Navigation Links
More doctors must join nurses, administrators in leading efforts to improve patient safety, outcomes
Date:2/1/2011

Efforts to keep hospital patients safe and continually improve the overall results of health care can't work unless medical centers figure out a way to get physicians more involved in the process.

"Physicians' training and perspectives on patient care make their contributions to improvement efforts essential," says Peter J. Pronovost, M.D., Ph.D., a Johns Hopkins patient safety expert and co-author of a commentary published in the Feb. 2 Journal of the American Medical Association. "But the work of improving quality currently rests primarily with hospital administrators and nurses, with physicians taking a peripheral volunteer role, often questioning the wisdom of these efforts."

The major obstacle to recruiting physician leaders to the safety movement, he says, is the failure of medical centers to professionally and financially compensate and reward physicians for spending time on quality-improvement projects. "Such projects take away from the time physicians spend treating patients and generating revenue," he says. "What's needed is a system that would support a portion of a doctor's time spent managing and standardizing quality of care on a particular unit, in a role similar to what now happens with nurse managers."

Pronovost, a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, and Jill A. Marsteller, an assistant professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, note that studies show little evidence that hospital quality-improvement programs have improved patient outcomes, despite buy-in from top administrators and a push for accountability. "Hospitals will only begin to see progress if they get physicians to not just participate more but to assume leadership roles in quality improvement," Pronovost says.

Pronovost and Marsteller argue that the root of the problem is the "antiquated" relationship between hospitals and the physicians who practice inside them. "The system we have is that most physicians act almost as independent contractors, autonomously caring for individual patients and essentially renting beds, nursing care and technology from the hospital," he says. "Physicians often sit on the sidelines, as nurses and executives push for changes they hope will improve patient outcomes."

Doctors need to focus more on not just the individual patients in their care, but also on the hospital's systems for caring for the patient population as a whole, they say.

Pronovost and Marsteller's prescription is for a formalized "physician management infrastructure" that encourages doctors to design scientifically rigorous quality-improvement interventions, develop performance measures, monitor performance, implement interventions and monitor their impact.

Such an infrastructure would include physician leadership training and development, an emphasis on reliable and valid performance measures, and creation of a chain of accountability from the hospital to physician leaders.

Pronovost and Marsteller acknowledge that their prescription will cost money that hospitals rarely have. "Hospital margins are thin if they exist at all, and current health reform efforts are focused on paying hospitals less not rewarding them for improving patient care," Pronovost says. "This makes it difficult for hospitals to financially support physician quality-improvement leaders, and in many cases hospitals are cutting positions, not adding them."

In the long term, however, Pronovost insists, investment in physician-led quality-improvement efforts will reduce costs and at least pay for themselves. The alternative, he says, is not good for patients or hospitals. "Without monetary support for physician leaders, the quality of care for populations of patients is unlikely to improve," he says.


'/>"/>

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Wiser Pregnancy Reveals What Doctors Did In Situations Like Yours
2. Helmets must be part of skiing and snowboarding culture, doctors urge
3. Doctors Have Many Ways to Say No
4. Doctors Working Less, Earning Less
5. Doctors Share Longevity Secrets on CBS Broadcasts
6. Shortage of Black Doctors Rooted in Social, Economic Ills
7. Doctors Practice Medicine in Fear, New Study Finds
8. Doctors Applaud House Vote to Remove Anti-Trust Exemption for Health Insurers
9. Napa State Hospital Doctors Question DMH Judgment
10. Doctors Applaud Latest Furlough Reversal
11. Star of TVs The Doctors Helping Put Smiles on Faces of Needy Children in India
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/22/2017)... ... 22, 2017 , ... Pivot Point Consulting, a ... as the firm’s new Consulting Services Executive. Mr. Tisch will oversee all aspects ... assisting clients with initial vendor selection and pre-implementation planning through go-live support and ...
(Date:8/22/2017)... ... August 22, 2017 , ... “To Walk Away”: a ... B17 bomber named Edward Koontz. “To Walk Away” is the creation of published author, ... published over two hundred manuscripts in chemistry and religion, as well as four novels. ...
(Date:8/22/2017)... Raleigh, North Carolina (PRWEB) , ... August 22, ... ... senior strategic advisor. Mr. Stewart is the Founder and Managing Member for t4 ... elements that have become critical to his definition of “success”: physician leadership development, ...
(Date:8/21/2017)... ... 22, 2017 , ... Nanoparticle research provides an exciting path ... learning and implementing best practices for containment using ventilated safety enclosures, many of ... a better understanding of a method for safely testing nanotechnology hoods. They will ...
(Date:8/21/2017)... , ... August 21, 2017 , ... Five chefs from ... awareness for Alzheimer’s Family Center. , Guests will be able to vote for ... Plaza, Braised Lamb Shank with Fennel Dill Salad, Feta Cheese Sauce & Garlic Pita ...
Breaking Medicine News(10 mins):
(Date:8/3/2017)... 3, 2017  Opioid addiction and other drugs of ... costs and threatening outcomes, were problems taken on directly ... industry that support them, met this week. This according ... that drugs of abuse, procalcitonin and acute kidney injury ... organization,s 69th meeting in San Diego, CA. ...
(Date:8/2/2017)... WASHINGTON , Aug. 2, 2017 CaryRx, a ... same day delivery service for patients in the ... the traditional retail pharmacy by providing delivery of medications through ... scheduled for future delivery or delivered within one hour to ... "We are excited to bring this invaluable service to ...
(Date:7/31/2017)... 7D Surgical, developer of ground breaking surgical navigation technologies, announced ... to support its strategic sales plan in Maryland ... 7D Surgical has entered into an exclusive sales representative agreement ... within those markets. ... Spartan Medical Purchases 7D Surgical ...
Breaking Medicine Technology: