Quality Update

The Director's Chair: Invitation to Exciting Ideas
By Richard "Chip" Davis, Ph.D., Executive Director

Richard "Chip" Davis, Ph.D., Executive Director, Center for Innovation in Quality Patient Care.

As the Center for Innovation in Quality Patient Care continues bringing Johns Hopkins’ excellence in patient care, education and research to its care delivery models, we’re reminded that progress initially can involve dismay, disruption and discomfort. Dismay comes with the discovery that hospitals, overwhelmed by sophisticated technology demands, reduced resources and ever-increasing administrative tasks and accountability, may be hampered in their efforts to heal.

Pursuing excellence also brings disruption. To craft successful interventions, we must be ready to redesign or eliminate well-established systems and processes, then challenge our cultural norms. And this process can create discomfort, particularly when achieving better care standards takes longer than expected.

But we work through these obstacles to find success. In some cases, it’s found in lessons learned from other industries and disciplines. Mostly, though, it’s relying on the ingenuity and quest for excellence we find in our people, their collaborative work and the commitment of our leadership to successfully redesign our care models that stand the test of time.

In this Quality Update issue, we’ve highlighted some examples of excellent redesign efforts. One article looks at how the aviation industry improved communication among flight crews and reduced human-error-related airplane crashes. We’re now applying the concept, initially in our operating rooms, where faculty and staff are finding that it helps target problems arising from poor communication—a major factor in nearly every medical mistake.

A second article discusses Dr. Trish Perl’s work in cutting catheter-related bloodstream infection rates. Perl and her Epidemiology and Infection Control team introduced evidence-based protocols and educated medical staff to follow them. Adapting best practices to current care delivery systems also can require a multidisciplinary approach, a theme behind a project to reduce cardiovascular disease risks among patients in two hospital units. An article explains how evidence-based medication guidelines and lifestyle education were successfully incorporated into cardiac care delivery models.

Einstein observed that “without changing our patterns of thought, we will not be able to solve the problems we created with our current patterns of thought.” These efforts exemplify the excellence that evolves when we disrupt old models and work as a team to develop new ones.