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Article reminds physician leaders of challenges ahead

Medical Staff Leader Connection, August 20, 2003

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Dear Medical Staff Leader,

When Don Berwick, MD, MPP, president and chief executive officer of the Institute for Healthcare Improvement speaks hospital and medical staff leaders should listen and react. Berwick is not a gadfly, outcast, or demigod but he may become a "Don Quixote" if medical staff leaders fail to react positively to his recent piece in the "New England Journal of Medicine" in which he reminds leaders of continued patient safety and quality improvement challenges.

The primary function of a medical staff is to promote and improve the quality of patient care. If past performance is truly a predictor of future performance, today's medical staff leaders will rise to the challenge just as they have countless times in the past. Keep in mind, intensive care units were not created by management-it was the medical staff that recognized the advantage of putting critically ill patients under the concentrated care of the most experienced nurses. It was physicians and not management who demanded that anesthesiologists adopt precise guidelines to reduce anesthetic complications. Further, it was not the governing board that first requested life-saving technology in the operating room, nor was it the county health department that first recognized the need for properly trained full time staff in the emergency department. Nearly all improvements in patient care and safety have been the result of management and physician leaders' joint efforts.

It is painfully obvious that today's medical staff leaders must mount a "Manhattan Project" effort to implement measures that eliminate unnecessary deaths and complications that arise during hospitalization. If Berwick is only half correct in his estimate that "100 patients will die unnecessarily in American hospitals today" the effort to improve patient safety must begin immediately and in earnest.

That's it for this week.

All the best,

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