One Doctor's Crusade For Hospital Reform
Dr. Donald Berwick's Institute for Healthcare Improvement Hopes To Save Lives By Making Hospitals Safer
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Play CBS Video Video Making Hospitals Safer Tens of thousands of Americans die in hospitals each year from hospital mistakes. One physician is on a crusade to drastically cut that number. Katie Couric reports.
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Video Eye To Eye: Donald Berwick Only On The Web: Dr. Donald Berwick, the president and CEO of the Institute for Healthcare Improvement, talks with Katie Couric about his crusade to make hospitals safer for patients.
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Dr. Brian Koll, left, of New York's Beth Israel Hospital, says his facility is one of more than 3,000 hospitals that have signed on to the Institute for Healthcare Improvement run by Dr. Donald Berwick, right. (CBS)
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"Hospitals are very dangerous places. I don't know how to explain this to the public in a way that doesn't create too much fear. But they need to be realistic, and the technologies that help you can also hurt you — and they do it every single day," Berwick says.
Berwick estimates that for every 100 patients admitted to hospitals, there are 40 to 50 incidents in which patients are harmed — ranging from bruises and bed sores to much more life-threatening situations.
"Between 44,000 and 98,000 Americans die in hospitals each year, killed by their care, not by their disease," Berwick says.
The doctor says he hear from family members all the time who say my husband or wife or sister died and it didn't have to be.
"My e-mail is full of the most poignant stories that are surfacing from families, loved ones, patients themselves, saying this happened to me, why did it happen? It didn't need to happen," Berwick says.
Stories like 18-month-old Josie King who came to the hospital to be treated for burns and died from dehydration. And 27-year-old Joshua Nahum, who came in with broken bones and died from an infection.Read How To Stay Safe In Hospitals
"We need to build a hospital like you build an airplane, so that everything works right and there's a kind of automatic excellence in the system instead of relying on human effort," Berwick says.
Berwick runs the Institute for Healthcare Improvement, and two years ago, he launched the 100,000 Lives Campaign. That's the number of lives he hoped to save by getting hospitals to have standard operating procedures for the way they care for patients. This includes hooking up a ventilator properly to eliminate the risk of pneumonia and ensuring that a patient's medication is monitored from the ICU to the hospital room to home.
Berwick says even something as simple as uniform hand-washing requirements would cut hospital infections in half.
"We have a campaign team that makes field visits all the time," he says.
New York's Beth Israel Hospital is one of the more than 3,000 hospitals that have signed on to his campaign. Dr. Brian Koll is the hospital's director of infection control.
"The belief was, 'they're at risk and this was something to be expected,'" Koll says, explaining hospitals' attitudes prior to the campaign.
Catherine De Santis would once have been at risk for a life-threatening infection because of the tube she needs for feeding. But new procedures, championed by Berwick, have greatly reduced this danger.
"We standardized practices so that the line is placed in a sterile manner," Koll says. Following the guidelines has saved untold lives, he adds.
"I feel — even though I don't want to be in the hospital — a lot more comfortable bring here," De Santis says.
The campaign does more than save lives — it saves hospitals money.
"A lot of people ask 'how can you afford to improve?' The answer is, 'you can't afford not to,'" Berwick notes.
Now his organization is making even more recommendations to ensure hospitals are safe.
"If I'm not fighting uphill battles against unreliability and dropped balls and things that go wrong, well, now I have time to sit with you and hold your hand and look at your face and answer your questions and do all the other things that only a caring, committed human being can do," Berwick says.
He's emotional about it because, he says, "it's in reach. It's just a matter of will and leadership."
The will to adopt small, simple steps that could greatly reduce complications and ensure that many more people live to leave the hospital.
© MMVII, CBS Interactive Inc. All Rights Reserved.
Read How To Stay Safe In Hospitals
Best-selling author Mitch Albom on his first nonfiction work since "Tuesdays with Morrie."





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See all 29 CommentsAlso check with your local hospital to see if they support these meetings on site.
I think some Doctos are too surgery happy these days....My Dad was strong as an ox, but something went terribly wrong in surgery and we lost him two days later. I do not feel that the hospital took care of him at all....Lisa Bartlett, Jacksonville Arkansas
I am a nurse and Risk Manager of a major medical center and I see first hand what happens. We all need to heighten awareness about medical errors, we need to educate our patients, we need to mentor our young new nurses. Harm occurs to only one patient at a time; not whole groups of patients making the incident less visible. What's the exaggeration? If anything understated. Shock - yes for the healthy person who doesn't have much interaction with the medical community. Our focus should be on system safety, not individual blame and errors do occur. I would work with Dr. Berwick in a minute to promote a culture of patient safety. You need to read the Institute of Medicine's landmark report To Err is Human: Building a Safer Health System. And how do you know they didn't wash their hands or maybe they used the hand gel! I have much respect for Katie Couric - she is a patient advocate in her own way...how many people do you know now go for colonscopy's because of Katie....I know many - Katie - you go girl....and Nurse Franklin remember we are all part of the patient saftey team and when you go to work make sure YOU wash your hands and fill out that incident report when an error occurs and send it to your Risk Manager!
And when you think there is somone more important than the patient...think again
I lost my daughter 12-30-1988
There was a statement made when I tried back in the 90's to collecting my records. They messed up by stating I never experienced any blood clots during my pregnancy's or delivery. And they base statue of limitation on murder in the medical field. I happened to develope PTD over what happened. I had amnesia for a period of time. And when it all came back to me was like reliving the whole ordeal.
Karen Johnson
I found out today that vacuum extractions can and has been dangerous to the unborn. And the pressure of this procedure I feel is what killed my daughter. If you can help me with whatever information I'd appreciate this so much. And I do feel greatful that Dr. Donald Berwick is helping ones like me. I know there's some good doctors left. And I was told by one of the senators that situations like this can cause problems for good doctors. But like I tried to explain this isn't the patients faught. We are vitims moreso by these bad choices these bad doctors make
Thank you,
Karen Johnson
And since I have a rare bloodtype I almost lost my other daughter because of what had happened in the pregnancy before. And this same place told my hometown physician to tell me to go home and propp my feet. This doctor had became upset
because the situation was bad. I have heard of
so many malpractice incidences. Gauze left
inside of a woman. Later develope cancer and she died. A wrong artery cut on my cousin she almost bled to death. And a papsmear done on another one of my cousins when she was pregnant. She lost her baby. There are so many cases. My question to you. Has there been any law changed over medical malpractice? And what was passed and if you know when? I have been in contact with senators and congressmens and so on. When I lost my baby during the pregnancy I did get to hear both heartbeats but there were no clearification the second time around so the doctor didn't record this thinking this was a mistake. And in the last trimester I was on the verge of loosing my other baby (twin) to where the part of placenta she was on fell to the bottom of my uterus. I could feel the pressure on my pelvis. But I know there was that great chance she was alive until the time for delivery.
I seen on your show yesterday about Dr. Donald Berwick is helping patients over malpractice issues.
I had encountered a medical malpractice experience myself. And had been trying to get changes made in the medical field. I was told when I had tried to get a petition going that this issue had been resolved. And I happen to be told that there were a law passed this year. I seriously haven't seen any changes made. During my experience a physician without knowledge I was carrying twins and end up killing my other
daughter by using the instrument vacuum
extraction on one of my daughters. I was ignored
by the nurses when I happened to go back in
labor. The doctor had already left. When my
other daughter happened to come out she was
covered with her own placenta. My daughter was
carried out by a dust pan (broom) by a nurse.
And she had stated she was a blood clot. Well my
records weren't sent to me at my request and
today has disappered. Now there are new workers there at this same place. And they have tried by the request of chickasaw nation to help me. These hospitals/clinics have control over the evidences the records. And can get by
with murder. I left that place sick along with
my other daughter that had survived.
Thanks CBS for airing the story.
P.C.Jones
Maine Medical Center
Portland, Maine
If their is still a problem today with hospital employes not washing their hands its really pretty sad and careless.
The focus such as procedure site seems rediculous from that aspect. There are only two sites, one the baby chooses and one the physician chooses. Mandating care takes away critical thinking skills and staffing shortages takes away consistency at the bedside.
aneurysm. The surgery was the radical choice and done on a monday. The nurse that was on the day shift that monday and the following wednesday would not give me the morphine that was ordered for pain. I ended up with no medication for approximately 8 hours per day. I registered many complaints with my doctor's knowledge and was only told that the hopital would check into the matter but I would never know the outcome. Nor did I get any thing the even resembled an "We are sorry."
My wife recently had a spinal infection from Staph, contracted thru surgery and then misdiagnosed for a month because physicians failed to put aside their egos and communicate well. She was eventually overdosed with pain meds, which were not monitored by nursing according to policy. Her breathing slowed, then stopped. I called the nurse and she wouldn't do anything without the doctor's permission (at 3 am). Being a lab person, Navy corpsman and an EMT, I told her to follow the universal protocol and discontinue the drugs and administer Narcan to counteract their effect. She wouldn't because she said she was intimidated by the doctor. She finally relented, providing I agreed to be a witness for her.
Later that day the (incompetent) doctor restarted the pain meds and subsequently my wife suffered respiratory arrest and was placed on a respirator for 15 days in ICU...where a competent surgeon reread the spinal images and performed emergency surgery. Few ever question the interpretations of the radiologists and pathologists. They send written reports that are accepted without sufficient critical analysis and rarely face a "real" patient.
The state governments we rely on do little or nothing to assure professional performance.
E Prichard, Kitsap Co, WA
Sincerely,
Brian Koll, MD
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