miércoles, 6 de abril de 2011

medico asistencial medico de salud ublica

Peter Provonost ha sido considerado por the New Yorker como alguien que ha salvado mas vidas que cualquier cientifico de laboratorio la decada pasada. El TIME lo ha considerado entre las 100 personas mas influyentes del ano en el mundo en el 2008.
Es el medico intensivista,  es profesor de medicina intensiva en la escuela de medicina del JOHNs Hopkins pero al mismo tiempo es profesor de la escuela de Salud publica de la misma Universidad y Director del centro para la imnovacion de la calidad de atencion de los pacientes. Su protocolo Check  list ha salvadoi 1500 vidas y ahorrado mas de 1oo millones de dolares en un lapso de 18 meses.
Lo curioso y no es tan curioso en un pais como USA es como un medico asistencial esta tan cerca de las politicas de salud de las politicas imnovadoras, porque el medico asistencial es quien conoce mejor como disenar estas politicas. Solo el que maneja pacientes sabe o puede saber lo que hay que hacer con las politicas. So el asistencial puede saber como se puede mejorar la calidad de la atencion
Todo esto debe hacernos reflexionar sobre como estamos trabajando en Peru en donde la parte asistencial esta divorciada de la parte de salud publica. Esto ha tenido graves consecuencias en la salud publica. Se ha privilegiado la atencion primaria en el Peru descuidando la atencion de especialidades tan necesaria como la primera.
Pero cuando alguien resuelve el problema en parte a traves de asociaciones publica privadas se busca todos los defectos que puedan haber para destruir el concepto. Es como si al descubrir la corrupcion en el programa de vaso de leche optaramos por no creer mas en los programas sociales. Son los prejuicios estatistas de siempre , de los que no quieren cambiar de mentalidad por un asunto emocional.
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Peter Pronovost
Peter J. Pronovost

Waterbury, Connecticut
ResidenceBaltimore, Maryland
Citizenship United States
Critical Care Medicine
InstitutionsJohns Hopkins Hospital
Alma materFairfield, B.A., Sc.D. (hon)[2]
Johns Hopkins, M.D., Ph.D
Known forIntensive care checklist protocol
Notable awards2008 Time 100

2008 MacArthur Fellow

Peter J. Pronovost[3] is an intensive care specialist physician at Johns Hopkins Hospital in Baltimore, Maryland.[4] He is a Professor at the Johns Hopkins University School of Medicine in the Departments of Anesthesiology and Critical Care Medicine, and Surgery, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, and is Medical Director for the Center for Innovation in Quality Patient Care.
He introduced an intensive care checklist protocol that during an 18-month period saved 1500 lives and $100 million in the State of Michigan.[5] According to Atul Gawande in The New Yorker, Pronovost's "work has already saved more lives than that of any laboratory scientist in the past decade".[6]
In 2008 Time named Pronovost one of the 100 most influential people in the world;[7] that same year, Pronovost was awarded a MacArthur Fellowship, otherwise known as a "genius grant".[1]
Pronovost's book Safe patients, smart hospitals: how one doctor's checklist can help us change health care from the inside out was released in February 2010.[8]
1 Career
2 See also
3 References
4 External links

[edit] Career
Pronovost grew up in Waterbury, Connecticut. His parents were an elementary school teacher and a math professor. He received his B.S. from Fairfield University, M.D. from the Johns Hopkins School of Medicine, and Ph.D. from the Johns Hopkins Bloomberg School of Public Health.[6]
In his Ph.D. thesis at Johns Hopkins Bloomberg School of Public Health, he documented that in intensive-care units in Maryland, an intensive care specialist on the staff reduced death rates by a third.
In 2003 he founded the Quality and Safety Research Group. He has published over 200 articles and chapters on patient safety and advises the World Health Organization on improving patient safety measurement through WHO's World Alliance for Patient Safety. [9]
He started studying hospital-acquired infections in 2001, concluding that a simple 5 item checklist protocol would greatly reduce infections when inserting a central venous catheter.
Doctors should:
Wash their hands with soap.
Clean the patient's skin with chlorhexidine antiseptic.
Put sterile drapes over the entire patient.
Wear a sterile mask, hat, gown and gloves.
Put a sterile dressing over the catheter site.[10]
In the 2003 Michigan study called the Keystone Initiative the median rate of infections dropped at a typical ICU from 2.7 per 1,000 patients to zero after three months. The Keystone Initiative published its results in the December, 2006 New England Journal of Medicine.[11] In the first three months of the project, the infection rate in Michigan's ICUs decreased by sixty-six per cent. In the Initiative's first eighteen months, they estimated that 1500 lives and $100 million were saved. These results were sustained for almost four years.[6]
Several reasons may explain why a simple checklist protocol is not more widely adapted:
Many physicians do not like being monitored by nurses or otherwise being forced to follow a checklist;
A wish to avoid standardized tasks and bureaucracy; and
A focus by researchers on "more exciting" issues such as disease biology and new treatment therapies.[12]
According to Pronovost:[6]
The fundamental problem with the quality of American medicine is that we've failed to view delivery of health care as a science. The tasks of medical science fall into three buckets. One is understanding disease biology. One is finding effective therapies. And one is ensuring those therapies are delivered effectively. That third bucket has been almost totally ignored by research funders, government, and academia. It's viewed as the art of medicine. That's a mistake, a huge mistake. And from a taxpayer's perspective it's outrageous.
An internationally recognized expert on hospital safety, Pronovost has raised an alarm about the unintended consequences of computerization of patient records.[13]
[edit] See also
Evidence-based medicine
Medical error
Patient safety
[edit] References
^ a b "2008 MacArthur Fellow: Peter Pronovost". John D. and Catherine T. MacArthur Foundation. http://www.macfound.org/site/c.lkLXJ8MQKrH/b.4537281/. Retrieved 2008-09-23.
^ Peter J. Pronovost, MD, PhD, ScD (hon), FCCM
^ Dreifus, Claudia (2010-03-09). "Doctor Leads Quest for Safer Ways to Care for Patient". The New York Times: p. D2. http://www.nytimes.com/2010/03/09/science/09conv.html. Retrieved 2010-03-09.
^ "Peter Pronovost, MD, PhD, FCCM". Center for Innovation for Quality in Patient Care. http://www.hopkinsquality.com/CFI/inside/experts/CFI_IH_Pronovost.asp. Retrieved 2008-05-14.
^ "Doctor Saved Michigan $100 Million". All Things Considered. National Public Radio. December 9, 2007. http://www.npr.org/templates/story/story.php?storyId=17060374. Retrieved 2008-05-14.
^ a b c d Gawande, Atul (December 2007). "The Checklist, If something so simple can transform intensive care, what else can it do?". New Yorker Magazine: p. 86. http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande. Retrieved 2008-05-14.
^ Kingsbury, Kathleen (May 2008). "The 2008 TIME 100". TIME Magazine (Time Warner). http://www.time.com/time/specials/2007/article/0,28804,1733748_1733754_1735344,00.html. Retrieved 2008-05-14.
^ O'Reilly, Kevin B. (2010-03-08). "Infection rates drop as Michigan hospitals turn to checklists". American Medical News. http://www.ama-assn.org/amednews/2010/03/01/prsa0301.htm. Retrieved 2010-03-09.
^ "Peter Pronovost recognised by Time Magazine". World Health Organization. World Health Organization. http://www.who.int/patientsafety/news/pronovost_time_100_list/en/index.html. Retrieved 2008-05-14.
^ Brody, Jane E. (January 22, 2008). "A Basic Hospital To-Do List Saves Lives". The New York Times. http://www.nytimes.com/2008/01/22/health/22brod.html?pagewanted=print. Retrieved January 8, 2009.
^ Pronovost P, Needham D, Berenholtz S, et al. (December 2006). "An intervention to decrease catheter-related bloodstream infections in the ICU". N. Engl. J. Med. 355 (26): 2725–32. doi:10.1056/NEJMoa061115. PMID 17192537. http://content.nejm.org/cgi/content/full/355/26/2725.
^ Goldsmith, Marshall (January 15, 2008). "Preparing Your Professional Checklist". Business Week. http://www.businessweek.com/managing/content/jan2008/ca20080115_768325.htm?chan=careers_managing+index+page_managing+your+career. Retrieved 2008-05-14.
^ Shabot MM (July 2004). "Ten commandments for implementing clinical information systems". Proc (Bayl Univ Med Cent) 17 (3): 265–9. PMC 1200662. PMID 16200110. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1200662.  Full text at PMC: 1200662
[edit] External links
Peter J. Pronovost, Testimony before Government Oversight Committee, April 16, 2008 from johnshopkins.edu
Johns Hopkins University Quality and Safety Research Group from jhu.edu
Teaming Up to Improve Quality
Video from the MacArthur Fellow website
Video "Dr. Checklist" on My Generation AARP.ORG
Dreifus, Claudia (March 8, 2010). "A Conversation with Dr. Peter J. Pronovost: Doctor Leads Quest for Safer Ways to Care for Patients". New York Times. http://www.nytimes.com/2010/03/09/science/09conv.html?partner=rss&emc=rss. Retrieved March 24, 2010.
NamePronovost, Peter
Alternative names
Short description
Date of birth1965
Place of birthWaterbury, Connecticut
Date of death
Place of death

Retrieved from "http://en.wikipedia.org/wiki/Peter_Pronovost"
Categories: American physicians | Johns Hopkins University faculty | 1965 births | Living people | Fairfield University alumni | Johns Hopkins School of Medicine alumni | Johns Hopkins Hospital physicians | Medical treatments | Patient safety | Evidence-based medicine | Healthcare quality | MacArthur Fellows
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