Peter Pronovost
Encyclopedia
Peter J. Pronovost is an intensive care specialist physician
at Johns Hopkins Hospital
in Baltimore, Maryland
.
He is a Professor at the Johns Hopkins University School of Medicine in the Departments of Anesthesiology and Critical Care Medicine, and Surgery, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health
, and is Medical Director for the Center for Innovation in Quality Patient Care.
He introduced an intensive care checklist
protocol that during an 18-month period saved 1500 lives and $100 million in the State of Michigan
.
According to Atul Gawande
in The New Yorker
, Pronovost's "work has already saved more lives than that of any laboratory scientist in the past decade".
In 2008 Time
named Pronovost one of the 100 most influential people
in the world; that same year, Pronovost was awarded a MacArthur Fellowship
, otherwise known as a "genius grant".
Pronovost's book Safe patients, smart hospitals: how one doctor's checklist can help us change health care from the inside out was released in February 2010.
. His parents were an elementary school teacher and a math professor. He received his B.S. from Fairfield University
, M.D. from the Johns Hopkins School of Medicine
, and Ph.D. from the Johns Hopkins Bloomberg School of Public Health
.
In his Ph.D. thesis at Johns Hopkins Bloomberg School of Public Health, he documented that in intensive-care units in Maryland, an intensive care specialist on the staff reduced death rates by a third.
In 2003 he founded the Quality and Safety Research Group. He has published over 200 articles and chapters on patient safety and advises the World Health Organization
on improving patient safety measurement through WHO's World Alliance for Patient Safety.
He started studying hospital-acquired infections in 2001, concluding that a simple 5 item checklist protocol would greatly reduce infections when inserting a central venous catheter
.
Doctors should:
In the 2003 Michigan study called the Keystone Initiative the median rate of infections dropped at a typical ICU from 2.7 per 1,000 patients to zero after three months. The Keystone Initiative published its results in the December, 2006 New England Journal of Medicine
. In the first three months of the project, the infection rate in Michigan’s ICUs decreased by sixty-six per cent. In the Initiative’s first eighteen months, they estimated that 1500 lives and $100 million were saved. These results were sustained for almost four years.
Several reasons may explain why a simple checklist protocol is not more widely adapted:
According to Pronovost:
In 2011, Pronovost was recognized for his outstanding professional achievement and commitment to service with election to membership in the Institute of Medicine
, one of the highest honors in the fields of health and medicine.
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
at Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...
in Baltimore, Maryland
Maryland
Maryland is a U.S. state located in the Mid Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east...
.
He is a Professor at the Johns Hopkins University School of Medicine in the Departments of Anesthesiology and Critical Care Medicine, and Surgery, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health
Johns Hopkins Bloomberg School of Public Health
The Johns Hopkins Bloomberg School of Public Health is part of Johns Hopkins University in Baltimore, Maryland, United States...
, and is Medical Director for the Center for Innovation in Quality Patient Care.
He introduced an intensive care checklist
Checklist
A checklist is a type of informational job aid used to reduce failure by compensating for potential limits of human memory and attention. It helps to ensure consistency and completeness in carrying out a task...
protocol that during an 18-month period saved 1500 lives and $100 million in the State of Michigan
Michigan
Michigan is a U.S. state located in the Great Lakes Region of the United States of America. The name Michigan is the French form of the Ojibwa word mishigamaa, meaning "large water" or "large lake"....
.
According to Atul Gawande
Atul Gawande
Atul Gawande is an American physician and journalist. He serves as a general and endocrine surgeon at Brigham and Women's Hospital in Boston, Massachusetts and associate director of their Center for Surgery and Public Health...
in The New Yorker
The New Yorker
The New Yorker is an American magazine of reportage, commentary, criticism, essays, fiction, satire, cartoons and poetry published by Condé Nast...
, Pronovost's "work has already saved more lives than that of any laboratory scientist in the past decade".
In 2008 Time
Time (magazine)
Time is an American news magazine. A European edition is published from London. Time Europe covers the Middle East, Africa and, since 2003, Latin America. An Asian edition is based in Hong Kong...
named Pronovost one of the 100 most influential people
Time 100
Time 100 is an annual list of the 100 most influential people in the world, as assembled by Time. First published in 1999 as a result of a debate among several academics, the list has become an annual event.-History and format:...
in the world; that same year, Pronovost was awarded a MacArthur Fellowship
MacArthur Fellows Program
The MacArthur Fellows Program or MacArthur Fellowship is an award given by the John D. and Catherine T...
, otherwise known as a "genius grant".
Pronovost's book Safe patients, smart hospitals: how one doctor's checklist can help us change health care from the inside out was released in February 2010.
Career
Pronovost grew up in Waterbury, ConnecticutWaterbury, Connecticut
Waterbury is a city in New Haven County, Connecticut, on the Naugatuck River, 33 miles southwest of Hartford and 77 miles northeast of New York City...
. His parents were an elementary school teacher and a math professor. He received his B.S. from Fairfield University
Fairfield University
Fairfield University is a private, co-educational undergraduate and master's level teaching-oriented university located in Fairfield, Connecticut, in the New England region of the United States. It was founded by the Society of Jesus in 1942, and today is one of 28 member institutions of the...
, M.D. from the Johns Hopkins School of Medicine
Johns Hopkins School of Medicine
The Johns Hopkins School of Medicine , located in Baltimore, Maryland, U.S., is the academic medical teaching and research arm of Johns Hopkins University. Hopkins has consistently been the nation's number one medical school in the amount of competitive research grants awarded by the National...
, and Ph.D. from the Johns Hopkins Bloomberg School of Public Health
Johns Hopkins Bloomberg School of Public Health
The Johns Hopkins Bloomberg School of Public Health is part of Johns Hopkins University in Baltimore, Maryland, United States...
.
In his Ph.D. thesis at Johns Hopkins Bloomberg School of Public Health, he documented that in intensive-care units in Maryland, an intensive care specialist on the staff reduced death rates by a third.
In 2003 he founded the Quality and Safety Research Group. He has published over 200 articles and chapters on patient safety and advises the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
on improving patient safety measurement through WHO's World Alliance for Patient Safety.
He started studying hospital-acquired infections in 2001, concluding that a simple 5 item checklist protocol would greatly reduce infections when inserting a central venous catheter
Central venous catheter
In medicine, a central venous catheter is a catheter placed into a large vein in the neck , chest or groin...
.
Doctors should:
- Wash their hands with soap.
- Clean the patient’s skin with chlorhexidine antiseptic.
- Put sterile drapes over the entire patient.
- Wear a sterile mask, hat, gown and gloves.
- Put a sterile dressing over the catheter site.
In the 2003 Michigan study called the Keystone Initiative the median rate of infections dropped at a typical ICU from 2.7 per 1,000 patients to zero after three months. The Keystone Initiative published its results in the December, 2006 New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
. In the first three months of the project, the infection rate in Michigan’s ICUs decreased by sixty-six per cent. In the Initiative’s first eighteen months, they estimated that 1500 lives and $100 million were saved. These results were sustained for almost four years.
Several reasons may explain why a simple checklist protocol is not more widely adapted:
- Many physicians do not like being monitored by nurses or otherwise being forced to follow a checklist;
- A wish to avoid standardized tasks and bureaucracy; and
- A focus by researchers on "more exciting" issues such as disease biology and new treatment therapies.
According to Pronovost:
- The fundamental problem with the quality of American medicine is that we’ve failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It’s viewed as the art of medicine. That’s a mistake, a huge mistake. And from a taxpayer’s perspective it’s outrageous.
In 2011, Pronovost was recognized for his outstanding professional achievement and commitment to service with election to membership in the Institute of Medicine
Institute of Medicine
The Institute of Medicine is a not-for-profit, non-governmental American organization founded in 1970, under the congressional charter of the National Academy of Sciences...
, one of the highest honors in the fields of health and medicine.
External links
- Peter J. Pronovost, Testimony before Government Oversight Committee, April 16, 2008 from johnshopkins.edu
- Johns Hopkins University Quality and Safety Research Group from jhu.edu
- Teaming Up to Improve Quality
- Video from the MacArthur Fellow website
- Video "Dr. Checklist" on My Generation AARP.ORG
- "The Secret to Fighting Infections", article on Pronovost by Laura Landro, Wall Street Journal, March 28, 2011.