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Peter Pronovost: Slashing Infection Rates

Cheryl Clark, for HealthLeaders Media, December 2, 2010

 "What really got us to zero was then we investigated every infection as a defect."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Peter Pronovost's story.

Ask Peter Pronovost, MD, what prompted him to try to slay the dragons of hospital-acquired infections, a strategy credited with saving thousands of lives and millions of dollars. He answers first by talking about his father and why he went into medicine in the first place.

"Dad was misdiagnosed with a type of cancer when I was in college," the Johns Hopkins Hospital intensivist explains. "He was told he had lymphoma." A while later, he got a second opinion at Johns Hopkins and learned he actually had leukemia. "He might have been treated with a bone marrow transplant. But now he was beyond treatment. He was essentially told to go home and die."

Home hospice quality "was poor," and his father died "a horrible death, writhing in pain. They said we've given you all the pain medication we can, there's nothing more we can do. He died unnecessarily and miserably. And I became convinced that patients deserve better than our health system was giving them."

Working in a hospital clinic in Ogbomocho, Nigeria at the end of his medical school years, he saw "every day, literally three to four hundred people waiting in line to come into this clinic, with burns, broken bones, infections. It just seemed never ending. Yet people were drinking dirty water, walking around with lanterns on their heads and they would trip, fall, and get burned." Broken bones came from many vehicle collisions. "And many people were critically ill from drinking dirty water."

That's when, he says, he "developed a broader sense of public health" in his mission to be a doctor.

Pronovost is a professor at the Johns Hopkins School of Medicine in the departments of anesthesiology, critical care medicine, and surgery, and professor in the department of health policy and management, Johns Hopkins Bloomberg School of Public Health and School of Nursing. He also is a recipient in 2008 of the MacArthur Foundation "Genius Award."

But he is best known for his five-point checklist to prevent central line associated bloodstream infections: Wash hands; wear sterile gloves, hat, mask, and gown and cover the patient with sterile drapes; avoid placing catheter in the groin; clean skin with chlorhexidine; and remove catheters when no longer needed.

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