Friday, March 5, 2010

Patient safety with Jeffrey B. Cooper, PhD


PATIENT SAFETY and excellent health care quality are at the forefront of every activity throughout the MGH. As part of a national education and awareness-building campaign aimed at improving patient safety across the country, the MGH will observe Patient Safety Awareness Week (PSAW) March 7 through 13. Informational activities will center on educating patients to become involved in their own health care, building awareness of quality and safety initiatives at the MGH, and acknowledging those hospital staff and employees who have excelled in enhancing patient safety.

On March 11, as part of PSAW, the MGH will host "The History of Safety at MGH; A Lot Has Happened Since Ether!" from 3 to 5 pm in the O'Keeffe Auditorium. The presentation will feature a panel of distinguished MGH patient safety experts who have had an important impact on the field: Jeffrey B. Cooper, PhD, director of the Center for Medical Simulation; Nathaniel Sims, MD, anesthesiologist and innovator at the Department of Biomedical Engineering; M. Ellen Kinnealey, BSN, RN, advanced infusion systems specialist; Carol Camooso Markus, RN, Patient Care Services staff specialist; and Karen Miguel, RN, patient safety officer for MGH Imaging. The group will discuss the MGH's role in shaping the course of patient safety internally, nationally and internationally.

Cooper is internationally renowned in the anesthesia community for his seminal contributions to the prevention of adverse events and patient injury and is considered a pioneer in the development of medical simulation. His studies of human error in medicine in the 1970s were among the first ever conducted. Cooper retired last April as the director of Biomedical Engineering of Partners HealthCare, having served in this role for 14 years. The following brief dialogue with Cooper is a preview of the March 11 event.

Q: Your contributions to patient safety are recognized nationally and internationally. How did you start down this path of focusing on and making major contributions to patient safety?

A: When I arrived at the MGH in the '70s there was no such thing as "patient safety." Human error was hardly mentioned openly. I was a biomedical engineer in the Department of Anesthesia. Our team studied errors in anesthesia and how they happened. We listened carefully to clinicians about their stories of error and interpreted those into ways to make anesthesia safer. Those lessons led me to help create the Anesthesia Patient Safety Foundation (APSF) in 1985. That was the first organization in the world that focused solely on patient safety. Some years later, research that APSF supported led me to see the value of simulation training for patient safety.

Q: What has been of significant influence and meaning to you during your journey as a patient safety expert?

A. Although I am a biomedical engineer, my work is really not primarily about technology, it's about people, especially about how they work together. The MGH was a fertile environment for people like me. I had freedom to explore new ideas. Ironically, while it can be challenging to get new ideas accepted into practice, it's still a great place to conceive them and try them out. I was lucky to have great mentors and colleagues, particularly in Ron Newbower, PhD, who is currently chief technology officer for CIMIT. Richard J. Kitz, MD, the Department of Anesthesia chief for 20 years, created the kind of environment that nurtured interdisciplinary collaboration. He formed the Bioengineering Unit in Anesthesia and enabled engineers like me to work closely with clinicians to see how things really worked, especially in the operating rooms. Whatever success is attributed to me is more appropriately due to our collaborative, supportive and synergistic interdisciplinary team. That wouldn't have happened without the environment created by their support and protection.

Q: You are one of the pioneers in health care simulation. What is medical simulation training, and how has it encouraged a culture change in health care?

A: Simulation is about practicing without putting patients at risk. At the Center for Medical Simulation, which is another example of MGH's enabling of innovation, we work to get people to be more self-reflective, to think more deeply about how they make mistakes, how accidents happen and how they can prevent them. By using simulated clinical situations for training on teamwork and managing emergencies, we are teaching caregivers how to avoid crises and develop better teamwork skills. We're working toward a fundamental culture change – that people don't practice on patients until they really know what they are doing first. While I have a broad focus in patient safety, simulation for teamwork and learning without putting patients at risk has become my main interest.

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