Published: April 23, 2009
Society of Cardiovascular Anesthesiologists Foundation and Dr. Peter Pronovost to Collaborate
(BUSINESS WIRE)
At the 31
st Annual Meeting of the Society of Cardiovascular
Anesthesiologists, the Society of Cardiovascular Anesthesiologists
Foundation and Peter Pronovost, M.D., PhD, Director of the Quality and
Safety Research Group at the Johns Hopkins School of Medicine, formally
announced that they have entered into a collaborative endeavor to reduce
human error in the setting of cardiovascular anesthesia and surgery. The
FOCUS project (Flawless Operative Cardiovascular Unified Systems), a
multi-year, multi-center initiative, will examine the physical and
cultural environment of the cardiac surgery operating rooms, and will
seek to define processes by which the cardiovascular operative teams can
reduce the occurrence of human error. The research will be based on the
cockpit (or crew) resource management (CRM) model, implemented worldwide
by the commercial aviation industry. The CRM model is based on the
concepts that "
although individuals may make mistakes, it is
possible for teams to be flawless" (John Nance), and embraces a
culture in which everyone involved in servicing, preparing, or flying an
aircraft is granted responsibility for that aircraft's safety.
Checklists, guidelines and standardization are tools used to ensure
flawless team operation. Although every individual involved in
cardiovascular operative patient care is dedicated to patient safety,
the processes and communication patterns that exist frequently are
inadequate to achieve the goal of absolute patient safety.
Why this initiative? In 1999, the Institute of Medicine report,
To Err is Human: Building a Safer Health System, estimated that
48,000-98,000 lives are lost every year in United Sates hospitals due to
human error, and that number is almost certainly an under estimation of
the extent of the problem. In aviation terms, that would mean the crash
of a fully loaded Boeing 747 every other day for one year. The cascade
of events that result in loss of a patient's life are typically rooted
in human error, and prior efforts to reducing human error have often
focused on disciplinary action and/or even the shunning/dismissal of a
highly trained physician or medical personnel. An elimination of the
offending human does not reduce the risk of future human error by itself
unless the physician has somehow been otherwise truly incompetent. Prevention
of future human error cascades requires understanding the human factors
that led to the human error and requires efforts to learn about the
systems that allowed failure to occur.
What is involved? The first step in the FOCUS initiative will be
in-depth observation of the physical, emotional and cultural environment
in the cardiovascular operating rooms. Using a set of highly refined
metric instruments, the research team led by Dr. Pronovost will gather
data from which a set of checklists, guidelines, or interventions will
be developed. These interventions will then be tested in a series of
beta sites, refined as needed, and then introduced to the national
community of cardiovascular operative personnel.
This initiative follows numerous others within the greater anesthesia
community which have led to this specialty being recognized as being one
of the safest in medicine. Five sites have been chosen for this initial
series of observations with support from the following teams:
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St. John's Mercy, St. Louis, MO
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Anesthesiologist: Christopher Young, M.D.
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Surgeon: Edward B. Savage, M.D.
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New York University, New York, NY
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Anesthesiologist: Marc Kanchuger, M.D.
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Surgeon: Aubrey C. Galloway, M.D.
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Medical University of South Carolina, Charleston, SC
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Anesthesiologist: Jake Abernathy, M.D.
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Surgeon: Fred A. Crawford, Jr., M.D.
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Baystate Medical Center, Springfield, MA
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Anesthesiologist: Gary Kanter, M.D.
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Surgeon: John A. Rosou, M.D.
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Lehigh Valley Hospital, Allentown, PA
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Anesthesiologist: Nanette Schwann, M.D.
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Surgeon: Gary Szydlowski, M.D.
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Dr. Pronovost and his team's proposal were selected by the FOCUS
Steering Committee from a Request for Proposals sent to 60 institutions.
Dr. Pronovost's special interest is applying research methods that
improve quality of health care and safety, especially in critical care
settings such as ICUs and operating rooms. His expertise in this area
has gained international attention, and Dr. Pronovost was awarded a
MacArthur Genius Grant in 2008. On a national level, Dr. Pronovost is
leading an effort to develop the idealized ICU design with the Institute
for Healthcare Improvement and developing standards for ICU quality
measures with the VHA. Dr. Pronovost is currently working with the
Michigan Hospital Association to improve intensive care unit care
throughout the state. He is an active member of the National Coalition
on Health Care and the medical advisor for the Leapfrog Group for
patient safety.
The SCA Foundation, founded in October of 2007, is the philanthropic arm
of the Society of Cardiovascular Anesthesiologists. The Foundation
promotes and supports excellence in the care of patients undergoing
cardiothoracic and vascular procedures through education and research.
The Society of Cardiovascular Anesthesiologists is an international
organization of over 7,000 cardiac, thoracic, and vascular
anesthesiologists that promotes excellence in clinical care, education,
and research. Formed in 1977 to promote the specialty of cardiovascular
anesthesia, it has grown rapidly with the growth of cardiac, vascular
and thoracic surgery. Over the past 30 years, the SCA has led the way in
the training and certification of intra-operative echocardiographers,
development of credentials for cardiovascular anesthesiology training
(fellowship), and has collaborated with the wider medical community in
setting guidelines for patient care.
Society of Cardiovascular Anesthesiologists Foundation
John
R. Melleky, CFRE
Executive Director
Office: 804-565-6324
Cell:
804-690-2879
johnm@scahq.org
www.scahqgive.org
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