Ernest Amory Codman
Encyclopedia
Ernest Amory Codman, M.D., (December 30, 1869 – November 23, 1940) was a pioneering Boston surgeon who made contributions to anaesthesiology, radiology, duodenal ulcer surgery, orthopaedic oncology, shoulder surgery, and the study of medical outcomes.
Codman was born in Boston
Massachusetts
. He attended the Fay School
in Southborough
, and prepped at St. Mark's School
, matriculating at Harvard College
.
He was an advocate of hospital
reform and is the acknowledged founder of what today is known as outcomes management in patient
care. Codman was the first American doctor to follow the progress of patients through their recoveries in a systematic manner. He kept track of his patients via "End Result Cards" which contained basic demographic data on every patient treated, along with the diagnosis, the treatment he rendered, and the outcome of each case. Each patient was followed up on for at least one year to observe long-term outcomes. It was his lifelong pursuit to establish an "end results system" to track the outcomes of patient treatments as an opportunity to identify clinical misadventures that serve as the foundation for improving the care of future patients. He also believed that all of this information should be made public so that patients could be guided in their choices of physicians and hospitals.
Codman graduated from Harvard Medical School
in 1895 and interned at Massachusetts General Hospital
. He joined the surgical staff of Massachusetts General and became a member of the Harvard faculty. While there, he instituted the first morbidity and mortality conferences. However, in 1914, the hospital refused his plan for evaluating surgeon competence, and he lost his staff privileges there. Dr. Codman eventually established his own hospital (which he called the "End Result Hospital") to pursue the performance measurement and improvement objectives he believed in so fervently. To support his "end results theory," Dr. Codman made public the end results of his own hospital in a privately published book, A Study in Hospital Efficiency. Of the 337 patients discharged between 1911 and 1916, Dr. Codman recorded and published 123 errors.
With an interest in health care quality, Dr. Codman also helped lead the founding of the American College of Surgeons
and its Hospital Standardization Program. The latter entity eventually became the Joint Commission on Accreditation of Healthcare Organizations
. He also established the first bone tumor registry
in the United States, an idea which had first been suggested by the British physician Sir Thomas Percival
in 1803.
Dr. Codman's name is also attached to "Codman's Exercises," a series of exercises for the purpose or regaining range of motion
(see Physical therapy
), and "Codman's Tumor," a benign tumor of the cartilage
.
Dr. Codman married Katherine P. Bowditch on November 16, 1899.
Codman was also a public health pioneer, studying hospital outcomes to determine how they could be improved. Codman wrote, "We believe it is the duty of every hospital to establish a follow-up system, so that as far as possible the result of every case will be available at all times for investigation by members of the staff, the trustees, or administration, or by other authorized investigators or statisticians."
In 1996, in tribute to Ernest Codman, M.D., the Joint Commission published the book "Codman: A Study in Hospital Efficiency." The Commission also established the Ernest A. Codman Award for the use of outcomes measures to advance the quality and safety of patient care.
Codman was born in Boston
Boston
Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...
Massachusetts
Massachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
. He attended the Fay School
Fay School
Fay School is an independent, coeducational day and boarding school, located on a campus some from Boston in Southborough, Massachusetts. It has 465 students enrolled from Pre-Kindergarten through grade 9; the boarding program enrolls 100 students from throughout the United States and more than...
in Southborough
Southborough, Massachusetts
Southborough is an affluent town in Worcester County, Massachusetts, United States. It incorporates the smaller villages of Cordaville, Fayville, and Southville. Its name is often informally shortened to Southboro, a usage seen on many area signs and maps. Its population was 9,767 at the 2010...
, and prepped at St. Mark's School
St. Mark's School (Massachusetts)
St. Mark’s School is a coeducational, Episcopal, preparatory school, situated on in Southborough, Massachusetts, from Boston. It was founded in 1865 as an all-boys' school by Joseph Burnett, a wealthy native of Southborough who developed and marketed the world-famous Burnett Vanilla Extract . ...
, matriculating at Harvard College
Harvard College
Harvard College, in Cambridge, Massachusetts, is one of two schools within Harvard University granting undergraduate degrees...
.
He was an advocate of hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
reform and is the acknowledged founder of what today is known as outcomes management in patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
care. Codman was the first American doctor to follow the progress of patients through their recoveries in a systematic manner. He kept track of his patients via "End Result Cards" which contained basic demographic data on every patient treated, along with the diagnosis, the treatment he rendered, and the outcome of each case. Each patient was followed up on for at least one year to observe long-term outcomes. It was his lifelong pursuit to establish an "end results system" to track the outcomes of patient treatments as an opportunity to identify clinical misadventures that serve as the foundation for improving the care of future patients. He also believed that all of this information should be made public so that patients could be guided in their choices of physicians and hospitals.
Codman graduated from Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
in 1895 and interned at Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...
. He joined the surgical staff of Massachusetts General and became a member of the Harvard faculty. While there, he instituted the first morbidity and mortality conferences. However, in 1914, the hospital refused his plan for evaluating surgeon competence, and he lost his staff privileges there. Dr. Codman eventually established his own hospital (which he called the "End Result Hospital") to pursue the performance measurement and improvement objectives he believed in so fervently. To support his "end results theory," Dr. Codman made public the end results of his own hospital in a privately published book, A Study in Hospital Efficiency. Of the 337 patients discharged between 1911 and 1916, Dr. Codman recorded and published 123 errors.
With an interest in health care quality, Dr. Codman also helped lead the founding of the American College of Surgeons
American College of Surgeons
The American College of Surgeons is an educational association of surgeons created in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.-Membership:...
and its Hospital Standardization Program. The latter entity eventually became the Joint Commission on Accreditation of Healthcare Organizations
Joint Commission on Accreditation of Healthcare Organizations
The Joint Commission , formerly the Joint Commission on Accreditation of Healthcare Organizations , is a United States-based not-for-profit organization that accredits over 19,000 health care organizations and programs in the United States...
. He also established the first bone tumor registry
Cancer registry
A cancer registry is a systematic collection of data about cancer and tumor diseases. The data is collected by Cancer Registrars. Cancer Registrars capture a complete summary of patient history, diagnosis, treatment, and status for every cancer patient in the United States, and other countries as...
in the United States, an idea which had first been suggested by the British physician Sir Thomas Percival
Thomas Percival
Thomas Percival FRS FRSE FSA was an English physician and author, best known for crafting perhaps the first modern code of medical ethics...
in 1803.
Dr. Codman's name is also attached to "Codman's Exercises," a series of exercises for the purpose or regaining range of motion
Range of motion
Range of motion , is the distance that a movable object may normally travel while properly attached to another object. It is also called range of travel, particularly when talking about mechanical devices and in mechanical engineering fields...
(see Physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
), and "Codman's Tumor," a benign tumor of the cartilage
Cartilage
Cartilage is a flexible connective tissue found in many areas in the bodies of humans and other animals, including the joints between bones, the rib cage, the ear, the nose, the elbow, the knee, the ankle, the bronchial tubes and the intervertebral discs...
.
Dr. Codman married Katherine P. Bowditch on November 16, 1899.
Codman was also a public health pioneer, studying hospital outcomes to determine how they could be improved. Codman wrote, "We believe it is the duty of every hospital to establish a follow-up system, so that as far as possible the result of every case will be available at all times for investigation by members of the staff, the trustees, or administration, or by other authorized investigators or statisticians."
In 1996, in tribute to Ernest Codman, M.D., the Joint Commission published the book "Codman: A Study in Hospital Efficiency." The Commission also established the Ernest A. Codman Award for the use of outcomes measures to advance the quality and safety of patient care.
External links
- Codman Biography on website of New England Shoulder and Elbow Society: http://www.neses.com/news.php
- The Ernest Amory Codman papers can be found at The Center for the History of Medicine at the Countway Library, Harvard Medical School.