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How to Make Hospitals Safer
July/August 2009
by Emily Anthes '05
Better medical care doesn’t always depend on technological
breakthroughs. For a new Yale study, researchers developed a suite of simple
safety practices for the obstetrical unit at Yale–New Haven Hospital—and found
that they drastically improved patients' well-being.
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Researchers tracked “adverse patient events.”
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In the fall of 2004, researchers from the hospital
and the medical school invited independent hospital safety experts to assess
the obstetrical unit. Then, says Christian Pettker, assistant professor at the
Department of Obstetrics, Gynecology, and Reproductive Sciences and lead author
of the study, the researchers used the assessment to find ways "to make patient
safety a priority of the unit.”
They developed protocols and guidelines for a variety
of clinical procedures, from admission criteria for patients to dosing
standards for drugs. They implemented a computerized program that staff members
could use to report medical errors and near misses anonymously. They hired a
new nurse dedicated to patient safety issues. And they required doctors,
nurses, midwives, and staff to complete team training seminars for better
communication. "That’s a very important part of the patient safety movement—to
get people who really have different ways of communicating to understand one another,"
says Pettker.
For three years, from September 2004 through August
2007, the researchers tracked "adverse patient events," ranging from unexpected
blood transfusions to serious maternal or neonatal injury. They found that
staff members perceived a 30 percent improvement in overall safety after the
new measures were put in. But the actual results were even better: the rate of
adverse events decreased by 60 percent. (The study appeared in the May American
Journal of Obstetrics and Gynecology.)
Many of the changes could easily be adopted by
hospital units in other medical specialties. For the obstetrical unit, the next
task is to make sure the changes stick. "The important thing with something
like this is that you can’t stop just after you’ve improved things," says
Pettker. "It constantly needs attending to.”  |