Why Hospitals Should Fly

Winner of the 2009 ACHE James A. Hamilton Book of the Year Award! "This book is a tour de force, and no one but John Nance could have written it. Only he could have made sophisticated, scientifically disciplined instruction about the nature and roots of safety into a page-turner. Medical care has a ton yet to learn from the decades of progress that have brought aviation to unprecedented levels of safety, and, in instructing us all about those lessons, John Nance is not just a bridge-builder he is the bridge." --Donald M. Berwick, MD, MPP, President and CEO, Institute for Healthcare Improvement (IHI)

The U.S. healthcare system is now spending many millions of dollars to improve "patient safety" and "inter-professional practice." Nevertheless, an estimated 100,000 patients still succumb to preventable medical errors or infections every year. How can health care providers reduce the terrible financial and human toll of medical errors and injuries that harm rather than heal? Beyond the Checklist argues that lives could be saved and patient care enhanced by adapting the relevant lessons of aviation safety and teamwork. In response to a series of human-error caused crashes, the airline industry developed the system of job training and information sharing known as Crew Resource Management (CRM). Under the new industry-wide system of CRM, pilots, flight attendants, and ground crews now communicate and cooperate in ways that have greatly reduced the hazards of commercial air travel. The coauthors of this book sought out the aviation professionals who made this transformation possible. Beyond the Checklist gives us an inside look at CRM training and shows how airline staff interaction that once suffered from the same dysfunction that too often undermines real teamwork in health care today has dramatically improved. Drawing on the experience of doctors, nurses, medical educators, and administrators, Beyond the Checklist demonstrates how CRM can be adapted, more widely and effectively, to health care delivery. The authors provide case studies of three institutions that have successfully incorporated CRM-like principles into the fabric of their clinical culture by embracing practices that promote common patient safety knowledge and skills. The coauthors infuse this study with their own diverse experience and collaborative spirit: Patrick Mendenhall is a commercial airline pilot who teaches CRM; Suzanne Gordon is a nationally known health care journalist, training consultant, and speaker on issues related to nursing; and Bonnie Blair O’Connor is an ethnographer and medical educator who has spent more than two decades observing medical training and teamwork from the inside.

"'Charting the Course' is the sequel to John J. Nance's best-selling, award-winning novel "Why Hospitals Should Fly". John Nance and his wife, Kathleen Bartolomew, have co-written the continuing story of Dr. Will Jenkins as he takes over the leadership the fictional Las Vegas Memorial Hospital. John Nance and Kathleen Bartholomew address head-on how to become a top-level institution by illuminating the norms of the current hospital culture and then demonstrating how each member of every medical facility, regardless of rank, must be a leader and owner of the cultural revolution needed to keep their hospital system viable and their patients safe. Whereas "Why Hospitals Should Fly" dealt more with the "why" of a cultural revolution, "Charting the Course" deals more with the "how" of changing an ingrained hospital culture. Study guide provided at end of book." -- publisher.

For decades, the manufacturing industry has employed the Toyota Production System — the most powerful production method in the world — to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method. Winner of a Shingo Research and Professional Publication Award! Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. The results speak for themselves, including: An innovative patient safety alert system Reduction in professional liability insurance expenses Foundational changes that make it possible for nurses to spend 90% of their time with patients A computerized module that sorts through electronic medical charts and automatically identifies when disease management and preventative testing due Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer – the patient. This book shows you how you use this system to transform your own organization.

The inspiring story of how a leading innovator in patient safety found a simple way to save countless lives. First, do no harm-doctors, nurses and clinicians swear by this code of conduct. Yet in hospitals and doctors' offices across the country, errors are made every single day - avoidable, simple mistakes that often cost lives. Inspired by two medical mistakes that not only ended in unnecessary deaths but hit close to home, Dr. Peter Pronovost made it his personal mission to improve patient safety and make preventable deaths a thing of the past, one hospital at a time. Dr. Pronovost began with simple improvements to a common procedure in the ER and ICU units at Johns Hopkins Hospital. Creating an easy five-step checklist based on the most up-to-date research for his fellow doctors and nurses to follow, he hoped that streamlining the procedure itself could slow the rate of infections patients often died from. But what Dr. Pronovost discovered was that doctors and nurses needed more than a checklist: the day-to-day environment needed to be more patient-driven and staff needed to see scientific results in order to know their efforts were a success. After those changes took effect, the units Dr. Pronovost worked with decreased their rate of infection by 70%. Today, all fifty states are implementing Dr. Pronovost's programs, which have the potential to save more lives than any other medical innovation in the past twenty-five years. But his ideas are just the beginning of the changes being made by doctors and nurses across the country making huge leaps to improve patient care. In Safe Patients, Smart Hospitals, Dr. Pronovost shares his own experience, anecdotal stories from his colleagues at Johns Hopkins and other hospitals that have made his approach their own, alongside comprehensive research-showing readers how small changes make a huge difference in patient care. Inspiring and thought provoking, this compelling book shows how one person with a cause really can make a huge difference in our lives.

The New York Times bestselling author of Being Mortal and Complications reveals the surprising power of the ordinary checklist We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third. In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds. An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.

A government investigator looks into the cover-up of a deadly plane crash in this aviation thriller from the New York Times–bestselling author of Lockout. In the control tower at Kansas City International Airport, all the radar displays are red. But for the experienced pilots of North America Airlines, the thunderstorms aren’t the problem: NAA has been cutting costs to stave off bankruptcy, and will do anything to keep their planes in the air. Unfortunately, no matter what they do, one is on its way down. After the aircraft collides with another plane on the Kansas City runway, in one of the worst aviation disasters of the decade, National Transportation Safety Board investigator Joe Wallingford arrives on the scene. As he studies the wreckage and pieces together the events that led to the tragedy, he realizes there’s far more at play than pilot error or equipment malfunction. Wallingford will have to risk his career—and perhaps even his life—to solve the puzzle of the crash.