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Cases & Commentaries
- Spotlight Case
- Web M&M
Lisa M. Bellini, MD; February 2004
Housestaff evaluate and admit a severely ill patient with lupus, suspect a viral syndrome, and do not initiate antibiotics. Despite discovery of the correct diagnosis in the morning by the attending, the patient dies.
Perspectives on Safety > Interview
Research in Patient Safety , June 2005
Peter J. Pronovost, MD, PhD, is Medical Director of the Johns Hopkins Center for Innovation in Quality Patient Care. A practicing anesthesiologist and critical care physician, he has appointments in both The Johns Hopkins University School of Medicine and its Bloomberg School of Public Health. Dr. Pronovost's research, which has focused on how to improve patient safety and quality in the ICU setting, has been characterized by a blend of methodologic sophistication and practical attention to the details of making change happen and making it stick. His many contributions include studies of the value of intensivists, of the use of daily goal cards on safety and communication, of an executive adopt-a-unit strategy, and of a comprehensive unit-based safety program. For this work, much of which has been supported by AHRQ, he was awarded the John M. Eisenberg Award in Research Achievement in 2004.
Journal Article > Study
Ward MM, Evans TC, Spies AJ, Roberts LL, Wakefield DS. Am J Med Qual. 2006;21:101-108.
This study assessed a representative group of hospitals to evaluate their perception and priority of each of the National Quality Forum's (NQF) 30 "safe practices." Investigators analyzed responses from 100 hospitals and determined higher ratings for priority than for progress of the practices overall. They noted the largest discrepancy between priority and progress in creating a safety culture with the highest progress rating for increasing safe medication use. Based on evaluating individual hospital characteristics, the authors also identified 20 safe practices not associated with measures of hospital structure, capacity, or resources. These particular findings may guide other organizations trying to develop strategic safety plans with respect to NQF safety recommendations.
Award > Award Recipient
Washington, DC: Leapfrog Group; September 24, 2008.
This announcement highlights the 33 hospitals recognized for high performance and continuous improvement in patient safety based on the 2008 Leapfrog Hospital Survey results.