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Medical Center / Health Care
“Hospitals can be considered ‘complex adaptive systems,’” said Dr. Strongwater. “These are systems where the outcome is not always predictable, sort of like the weather; we can measure and forecast it, but sometimes it rains when you predict clear skies. Health care is far more complicated than the weather. To assure the best medical outcomes, we must continually examine where a system might be imperfect and develop solutions to prevent problems. When you have gotten the system nearly perfect, you have developed what is referred to as a “highly reliable system” said Dr. Strongwater. “Part of my job is to continue Stony Brook’s forward progress on its journey to becoming a ‘highly reliable system,' and the Patient Safety & Quality Council will greatly contribute to that process.” The group will meet two to four times a year and include safety experts from the medical and nursing communities a representative of the Hospital Auxiliary, a member of the spiritual community, a patient advocate, and, potentially, health service researchers. Inherent in its objectives will be to monitor, evaluate and recommend patient safety programs and standards for the hospital as well as help identify new initiatives. Dr. Strongwater says that Stony Brook is at the forefront on Patient Safety on a national level, and “that message needs to be heard in our community. Our patient safety specialists are highly regarded and invited to speak nationally to share advances put into place at SBUMC.” SBUMC’s mortality statistics are among the best in the country when compared to University HealthSystem Consortium peer institutions, and it has been a long established goal to continue in that direction. Hospital-wide mortality at Stony Brook has been a strong quality indicator, showing a steady decline over the past three-and-a-half years. In 2003, the hospital-wide mortality rate at Stony Brook was 2.01 percent compared to 2.22 locally and 2.39 nationally; through September this year mortality has declined to 1.71 percent compared to 2.14 percent locally and 2.33 percent nationally. Over the past three years, Stony Brook’s Heart Center has made tremendous strides in reducing the time a heart attack patient undergoes angioplasty from the time they arrive at the hospital. A study out in March in the journal Circulation showed only about one-third of heart attack patients get angioplasty within the American Heart Association's recommended 90-minute window. Through its Code H protocol, the Heart Center at Stony Brook has systematically reduced its “door to balloon time” for heart attack patients to consistently below 90 minutes as of June this year. The primary focus of the patient safety program at Stony Brook is to follow the tenets outlined by the Institute of Medicine’s “Crossing the Quality Chasm.” This includes programs for safe, effective, timely, efficient, equitable and patient centered care. Incidents resulting in actual or potential patient harm are traced back to their root cause and system fixes are put in place to prevent future potential adverse events. It is in the best interest of patient safety to understand system flaws and work to reduce them. “Front line health care workers are a rich source of information about specific contributions that would increase the safety of their environment,” said Dr. Strongwater. “Enhancing patient safety requires creating a culture in which openness and learning are valued. “Lucian Leape, M.D., of the Harvard School of Public Health once said, ‘Incompetent people are, at most, one percent of the problem. The other 99 percent are good people trying to do a good job who make very simple mistakes and it’s the processes that set them up to make these mistakes.’ I agree, and it’s the processes we will focus on,” said Dr. Strongwater. Dr. Strongwater is also concerned with bringing compassion back to healthcare. He believes that in the 21st century, healthcare institutions around the country have been inundated with new technology and regulatory demands that have lead hospitals down a path of limited personal interaction with patents. “Technology is good and regulation important, but there needs to be a reassessment of how we interact with the most important member of the health care team – the patient,” said Dr. Strongwater. “Communication and patient education are very important elements for patients and their family, which will be a key focus of our work. Patients want to leave the hospital when they feel better, but they need more communication at discharge so they can better manage their health so they don’t have to come back. We will be evaluating the best approaches to improving the overall patient and family experience. “This will evolve as I am in a better position to be directly involved next month,” said Dr. Strongwater, who will officially join Stony Brook on January 1. “The community needs to know that things are happening right now, and patient safety is a top priority.” © Copyright 2005 by Stony Brook University |
