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 the story of Vineet Arora, MD.
This profile was published in the December, 2011 issue of HealthLeaders magazine.
"When I was a resident, you never had to hand off anything … That meant you stayed until your work was done."
Vineet Arora, MD, MPP, FACP, an associate professor of medicine at the University of Chicago's Pritzker School of Medicine, says she was always interested in finding out why things work—or don't—in healthcare, and that inquisitive nature led her to sleep.
Not necessarily her own sleep, mind you, although Arora will tell you when she was a resident she had her share of sleepless nights like many of her colleagues.
Arora, also assistant dean of scholarship and discovery at the Pritzker School of Medicine, is leading research that is reshaping sleep schedules for residents to improve quality and safety of patients. “You don't want doctors fatigued to the point they are hurting anybody,” she says.
“It's a fascinating area to work in. It's complex. If you change one thing in the system, you can change a lot of things. Everybody needs sleep. It doesn't matter who you are. You can't function without it. You'll die.”
Arora also has concentrated on studying handoffs from one physician to another in hospital settings as they change shifts, with a specific emphasis on communication procedures. In the 1990s, “when I was a resident, you never had to hand off anything,” she says. “A good handoff was no handoff. That meant you stayed until your work was done. People are now aware it’s a problem, and the challenge to the system is to make better handoffs.”
The importance of proper communication in handoffs cannot be overstated, but it is often difficult to address, she says. “I think it's a very big assumption you can just hand off patients to another doctor and this new doctor is going to do a surgery, for instance, with the same skill. Patients often say, 'why am I repeating the story' to a new doctor. The reason patients are repeating their stories is because there is something different. A detail is discovered that builds a new memory of the patient's condition and needs.”
Arora says she loves research and teaching, and the impact that can have on improving health systems. She uses play-acting to get a visual message across when she can. She and her colleagues put together a video in which she plays a physician who didn't do a very good job of handing off information to her harried colleague because she had to rush out of the hospital after being “super late” for dinner plans.
Arora took an unusual path out of residency, spending two years pursuing a master's degree in public policy at the University of Chicago Irving B. Harris School of Public Policy after receiving her medical degree from Washington University in St. Louis. At the time, she felt it was important to step back from medical training and concentrate on public policy. “I thought I should pause and learn this stuff, how medicine and healthcare systems are integrated,” Arora says.
Arora views her roles as mentor and educator as natural extensions of her research interests. “I see myself continuing to study and teach about handoffs and seeing if we can achieve better outcomes,” she says. “The nice thing about studying handoffs is that this area needs to be improved and be taught—a lot of our work now is focusing on how to teach it.”
“The hospital is a place of healing,” she says. “We are just at the tip of the iceberg how to improve practices, evaluate fitness for work, and attend to the needs of patients.
Arora’s resident days are long gone. “My husband will tell you, I always try to get enough sleep.”
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
