This week at a Congressional Biomedical Research Caucus briefing, Peter Pronovost, MD, a recent recipient of the MacArthur “Genius Grant” Fellowship, presented on his work on patient safety involving checklists.
Pronovost had found that there was little knowledge about risks to patient safety, such as the original subject of his work, infections at the site of catheter insertion. While there was significant evidence behind the cause and prevention of these infections, they were still causing deaths and costing states millions of dollars each year.
Pronovost’s solution was to condense the evidence into a five-item checklist, lowering the barriers to use at the patient’s bedside. When doctors and nurses used and held each other accountable to this checklist, these infections were virtually eliminated in a study at Johns Hopkins Hospital.
Next, Pronovost used an AHRQ grant to roll out the checklist system in the state of Michigan. After tracking the rates of infection, it was found that over two years, implementation of the checklist saved Michigan 1,800 deaths and $200 milion per year by eliminating the infections.
After this enormous success, Pronovost has faced challenges “bridging the gap” between his work in Michigan and federal coordination of these efforts. Pronovost made the point that translational research is inefficient because basic scientific research is a “feed forward” system. Implementing research into practice, on the other hand, is a “feed back” system. Pronovost proposed the creation of what he called a “knowledge market”, in which knowledge is shared and democratic. The use of these checklists achieves this democratization because everyone can understand and implement each of the five items to achieve safe care for patients.
The Hon. Rush Holt, chair of the Biomedical Research Caucus, was in attendance, and called for more funding for research. “Research can take all forms,” he said. “Funding research is not about funding people in lab coats. It’s about improving quality of life and saving lives.”