responsible for target measures reported progress to the Johns Hopkins Medicine Patient Safety and Quality Board Committee. Better communications and identification of specific opportunities for improvement, according to the study, were also critical for success.”
The other critical element to succeeding with a patient safety goal is establishing a transparent reporting system, said the authors. Hospitals that did not meet the goal of 96% compliance in one or more of the safety targets had to undergo a four-level review process. Hospitals that repeatedly missed the goal were referred to higher levels of leadership for review and possible auditing.
Regarding the biggest challenge involved with the work groups, Pronovost told OTW, “The clinical communities are peer-driven networks, with members from across the institution. Identifying a collaborative leader to help the network establish safety and quality priorities, set goals and achieve results is critical for success.”
Asked what advice he might have for smaller institutions with limited resources, Pronovost added, “The clinical communities framework works best when you take the key principles—collaboration, social connections and active engagement—and apply them in a manner that aligns with your institution’s goals and culture.”
