26
Advancing the Science of Medical Transparency
Marty Makary MD, MPHDepartment of Health Policy & Management
Johns Hopkins University
210,000 deaths
Causes of Death in the U.S.Causes of Death in the U.S.
Cotman
1. Heart disease: 597,6892. Cancer: 574,743
3. Chronic lower respiratory diseases: 138,080
Source: CDC
Cotman
Trip Advisor
Apple Store
Safety Attitudes Questionnaire (SAQ)Safety Attitudes Questionnaire (SAQ)
It is easy to speak up if I perceive a problem in the OR
I would feel comfortable having my own care here
Makary M, Sexton JB, Freischlag J et al. Patient Safety in Surgery. Ann Surg, 2006;243:628-32.
“I would feel safe being operated upon here as a patient”
0102030405060708090
100
Hospital (each bar = 1 Hospital)
% re
spon
dent
s rep
ortin
g go
od sa
fety
clim
ate OR Safety Climate by Hospital
Makary M, et al., Patient Safety in Surgery, Annals of Surgery, 2006
Introduction
6.1
9.3
0
1
2
3
4
5
6
7
8
9
10
Bayview
Poor Culture Good Culture
AHRQ National Avg.
Rates of PE/DVTEv
ents
per 1
000 d
ischa
rges
PostopPostopSepsisSepsis
PostopPostopBleedingBleedingS.S.I.S.S.I.
p<0.05p<0.05 p<0.05p<0.05 p>0.05p>0.05
Unpublished data
% A
gree
“It was difficult to speak up if I perceived a problem with patient care.”
Makary et al. Operating room briefings and wrong-site surgery. J Am Coll Surg 2007;204:236-43.
Nundy S, et al. Impact of Preoperative Briefings on Operating Room Delays Archives of Surgery, 2008143:1068-72.
“There was an unexpected delay related to the case.”
