Portal de Periódicos da CAPES

Science-Based Training in Patient Safety and Quality

2012; American College of Physicians; Volume: 157; Issue: 2 Linguagem: Inglês

10.7326/0003-4819-157-2-201207170-00457

1539-3704

Peter J. Pronovost, Myron L. Weisfeldt,

Aortic aneurysm repair treatments

Ideas and Opinions17 July 2012Science-Based Training in Patient Safety and QualityPeter J. Pronovost, MD, PhD and Myron L. Weisfeldt, MDPeter J. Pronovost, MD, PhDFrom Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. and Myron L. Weisfeldt, MDFrom Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-2-201207170-00457 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The American public has benefited tremendously from its investments in biomedical research. The increase in life expectancy is a testament to this benefit (1). Patients with AIDS grow old; most children with cancer survive; patients undergoing dialysis receive kidney transplants; patients with orthopedic conditions have hip replacement and can play tennis again; patients with lung cancer receive chemotherapy targeted to their unique genes; and patients with heart failure live longer, more active lives with carefully titrated drug therapies.Consider the Marfan syndrome. This genetic disease dilates the aorta until it ruptures. Twenty years ago, we lacked methods to diagnose and ...References1. Lenfant C. Shattuck lecture—clinical research to clinical practice—lost in translation? N Engl J Med. 2003;349:868-74. [PMID: 12944573] CrossrefMedlineGoogle Scholar2. Gott VL, Greene PS, Alejo DE, Cameron DE, Naftel DC, Miller DC, et al. Replacement of the aortic root in patients with Marfan's syndrome. N Engl J Med. 1999;340:1307-13. [PMID: 10219065] CrossrefMedlineGoogle Scholar3. Brooke BS, Habashi JP, Judge DP, Patel N, Loeys B, Dietz HC. Angiotensin II blockade and aortic-root dilation in Marfan's syndrome. N Engl J Med. 2008;358:2787-95. [PMID: 18579813] CrossrefMedlineGoogle Scholar4. DeMets DL, Califf RM. A historical perspective on clinical trials innovation and leadership: where have the academics gone? JAMA. 2011;305:713-4. [PMID: 21325190] CrossrefMedlineGoogle Scholar5. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635-45. [PMID: 12826639] CrossrefMedlineGoogle Scholar6. Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007;122:160-6. [PMID: 17357358] CrossrefMedlineGoogle Scholar7. Newman-Toker DE, Pronovost PJ. Diagnostic errors—the next frontier for patient safety. JAMA. 2009;301:1060-2. [PMID: 19278949] CrossrefMedlineGoogle Scholar8. U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism. Washington, DC: U.S. Department of Health and Human Services; 2008. Google Scholar9. Sisko AM, Truffer CJ, Keehan SP, Poisal JA, Clemens MK, Madison AJ. National health spending projections: the estimated impact of reform through 2019. Health Aff (Millwood). 2010;29:1933-41. [PMID: 20829295] CrossrefMedlineGoogle Scholar10. DePalo VA, McNicoll L, Cornell M, Rocha JM, Adams L, Pronovost PJ. The Rhode Island ICU collaborative: a model for reducing central line-associated bloodstream infection and ventilator-associated pneumonia statewide. Qual Saf Health Care. 2010;19:555-61. [PMID: 21127114] MedlineGoogle Scholar11. Lin DM, Weeks K, Bauer L, Combes JR, George CT, Goeschel CA, et al. Eradicating central line-associated bloodstream infections statewide: the Hawaii experience. Am J Med Qual. 2012;27:124-9. [PMID: 21918016] CrossrefMedlineGoogle Scholar12. Miller MR, Griswold M, Harris JM, Yenokyan G, Huskins WC, Moss M, et al. Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts. Pediatrics. 2010;125:206-13. [PMID: 20064860] CrossrefMedlineGoogle Scholar13. Centers for Disease Control and Prevention (CDC). Vital signs: central line-associated blood stream infections—United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep. 2011;60:243-8. [PMID: 21368740] MedlineGoogle Scholar14. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725-32. [PMID: 17192537] CrossrefMedlineGoogle Scholar15. Lipitz-Snyderman A, Steinwachs D, Needham DM, Colantuoni E, Morlock LL, Pronovost PJ. Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis. BMJ. 2011;342:d219. [PMID: 21282262] CrossrefMedlineGoogle Scholar16. Pronovost PJ, Goeschel CA, Colantuoni E, Watson S, Lubomski LH, Berenholtz SM, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. BMJ. 2010;340:c309. [PMID: 20133365] CrossrefMedlineGoogle Scholar17. Waters HR, Korn R, Colantuoni E, Berenholtz SM, Goeschel CA, Needham DM, et al. The business case for quality: economic analysis of the Michigan Keystone Patient Safety Program in ICUs. Am J Med Qual. 2011;26:333-9. [PMID: 21856956] CrossrefMedlineGoogle Scholar18. Gurses AP, Ozok AA, Pronovost PJ. Time to accelerate integration of human factors and ergonomics in patient safety. BMJ Qual Saf. 2012;21:347-51. [PMID: 22129929] CrossrefMedlineGoogle Scholar19. Berenholtz SM, Needham DM, Lubomski LH, Goeschel CA, Pronovost PJ. Improving the quality of quality improvement projects. Jt Comm J Qual Patient Saf. 2010;36:468-73. [PMID: 21548508] CrossrefMedlineGoogle Scholar20. Needham DM, Sinopoli DJ, Dinglas VD, Berenholtz SM, Korupolu R, Watson SR, et al. Improving data quality control in quality improvement projects. Int J Qual Health Care. 2009;21:145-50. [PMID: 19218334] CrossrefMedlineGoogle Scholar21. Wachter RM, Pronovost PJ. Balancing "no blame" with accountability in patient safety. N Engl J Med. 2009;361:1401-6. [PMID: 19797289] CrossrefMedlineGoogle Scholar22. Pronovost PJ, Berenholtz SM, Morlock LL. Is quality of care improving in the UK? [Editorial]. BMJ. 2011;342:c6646. [PMID: 21292716] CrossrefMedlineGoogle Scholar23. Benning A, Ghaleb M, Suokas A, Dixon-Woods M, Dawson J, Barber N, et al. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation. BMJ. 2011;342:d195. [PMID: 21292719] CrossrefMedlineGoogle Scholar24. Gosfield AG, Reinertsen JL. The 100,000 lives campaign: crystallizing standards of care for hospitals. Health Aff (Millwood). 2005;24:1560-70. [PMID: 16284030] CrossrefMedlineGoogle Scholar25. Dixon-Woods M, Bosk CL, Aveling EL, Goeschel CA, Pronovost PJ. Explaining Michigan: developing an ex post theory of a quality improvement program. Milbank Q. 2011;89:167-205. [PMID: 21676020] CrossrefMedlineGoogle Scholar26. Auerbach AD, Landefeld CS, Shojania KG. The tension between needing to improve care and knowing how to do it. N Engl J Med. 2007;357:608-13. [PMID: 17687138] CrossrefMedlineGoogle Scholar27. Pronovost PJ, Cardo DM, Goeschel CA, Berenholtz SM, Saint S, Jernigan JA. A research framework for reducing preventable patient harm. Clin Infect Dis. 2011;52:507-13. [PMID: 21258104] CrossrefMedlineGoogle Scholar28. Wachter RM. Patient safety at ten: unmistakable progress, troubling gaps. Health Aff (Millwood). 2010;29:165-73. [PMID: 19952010] CrossrefMedlineGoogle Scholar29. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney SE; SQUIRE development group. Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. BMJ. 2009;338:a3152. [PMID: 19153129] CrossrefMedlineGoogle Scholar30. Leape L, Berwick D, Clancy C, Conway J, Gluck P, Guest J, et al; Lucian Leape Institute at the National Patient Safety Foundation. Transforming healthcare: a safety imperative. Qual Saf Health Care. 2009;18:424-8. [PMID: 19955451] CrossrefMedlineGoogle Scholar31. Thompson DA, Cowan J, Holzmueller C, Wu AW, Bass E, Pronovost P. Planning and implementing a systems-based patient safety curriculum in medical education. Am J Med Qual. 2008;23:271-8. [PMID: 18658100] CrossrefMedlineGoogle Scholar32. Kirch DG, Boysen PG. Changing the culture in medical education to teach patient safety. Health Aff (Millwood). 2010;29:1600-4. [PMID: 20820014] CrossrefMedlineGoogle Scholar33. Greiner AC, Knebel E. Health Professions Education: A Bridge to Quality. Institute of Medicine, Committee on the Health Professions Education Summit Report. Washington, DC: National Academies Pr; 2003. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Acknowledgment: The authors thank Christine G. Holzmueller, BLA, for her assistance in editing the manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2717.Corresponding Author: Peter J. Pronovost, MD, PhD, 1909 Thames Street, 2nd Floor, Baltimore, MD 21231; e-mail, [email protected]edu.Current Author Addresses: Dr. Pronovost: 1909 Thames Street, 2nd Floor, Baltimore, MD 21231.Dr. Weisfeldt: 1830 East Monument Street, Suite 9026, Baltimore, MD 21287.Author Contributions: Conception and design: P.J. Pronovost, M.L. Weisfeldt.Drafting of the article: P.J. Pronovost, M.L. Weisfeldt.Critical revision of the article for important intellectual content: P.J. Pronovost, M.L. Weisfeldt.Final approval of the article: P.J. Pronovost, M.L. Weisfeldt.Administrative, technical, or logistic support: P.J. Pronovost.This article was published at www.annals.org on 12 June 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByStrategies for Developing and Recognizing Faculty Working in Quality Improvement and Patient SafetyHuman factors systems approach to healthcare quality and patient safetyResident Education in the Era of Patient Safety: A Nationwide Analysis of Outcomes and Complications in Resident-Assisted Oncologic SurgeryOsteoporosis Update From the 2012 Santa Fe Bone SymposiumA Framework for Patient Safety: A Defense Nuclear Industry–Based High-Reliability ModelThe Research-Treatment Distinction: A Problematic Approach for Determining Which Activities Should Have Ethical Oversight 17 July 2012Volume 157, Issue 2Page: 141-143KeywordsEngineersHealth careHealth care qualityPatientsPrevention, policy, and public healthQuality improvementResearch fundingSafetySafety studiesScientists ePublished: 17 July 2012 Issue Published: 17 July 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...