Each year, 100,000 people die from infections they picked up in the hospital. These are completely preventable diseases, caused by human error. But they result in as many annual deaths as AIDS, breast cancer and car accidents combined. They cost our health-care system $33 billion annually.
As a physician and parent, I’ve seen the tragic consequences of this phenomenon firsthand. Five years ago, my young son required an emergency appendectomy. His surgery went well and his recovery was on track. Then, he was exposed to Clostridium difficile by his roommate. Instead of returning to school within the week, he was bedridden for nearly two months with unrelenting diarrhea, weight loss and fevers. It took many courses of antibiotics for him to finally resolve the infection, and almost a year for him to feel truly well.
Worldwide, organizations have tried to fight hospital-acquired infections. The World Health Organization and Centers for Disease Control both publish guidelines for hospitals. The U.S. Department of Health and Human Services identified the reduction of the infections as a top priority in 2010.
These groups encourage hospitals to do things like s aviation-style checklists and multidisciplinary team rounds with a team approach to improve communication among nurses, physicians and other caregivers. Other strategies include strict isolation precautions, infection control teams and improved surveillance and reported of infections. Medicare is imposing financial penalties as an incentive for hospitals to achieve lower rates of infections.
But while we’ve seen some progress, it’s nowhere close to the goals set by the Federal Steering Committee for the Prevention of Health Care-Associated Infections, a senior level group convened to coordinate HAI prevention efforts. For example, the 2012 assessment of Clostridium difficile infections reported only a 10 percent reduction, short of the national target of 30 percent.
The problem is not, simply, that hospitals have failed to fully implement the WHO’s recommendations. Doctors and nurses are pulled in a million directions and are expected to implement recommendations on best practices for everything from which test to order to what treatment to prescribe. Guidelines will never succeed unless our healthcare providers are given an environment to foster concentration and focus, to minimize avoidable errors. It’s time to try another approach: mindfulness meditation for healthcare workers.
Mindfulness, rooted in Hindu and Buddhist teachings, is the practice of maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment. Mindfulness meditation can help us identify those unconscious thoughts, feelings, and behaviors that sabotage our emotional, physical, and spiritual health. Meditation also has a balancing effect on our body’s response to stress, calming the autonomic nervous system.
My research group at the Osher Center for Integrative Medicine at Northwestern University has been investigating whether these positive impacts could improve doctor and nurse decision-making and quality of care, thereby improving patient safety and outcomes.
So far, the results are good. Physicians participating in mindfulness training report enhanced personal well-being, decreased burn-out, and improved attitude toward patient-centered care. This is important, because health-care provider burnout has been significantly associated with an increase in medical errors. In particular, errors spike when doctors and nurses respond to chronic excessive stress with depersonalization of their patients- a detached, cynical attitude- and emotional exhaustion. For example, the likelihood of a surgeon self-reporting a major medical error increased by 11 percent per one point increase on a depersonalization scale (from 0 – 33).
A growing number of institutions are exposing their staff to mindfulness practices. Scripps Health system is exploring a pilot program where training will be available at no cost to all employees. Georgetown School of Medicine has a mind-body medicine elective in which 40 percent of the class enrolls. At my own academic health center, Northwestern Medicine, we offer mindfulness courses tailored for healthcare professionals that several medical divisions have taken. The Northwestern Feinberg School of Medicine is also experimenting with ways to incorporate relaxation techniques into a longitudinal wellness curriculum to address student stress.
To better understand the outcomes of these kinds of programs, my research team is collaborating with the medical school and Northwestern Memorial Hospital leadership to study the impact of mindfulness meditation on multiple outcomes, include medical error. My team is also conducting research to discover the “minimum dose” needed for mindfulness training to have an impact and how a successful mindfulness program can become scalable.
Of course, hospital-acquired infections won’t be completely eradicated with this simple intervention. But getting our medical professions to slow down and pay attention can have a big impact on patient safety — and their own lives as well.