When we talk about harm in the world of health care, we're usually referring to patients and the facilities in which we provide care. These are the typical things we hope to avoid, not only because they are bad outcomes, but because they now carry the specter of financial penalties when they occur:
• medication errors
• wrong side surgeries
• hospital mishaps, like falls
• missing a diagnosis
• hospital-acquired infections and those induced by medical hardware
But Gary Cohen of the advocacy coalition Health Care Without Harm takes a much broader view of the harms that health enterprises can cause. Founded in 1996, HCWH is now a multi-national coalition of health care enterprises, governmental and non-governmental agencies, and other advocacy groups.
Cohen and HCWH have had some amazing successes. In less than two decades, HCWH has been able to reduce the number of medical waste incinerators in the U.S from more than 5,000 to fewer than 100. Why should we care? It turns out that burning medical waste pours tons of the harmful chemical dioxin into the environment.
Another example: The formerly ubiquitous mercury thermometer. They used to break all the time. Fun to play with the drops of mercury, but highly toxic. Neurotoxic, in fact. And when mercury gets in our water supply, the fatty fish we eat (salmon, swordfish, tuna, mackerel, even shark) slowly poison us, which is why pregnant women and children are advised to avoid eating fresh fish in more than minute quantities.
HCWH was able to make the case that there are technological alternatives to mercury thermometers that work just as well and are much, much safer. And they've been successful. When's the last time you saw or used a mercury thermometer?
For this tireless advocacy, which also includes making hospital food supplies safer and hospital buildings themselves green and super safe (think natural disasters), Cohen was awarded a MacArthur Foundation Fellowship (think “genius grant”) last Fall.
You can hear an interview with Cohen here — give a listen and broaden your perspective on reducing harm in health care.
This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.