A Study in Hospital Efficiency: As Demonstrated by the Case Report of the Second Two Years of a Private Hospital

Codman, Ernest Amory

1918

Bound in publisher's blue cloth. No date, presumed ca 1918. Hardcover. Fine binding and cover. A crisp, fresh copy.  Clean, unmarked pages. 179 p. Folding chart on index of cases combined with statistical tables using anatomic and pathologic classification of diseases and operations in pocket in back.  

Dr. Ernest Amory Codman was an influential proponent of the "End Result Idea."  "The 'Idea' was simply the premise that hospital staffs would follow every patient they treat long enough to determine whether or not the treatment was successful, then learn from any failures, and how to avoid those situations in the future.  Surprisingly controversial at the time, the "Idea" was the basis for the Hospital Standardization movement founded by the American College of Surgeons, and the precursor to the Joint Commission on Accreditation of Hospitals (JCAH)." - American College of Surgeons, Ernest A. Codman, MD, FACS (1869-1940). 

Codman worked at Massachusetts General Hospital "as Surgeon to outpatients in 1899, and from 1902 to 1914 was an assistant visiting surgeon at the hospital." (Ibid). Codman printed End Result Cards and gave them to his patients to track demographics, follow up on the care given, and track long term outcomes.  From 1913-1915 Codman taught at Harvard Medical School as a lecturer.  He passionately advocated his End Result Idea in speeches to the Boston Medical Society at the Boston Medical Library in 1915.  The presentation led to his dismissal from Massachusetts General Hospital and his resignation from the Standardization of Hospitals Committee, much to the chagrin of Drs. William and Charles Mayo.  Codman controversially attacked the seniority based system at MGH and advocated transparency in admitting and addressing medical mistakes in the course of treatment to avoid repetition and increase the quality of care.  Codman self-published this book A Study in Hospital Efficiency, to promote his End Result System.  He provided a review of 337 of his patients discharged between 1911 and 1916, and recorded and published 123 errors.  An important book advancing the quality of medical care by a hero of American medicine. 

Provenance: This copy came from the library of Edward D. Churchill (1897-1972), M.D.  Churchill was a Professor of Surgery at Harvard Medical School and Chief of Surgical Services at MGH.