Fixing America's Hospitals

Every day, hospitals across the country care for Americans in need. Babies are born, heart-attack victims are saved, broken bones are healed. But today, as the population ages, medical demands surge and costs rise, America's hospitals are being tested like never before. Solving the crisis is a formidable task, but innovative hospitals are rising to the challenge--they're reforming nursing practices, digitizing medical records, transforming end-of-life care.

The most urgent hurdle of all: improving patient safety. In 1999, the Institute of Medicine declared that close to 100,000 Americans die annually from medical errors. This year, more dire news: medication errors harm at least 1.5 million people and cost some $3.5 billion per year. What goes wrong? Missed diagnoses, incorrect drug dosing, failure to treat promptly. Experts agree that doctors, nurses, pharmacists and technicians will always make mistakes--it's the safety net around them that needs to be fixed. "No matter how good people are, they suffer from being human and they're going to screw up," says Jim Conway, senior vice president at Boston's Institute for Healthcare Improvement. "We have to put systems in place that stop that error from causing harm."

Those systems may be simple or high tech. In 2005, Good Samaritan Hospital in Suffern, N.Y., launched Rapid Response Teams--on-call experts to tend to patients in distress. Since then, "codes" for cardiac and respiratory arrests have dropped 22 percent. "This is one of the best interventions I've seen in my entire career," says Kathleen Lynam, chief nurse officer. At Intermountain Healthcare in Salt Lake City, which owns or operates 22 hospitals, the timely use of antibiotics has slashed postoperative infections. And controlling blood-sugar levels during open-heart surgery has reduced the death rate from 2.49 percent to 0.18 percent.

Patient tragedies often trigger change. When Southwestern Vermont Medical Center execs heard Dale Micalizzi talk about the death of her 11-year-old son, Justin, after surgery for a swollen ankle at another hospital--and that hospital's lack of response--they reached out to her. Now, with Micalizzi's help, Southwestern is adopting a culture of openness after mistakes. "This is an injustice I experienced," she says, "and I can't let another mother go through it." A worthy goal for all.

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