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Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Us Change Health Care from the Inside Out (Pronovost, Safe Patients, Smart Hospitals) Hardcover – February 18, 2010

4.6 out of 5 stars 36 customer reviews

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Editorial Reviews


"Safe Patients, Smart Hospitals is the tough-minded and revealing story of a leading doctor's crusade against medical harm. The tale of Peter Pronovost's journey in patient safety is fascinating reading."
-Atul Gawande, author of The Checklist Manifesto, Better, and Complications

"No one in America has thought more -- and done more -- about patient safety than Dr. Pronovost. Safe Patients, Smart Hospitals is the right prescription for American health care."
-Sherrod Brown, United States Senator (Ohio)

"Dr. Pronovost and Mr. Vohr offer a constructive and compelling case for patient safety and improving health care quality in the United States. Health providers and policy makers would benefit greatly from reading this book."
-Tom Daschle, former Senator and author of Critical: What We Can Do about the Health-Care Crisis

"Both riveting and important.... Safe Patients, Smart Hospitals gives an excellent overview of changes in hospital practice which, when instituted, profoundly affect rates of serious medical complications and death. A pioneer in the field of patient safety, [Peter Pronovost] has radically altered how modern medicine is practiced."
-Kay Redfield Jamison, Ph. D., author of An Unquiet Mind and Nothing Was the Same

"A must read for doctors, nurses, administrators and especially the public. Patient safety can only be achieved by everyone being informed and asking questions when...the train is [headed] off the track."
-Edward D. Miller, M.D., Chief Executive Officer of Johns Hopkins Medicine, Dean of the Johns Hopkins University School of Medicine, and and vice president for medicine of The Johns Hopkins University

"A wonderful, beautifully written book-if every hospital in the country read it and followed Peter's advice, I believe there would be fewer deaths from medical efforts and we would all benefit. Dr. Pronovost is a true hero, both to many in the healthcare industry and patients as well. Because of his hard work, passion, and brilliance, Peter has made hospitals around the world safer for us all. Safe Patients, Smart Hospitals is a true testament that one person can make a difference."
-Sorrel King, patient safety advocate and author of Josie's Story

"Safe Patients, Smart Hospitals reminds us how great change can be wrought by one person with the courage to do the right thing. Dr. Pronovost's account tells the thrilling story about how--not so long ago--sloppiness and medical arrogance made even the best American hospitals perilous places to spend the night. His remedy: something simple, elegant, convincing."
-Jean McGarry, professor at The Writing Seminars, Johns Hopkins University and author of seven books of fiction

"Peter Pronovost is a true visionary, whose simple checklist will save many lives and highlight the fact that the simplest answer is often the best, a must- read for all healthcare workers."
-Patrick Perry, M.P.H, Executive Editor, The Saturday Evening Post

"Captivating and readable, this book takes a hard, honest look at the truth about toxic hospital cultures and the need for addressing culture, teamwork and cooperation. The compelling stories Peter shares illustrate the transformation that occurs when institutions address these issues. I also think the emphasis on improving work environments and respect among all professions involved in patient care clearly impacts nurses' satisfaction, retention, and the nursing shortage in hospitals."
-Martha N. Hill, PhD, RN, Dean and Professor of Nursing, Medicine and Public Health at Johns Hopkins University

"A riveting account right from the first page... Safe Patients, Smart Hospitals is a must read for everyone in healthcare including consumers. The authors have covered particularly well the perspectives and challenges of nurses in keeping patients safe. The book is a "good read" for us all."
-Linda H. Aiken, Ph.D., The Claire M. Fagin Leadership Professor of Nursing and Professor of Sociology, Director, Center for Health Outcomes and Policy Research; University of Pennsylvania

"Dr. Peter Pronovost was first to recognize checklists have power to save lives and save money. We've heard about Dr. Pronovost's checklists from learned journals and from the TV show 'ER. His innovative ideas promote low cost, low tech solutions that have a high impact."
-Barbara Mikulski, US Senator (Maryland)

"Having been at Hopkins for over three decades, I have been privileged to witness first- hand enormous advances in patient safety, largely through the efforts of Dr. Peter Pronovost. Through this book, the authors are making life- saving knowledge widely available not only to healthcare providers, but to patients and their loved ones. This book is a long overdue and welcome addition to the body of critically important medical information and it will save lives."
-Benjamin S. Carson, Sr., M.D., Professor of Neurological Surgery, Oncology, Plastic Surgery, and Pediatrics

"Dr. Pronovost's engaging book describes his journey to galvanize the healthcare community to eliminate bloodstream infections. It is an excellent case study in leadership, and should be read by anyone trying to lead a change effort."
-Nolan D. Archibald, Chairman of the Board, President & Chief Executive Officer, The Black & Decker Corporation

About the Author

PETER PRONOVOST, Ph.D, M.D., is a professor at Johns Hopkins University School of Medicine and serves as medical director for the Johns Hopkins Center for Innovation in Quality Patient Care.
ERIC VOHR was formerly the assistant director of media relations at Johns Hopkins University School of Medicine and he teaches technical writing at Johns Hopkins University.

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Product Details

  • Series: Pronovost, Safe Patients, Smart Hospitals
  • Hardcover: 304 pages
  • Publisher: Hudson Street Press; 1 edition (February 18, 2010)
  • Language: English
  • ISBN-10: 159463064X
  • ISBN-13: 978-1594630644
  • Product Dimensions: 9.1 x 6.3 x 1.1 inches
  • Shipping Weight: 1.1 pounds
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (36 customer reviews)
  • Amazon Best Sellers Rank: #541,729 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover Verified Purchase
Having already read Dr. Atul Gawande's popular book, The Checklist Manifesto, I wondered whether or not Safe Patients, Smart Hospitals, by Peter Pronovost, M.D., Ph.D., would capture and hold my attention. After one chapter, I had no doubts.

As hard as it may be to believe in a country as advanced as the United States, thousands of people die each year from preventable medical mistakes. This book addresses why this happens and what can be done to save many of these people. Dr. Pronovost begins with the tragic story of 18-month-old Josie King, who was accidentally scalded at home and developed second degree burns. She acquired an all-too-common bacterial infection from a central line catheter while in the hospital, and then she got a secondary infection when the antibiotics administered to control the original infection killed helpful bacteria in her digestive system. Then there was sepsis and dehydration, but even all of this would not have killed the young girl were it not for lack of sufficient coordination and cooperation among the medical staff treating her. Just one chapter into this book you are already grieving, and you want to know more. By the way, if the term "central line catheter infection" sounds familiar, Dr. Gawande writes extensively about this problem in his book (and he characterizes Dr. Pronovost's book as a "tough-minded and revealing story of a leading doctor's crusade against medical harm").

It turns out that Dr. Pronovost's own father died in part because his cancer was not correctly characterized early enough--so Dr. P. finally enlists in the army of reformers.
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Format: Hardcover
Peter Pronovost's father died early, primarily due to medical error; the 'good news' is that it galvanized Peter to ensure his own life made a contribution. He continued his education, becoming an M.D. and then carried on to become a researcher as well. Pronovost's PhD. dissertation summarized research on the value of intensivists (specially-trained ICU physicians) in hospital intensive-care units (ICUs) and found they reduced mortality by one-third, and length-of-stay as well. Soon after publishing his findings, providing ICU care via intensivists became medicine's 'gold standard' and spread across the nation. In 2008, Time magazine named him one of the 100 most influential people on earth, and that same year he won a MacArthur ('genius grant') Fellowship. Not bad for someone only 43-years old. But there's more!

Overall it is estimated that patients receive barely 50% of recommended therapies and only about 30% of those are administered as recommended. This despite the U.S. spending more on health care than any other developed nation, while leaving some 40 million uncovered by insurance, and medical costs being a major cause of personal bankruptcy. The result of medical errors, Dr. Pronovost estimates, is that hundreds of thousands needlessly die each year. He became focused on quality improvement after a young patient died in his hospital due to a catheter-caused infection. Pronovost then led a team effort that first created a five-step checklist distilled from a 120-page CDC set of catheter placement guidelines and underlying rationale. This improved protocol compliance to 38%. Compliance was limited partly due to difficulty finding needed supplies.
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As a book, it was a bit disappointing. Someone did a very poor job of editing; there were too many word, grammar, and punctuation errors to satisfy me. In addition, it is a prime example of a current fad in nonfiction that overemphasizes the "human" element in whatever subject is being discussed. The book opens, for example, with an extended recount of the admittedly very sad story of a little girl who died unnecessarily at Hopkins due to several shortcomings. This type of narrative continues throughout the book, including long discussions of Pronovost's experiences trying to get his ideas adopted.(How much of this was a literary technique and how much was ego I would not say without knowing the man.). There was way too much of this kind of thing at the expense of CONTENT.

That being said, there is a lot of good stuff here that applies equally well to safety, efficiency, and/or customer satisfaction in most fields, not just hospital care. The principles are the same, although different people express them differently. Pronovost's program has two aspects, TRIP and CUSP. Translating Research into Practice (TRIP) is the problem-solving part. It involves the checklists and other changes to practices, such as the simple idea of storing items often used together in the same cabinet and putting them close to the places where they are used, thereby both saving time and making it less likely that a busy provider will "not bother" with a particular safety item because it is too much trouble to go get it. Although the checklists are the item that grabbed attention, the other aspect, looking at an organization's specific procedures and making improvements, is also a component of CUSP.
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