Fairfield Now - Spring 2009
Fairfield Alumus Dr. Peter Pronovost '87 wins a MacArthur Fellowship for his revolutionary work in emergency care
By Meredith Guinness
Eight-year-old Emma Pronovost knows how to keep her daddy grounded.
When her teacher announced to the class that Emma's father, Dr. Peter Pronovost '87, won a MacArthur Foundation Fellowship - a no-strings-attached $500,000 grant known as the 'genius grant' - she immediately took issue.
"My daddy's not a genius," she told her fellow third-graders. "Sometimes I put peanut butter on his nose and he lies down on the floor and our yellow lab licks it off. That's not genius!"
Apparently, the John D. and Catherine T. MacArthur Foundation didn't take extracurricular activities into account when it awarded Pronovost, a Johns Hopkins University professor and critical care specialist, one of just 25 of the coveted grants this year. And Time Magazine must not have researched his unusual hobby when it named him one of the "most influential people of 2008."
So what makes Pronovost a 'genius?' In the end, it's a simple checklist.
In 2001, Pronovost began studying hospital-acquired infections at the Baltimore-based medical center. They affect about 10 percent of all patients nationwide, resulting in an estimated 90,000 deaths a year. Pronovost decided to zero in on line infections - those caused when a needle and catheter are inserted into a vein. It's a common procedure, so common that harried medical staffers sometime forget the routine steps needed to do it properly. What if, he wondered, he created a checklist reminding them of the steps to take?
A year after instituting the checklist, he had his staggering answer: the line-infection rate at Johns Hopkins had plummeted from 11 percent to zero. His dedicated team of doctors, nurses, researchers, and administrative staff estimated their straightforward, one-page chart prevented 43 infections and eight deaths and may have saved about $2 million.
Dr. Peter Provonost '87 meets with fellow staffers at Johns Hopkins Medical Center.
In the years since, Pronovost and his team have turned their attention to other areas where a checklist might come in handy, finding more success along the way. Their work has created quite a stir: With Pronovost's help, hospitals in Michigan, Rhode Island, the United Kingdom, and Spain have adopted similar protocols. This spring 10 states, including Connecticut, will join a federally funded cohort replicating the system and researching and reporting results, which is key to gauging its usefulness. Through philanthropic support, another 10 will soon join them, building on what Pronovost calls a "more efficient knowledge market."
Buoyed by international interest and a deep-seated passion for patient safety, Pronovost is also working with the World Health Organization to set up such safety programs in entire countries, in which Johns Hopkins would design projects, provide oversight, measure results, and create "safety scholars" who would get a Hopkins master's degree in public health and bring their new knowledge back to countries around the globe. He'll use the MacArthur grant to develop The Checklist Maker, a software product allowing healthcare professionals to make checklists using prediction markers, an idea that may have far-reaching applications outside of medicine as well.
"It seems ridiculous. Why the hell aren't we doing this in healthcare?" he said during a rare moment of downtime between ICU rounds, speaking engagements, and teleconferences with the Obama administration. "This year has been very busy for me, but it's incredibly rewarding. The ability to do this kind of work and to get it implemented and used... We're helping to make the delivery of healthcare safer. The return on investment is unbelievable."
While a checklist assumes there is a set of things to do in a particular situation, Pronovost realizes science is constantly advancing and checklists may need to evolve with it. A side benefit: The system fosters teamwork, empowering nurses and other medical staff to speak up if a step is missed. "I get more nursing invites to speak than anything," he said with a laugh.
While someone else might have been able to come up with the seemingly simple protocols, it's Pronovost's drive that makes things happen. On his desk at Johns Hopkins sits a ship's telescope over the words "Focus" and "Execute." He takes the words to heart, propelling himself through a typical day.
Dr. Provonost examines a patients in the ICU. He will be giving the 2009 Fairfield University Commencement Address in May.
"What's a typical day like?" he said, thumbing through his calendar. "Well, yesterday started with a run at 5 a.m. with my dog, then at 6:30 a safety ICU meeting, then I had a meeting on a webcast for nurses on patient safety, then a call with India, then a Johns Hopkins medicine safety meeting, then a state planning meeting, then I talked to the CEO of the Maryland Hospital Association, then I had a call with the Kennedy, Obama, and McClusky staffs on healthcare reform, and that was interrupted by a safety issue... and then at 5:30 I ran home to take my daughter to ballet."
Not surprisingly, Pronovost keeps his busy life in check with his own personal checklist. It focuses on the four key relationships in his life: God, self, his family - wife, Marlene Miller, Emma, and his 11-year-old son, Ethan - and others. "I literally go through my day and say, 'Did I do some scripture reading? Did I eat well, sleep well? Am I present with my kids when I'm home? Am I serving others?"
Pronovost realizes that the growing spotlight on his research means he is seen as a leader in the field of healthcare safety, an area that he says "hasn't gotten a lot of traction" when it comes to research or research dollars. But he's prepared - in large part, he said, through his years at Fairfield. The Jesuit sense of caring for others, integrity, and discipline inform everything he does now. "I have a strong commitment to making the world a better place," he said simply.
That commitment will probably come up when he delivers the 2009 Fairfield University Commencement speech this May. He said he's humbled to have been chosen to receive an honorary degree and to give new graduates some advice as they go out into world.
"I want to talk a lot about what leadership is," he said. "You don't need to have all the answers, but you need the courage to ask the question, the clarity to address the task at hand, and the commitment to execute."