Report: Hospitals get it right only half the time

Little progress has been made in recent years to make hospitals safer, according to a report from Dr. Peter Pronovost, a Johns Hopkins critical care specialist.

He noted in a Dec. 24 article in the Journal of the American Medical Association that physician autonomy and a lack of standardization of safety rules are key reasons for lack of improvement in patient safety.

“It’s been almost 10 years since the Institute of Medicine published ‘To Err Is Human,’ its treatise on the need for increased patient safety initiatives at hospitals,” Pronovost said. “Yet we really haven’t made much progress.”

According to Pronovost, an average hospitalized adult will receive recommended therapy only 53 percent of the time. This accounts, in part, for the nearly 100,000 patients who die each year in the United States because of hospital error.

“America has some of the best doctors and medicine in the world, yet we are only getting it right half of the time,” Pronovost reported.

He cited three avenues to improvement:

• Physicians must balance their autonomy with team-based standardized care protocols.

• Medical students and residents need to be trained in this new approach so they are fully socialized in their roles as patient agents rather than autonomous decision makers.

• The process by which evidence-based standards and protocols are developed should itself be standardized and made clear.

“Gone are the days when a doctor was on his own carrying all the tools of modern medicine in a black leather bag,” Pronovost said. “Today, much of care is team based, and the wealth of techniques and wisdom is too much for one doctor to keep in his or her head. Standardization and a move away from physician autonomy will help guarantee that each patient receives the best treatment available.”