Latif, Asad

Medicine - Anesthesiology & Critical Care Medicine

Implementation and validation of a comprehensive unit-based safety program to improve safety culture in a developing country

 Current conceptual thinking about patient safety places the prime responsibility for adverse events on deficiencies in system design, organization, and operation rather than on individual practitioners or products. Countermeasures based on changes in the system are, therefore, more productive than those that target the behavior of individuals and their propensity to commit errors. The World Health Organization (WHO) acknowledges that to tackle patient safety internationally, a comprehensive, multifaceted approach involving cultural change, system development, and technical expertise is necessary. Using the comprehensive unit-based safety program (CUSP) in Baltimore and Michigan, our group has previously produced statistically significant improvements in safety culture, central line-associated bloodstream infections (CLABSI), and intensive care unit (ICU) length of stay. Recent evidence suggests that patients in developing countries suffer from substantial preventable harm that is likely greater than that in the developed world, but strategies to reduce that harm have yet to be properly developed and tested, let alone implemented. In this proposal, our goals are to implement CUSP in ICUs in Karachi, Pakistan; to identify the unique barriers to implementing these measures in developing countries; to evaluate the efficacy of CUSP in improving the existing safety culture in a developing country and in training healthcare personnel to learn from mistakes; and to reduce the incidence of CLABSI. By identifying potential barriers and learning to adapt to local context, we can use what we learn to produce scalable programs that can be broadly applied, with the ultimate goal of improving healthcare safety around the world.

Peter Pronovost, SOM, Anesth; Adnan Hyder, SPH, IH; Adil Haider, SOM, Surg

People

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...
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May 2017

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