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Nursing: You Wanna Know What I Think?

In Healthcare, One Size Does Not Fit All

Published September 6, 2012 12:36 PM by Pat Veitenthal
"Johns Hopkins' Armstrong Institute for Patient Safety and Quality has received an $8.9 million grant from the Gordon and Betty Moore Foundation, the first award given as part of an ambitious new $500 million, 10-year program designed to eliminate all preventable harms that patients experience in the hospital."

OK, really? Eliminate ALL preventable harms? That's a pretty tall order that goes beyond ambitious, especially when actual human beings are involved. Unless the plan involves some sort of robotic, computer-driven avatar being assigned to each person admitted, they won't even get close to succeeding.

Wait...that's not too inconceivable these days, is it? My sister (a 38-year CCU RN) believes this issue is more troubling on a deeper level.

"Despite heroic efforts by clinicians, patients continue to suffer preventable harm, in large part because health care is grossly under-engineered: Devices don't talk to each other, treatments are not specified and ensured, and outcomes are largely assumed rather than measured," said Peter J. Pronovost, .D, PhD, the senior vice president for patient safety and quality at Johns Hopkins Medicine. "This project will seek to change that by enlisting systems engineers to ensure patients always get the treatments they should, by engaging patients in every aspect of their care and creating a health care system that continuously improves."

We are all for improvement, but is removing the collaborative efforts of practitioners the way to go? I agree with my sister; I see this as an expansion of evidence-based order sets (EBOS) and I am ANTI-EBOS.

Just as one size does not fit all, neither does one set of standardized orders fit every person. It will become too easy to do things the "way it is written" rather than give actual THOUGHT to the person, the disease process and the treatment plan. If this underlying ideal isn't closely monitored, nurses will become a voice over a box just like at the drive thru..."Welcome to McHospital. Your doctor has ordered a number six. We hope you enjoy your stay."

posted by Pat Veitenthal

2 comments

Well said.

Leigh November 19, 2012 11:40 AM

Further bureaucratization of medicine; the wave of the future. MDs and RNs will be given little choice about following these one size fits all treatment plans decided by a faceless, nameless committee of 15 in DC or else lose your funding, payments, etc. if I'm not mistaken, this is where the "ACA"/Obamacare is taking us.

Ed September 6, 2012 8:30 PM

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About this Blog


    Pat Veitenthal, BSN, RN
    Occupation: Per diem nursing supervisor and cruise ship nurse
    Setting: Community hospital and cruise ships
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