This past year, Pronovost has realized many successes from his efforts to improve hospital care.
First, health reform legislation now encourages hospitals to publicly report central line bloodstream infections starting in January 2011, and by 2013, those rates will be used to set Medicare reimbursement. Sometime between now and then those infection rates will be posted on www.hospitalcompare.hhs.gov.
"They get a pay increase if they report, so most hospitals likely will," Pronovost says.
Second, federal funding has been enhanced to improve the science behind infection prevention, an effort that has historically been abysmal, he says.
"We have traditionally spent two cents on the science of health delivery for every dollar we spend to on studying new genes and drugs. So it's no surprise that the science is poor. We haven't invested in it."
Third, throughout hospitals around the country, nurses are increasingly empowered to stop physicians from inserting central lines or catheters if they notice that infection control procedures have not been strictly followed. That has been a huge battle and is still under way, he says. "Nursing culture was not used to questioning physicians, and if they did, they got their heads bit off because doctors were not used to being questioned," he says.
Fourth, in February, Pronovost saw the publication of his book: "Safe patients, smart hospitals: how one doctor's checklist can help us change health care from the inside out." The book is dedicated to his father.
Pronovost says that while there's still more work to be done with hospital infections involving catheters, he's reaching out to some frontiers: creating similar strategies to reduce ventilator-associated pneumonia, pulmonary emboli, and deep vein thrombosis.