March 9, 2010Nurses and patients use PowerPhrases to stop death by hierarchy
When Dr. Peter J. Pronovost of Johns Hopkins Hospital told staff,
- Doctors, we know you’re busy and sometimes forget to wash your hands. So nurses, you are to make sure the doctors do it. And if they don’t, you are empowered to stop takeoff on a procedure.
he thought he’d started WWIII. The nurses said it wasn’t their job to monitor doctors; the doctors said no nurse was going to stop takeoff. He said,
- Doctors, we know we’re not perfect, and we can forget important safety measures. And nurses, how could you permit a doctor to start if they haven’t washed their hands?
He continued with the offer that nurses could page him day or night and he would back them up. Infection rates dropped dramatically.
Pronovost went on to comment that every hospital has fallen prey to “death by hierarchy.”
I list eight reasons why people don’t speak up. Misplaced respect for authority is one. In hospitals, that can translate into death by hierarchy.
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