Teamwork a Key Feature of Patient Safety Improvement Program
By Carolyn M. Clancy, M.D.
October 2, 2012
If you're a
football fan like I am, you know that teams win or lose depending on teamwork.
A good team may have a quarterback who can throw an accurate pass. But a great
team also has players who can protect the quarterback and catch those passes.
In short,
when teams work together, everyone can do their best job.
Today, this approach
is catching on in health care in a big way. Doctors, nurses, and other staff
have always depended on each other to provide high-quality care to patients.
Now they're learning how to apply specific teamwork principles to produce better
and safer care.
A terrific
example is how clinicians are reducing—and even getting rid of—infections
that patients can get while they are in the hospital. Healthcare-associated
infections happen when patients are in the hospital getting treatment for
another condition. They affect 1 in 20 patients at any point in time.
People used
to think that these infections couldn't be avoided.
Now, we know
this is not the case. In fact, a newly completed program showed that a combination of
teamwork, the best clinical practices, and a strong commitment to safety
reduced by 40 percent the chance that patients would get one type of these
infections. The national project was funded by my agency, the Agency for
Healthcare Research and Quality, and involved partners from the American Hospital Association  and Johns Hopkins Medicine .
The type of infection
tested in this project happens in intensive care units when germs infect the
central line that delivers drugs and fluids patients. The infection is very
serious and can be deadly. By following this teamwork-based approach, hospitals
prevented more than 2,000 infections, saved 500 lives, and avoided more than
$34 million in health care costs.
Results of
this project, called the Comprehensive Unit-Based Safety
Program, or CUSP, are
exciting for two reasons. One is that it proves how a careful, teamwork-based
approach can prevent a deadly type of infection. The second reason is that the
program can also make care safer for patients with other health conditions.
Let's take
the case of Laura, a hypothetical 70-year-old patient who is in the hospital after
having a stroke. She is on a ventilator to help her breathe until she recovers.
But being on a ventilator also puts her at higher risk for getting pneumonia.
Laura is
fortunate that her hospital team is using CUSP as a part of her care. As a
result, Laura's doctors, nurses, respiratory therapists, and others make sure
the head of her bed is raised to the right level, check that hands are always
washed properly before all exams, and follow all other infection-control steps.
Laura's care team members talk to each other every day to make sure that everyone
follows the care plan.
In addition
to the clinical staff, Laura's family members are considered part of the team.
The care team explains to the family why pneumonia is a risk, what steps they
are taking to prevent it, and how to help.
You may not
know whether your hospital is using CUSP. But you should speak up if you're
concerned or unsure about the care your loved one is getting. If you need help
asking questions, check out this resource for help.
Of course,
teamwork and other important elements of CUSP can't change the outcome of every
illness or condition. But they help many patients avoid getting sicker and help
clinicians work together to do what they do best.
I'm Dr.
Carolyn Clancy, and that's my advice on how to navigate the health care system.
Resources
Agency
for Healthcare Research and Quality
AHRQ Patient
Safety Project Reduces Bloodstream Infections by 40 Percent
http://www.ahrq.gov/news/press/pr2012/pspclabsipr.htm
Using a
Comprehensive Unit-Based Safety Program to Prevent Healthcare-Associated
Infections
http://www.ahrq.gov/qual/cusp.htm
Questions
are the Answer: Questions for Your Health Care Provider
http://www.ahrq.gov/questions/tenquestions.htm
American Hospital Association
AHRQ patient
safety project reduces bloodstream infections by 40 percent
http://www.aha.org/search?q=CUSP&site=redesign_aha_org
Johns Hopkins Medicine
http://www.hopkinsmedicine.org
Current as of October 2012
Internet Citation:
Teamwork a Key Feature of Patient Safety Improvement Program. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, October 2, 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc100212.htm
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