Sustainable Community HealthCare Systems

With so much flying around the media regarding health insurance infrastructure recently, I think it's time we took a step backward and focused on an oft-ignored aspect of the health care monolith: the realities of health care implementation at the local level. As a recent college graduate who has faced more than my fair share of battles with the health system, I have noted first-hand how drastically doctors and clinics need to change their interactions with patients. Rushed appointments, long waiting periods, and sloppy preparation techniques contribute to a growing number of citizens fearing health care and pushing back against getting proper medical attention. As the 2007 Annual Report of the Robert Wood Johnson Foundation states, "more than half [of patients] fear something bad will happen to them if they go into the hospital. Research into medical errors says their fears are justified."

Enter Dr. Peter Pronovost of the Johns Hopkins School of Medicine, who has launched a simple, grass-roots style campaign for the improved implementation of health care in American hospitals and clinics. After writing a simple checklist of activities that should be conducted before any procedure or examination, Dr. Pronovost sent it to his colleagues and encouraged they take the time to check it before each appointment. Staggering results were found for those hospitals who adopted the policy: "participating Michigan hospitals estimated that within 18 months the checklists saved 1,500 lives and an estimated $175 million." Dr. Provonost's work focuses on revitalizing health care from the community level up: change simple, low-tech and econo-friendly techniques used by doctors and nurses, and drastically alter the quality of health care implementation. An added side effect of this process will be a population that looks positively upon their health care providers, and will be more likely to champion additional changes to the health care system, on both a large and small scale.

Dr. Pronovost's work raises an important point for donors interested in forwarding the American health care system. The presidential campaign has focused attention on reforming health care mega-powers and insurance giants, leaving us bogged down in policies as large as encyclopedias that have extremely lengthy implementation periods. If instead we focus some of this energy on practical solutions to more locally-encountered issues within the health care system, we may find surprisingly positive results. The purpose of health care is to support and strengthen the population; what better way to begin this process than in the communities, where people can really experience some immediate, important changes.

Dana Variano