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Door to Antibiotics Time in Pneumonia: Lessons from a Flawed Quality Measure by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy In today’s Annals of Internal Medicine, my colleagues and I describe the saga of the four-hour measure of door-to-antibiotics time for pneumonia – the first truly dangerou ... Read on »
The New (CMO) Math: Passion + Power = Progress by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy In his five years on the job, Dr. Ernie Ring taught me why the Chief Medical Officer role is crucial, and how to do it right. Since Ernie is retiring at week’s end, it see ... Read on »
The Best and Worst of Times For "Infection Preventionists" by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy As I mentioned in my last post, these should be the best of times for "Infection Preventionists" (formerly known as Infection Control Officers). After years of trying to g ... Read on »
How Infection Prevention Came to Dominate the Patient Safety Movement by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy The Joint Commission just released its 2009 National Patient Safety Goals, and – no surprise – they focus on infection prevention. While this seems natural today, it wasn’ ... Read on »
Announcing our Hospitalist CME Course, and a New Hospitalist Mini-College by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy A quick heads-up for those of you thinking about attending this year’s Management of the Hospitalized Patient (MHP) conference, October 23-25 in SF… we’re adding a hands-o ... Read on »
Could Intensivists Be Harmful to ICU Patients' Health? by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Of all the structural (how care is organized) “evidence-based markers of high quality care,” perhaps the most ironclad has been the involvement of critical care physicians i ... Read on »
Why Diagnostic Errors Don't Get Any Respect - And What Can Be Done About It by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Rica ... Read on »
The Funniest Satire on Interoperability You've Ever Seen (Trust Me) by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy There is nothing better than a good satire to capture certain (uncomfortable) truths – just ask any of the presidential candidates after an episode of Saturday Night Live. ... Read on »
The "Technology Hype Cycle": Why Bad Things Happen to Good Technologies by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Fresh on the heels of my recent bar coding epiphany comes another “unintended consequences” article. It turns out that the whipsawing that accompanies the adoption of new ... Read on »
Should Hospitals Install Bar Coding or CPOE First? Why IĆ¢??ve Changed My Tune by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy This is one of the most commonly asked questions in IT World, and my answer has always been “CPOE first” – largely because that has always been David Bates’s (the world’s le ... Read on »
Snooping At Britney's Chart: Why Should Docs and Nurses Have Different Rules? by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Should doctors and nurses be subject to different penalties for precisely the same infraction? Of course not. Are they? Sure. Just ask Britney Spears. Britney was ... Read on »
Should Patient Satisfaction Scores Be Adjusted for Where Patients Shop? by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Last week, Medicare added patient satisfaction data to its hospital reporting website. This is progress, but it raises an interesting question: should patient satisfaction ... Read on »
Notes from the Society of Hospital Medicine's Annual Meeting by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy A few random observations from the Society of Hospital Medicine’s annual meeting in San Diego: There are about 1600 people here, most of whom I don’t know. How did this ... Read on »
Average Time of Discharge: Why a Hospital is Not a Hilton by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Do you get as annoyed as I do about being pressured on your “Time of Discharge?” I just received my monthly report, and we’re in The Doghouse again: our average TOD – 3:28 p ... Read on »
The Great Quality Debate: Berwick's Plea for Action vs. Evidence-Based Medicine by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy In this week’s JAMA, Dr. Don Berwick, CEO of the Institute for Healthcare Improvement, argues that evidence-based standards should be relaxed for quality improvement practic ... Read on »
Absurd: Resuscitating 90-year-olds with Dementia or Metastatic Cancer by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy Last month on the wards, I unilaterally told two patients’ families that we were not going to resuscitate their loved ones. My residents were horrified – this violated the D ... Read on »
And Speaking of the Unintended Consequences of Quality Measurement... by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy I must have "you can't manage what you don't measure" on the brain – here's a piece I wrote this week for AHRQ's Guidelines/Quality Measures Clearinghouses called " Is the ... Read on »
Quality Measurement and the Risk of Yin Without Yang by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy " You can’t manage what you don’t measure." This well-worn business axiom has been embraced by the healthcare quality movement, a trend this is healthy and long past due. ... Read on »
Is Medicare's "No Pay for Errors" Plan a Good Idea? by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy In this month’s issue of the Joint Commission Journal of Quality and Patient Safety, I (with UCSF’s Adams Dudley and the American Hospital Association's Nancy Foster) tackle ... Read on »
Can Medical Errors Be Funny? You Betcha. by Dr. Robert W. Medical Doctor Posted in: Blog Posts in Healthcare Industry & Policy All medical mistakes are problematic. A few are truly tragic. But every now and then, a medical error comes along that is downright hilarious. From AHRQ WebM&M, the case-bas ... Read on »