I recently participated in a meeting whose aim was to develop safety measures for hospital units (ie, med-surg, ED, L&D). As various measures were being ticked off, I muttered that we should also try to capture errors that occur as patients move between units. One of my colleagues, quite sensibly, asked, “but who will be [...]
Fixing Fumbled Handoffs
by Bob Wachter on December 25, 2007 in Ambulatory/Primary Care, Health Policy, Hospital Care, Patient Safety/Medical Errors, Quality Improvement, Quality Measurement, Transparency and Reporting
Today’s New England Journal Hospitalist Study
by Bob Wachter on December 20, 2007 in Ambulatory/Primary Care, Efficiency, Health Policy, Hospital Care, Hospitalists/Hospital Medicine, Medical Education/Academia, Quality Measurement
Today my pals Peter Lindenauer and Andy Auerbach (and colleagues) published the largest hospitalist outcomes study to date, in the New England Journal of Medicine. It is a rigorous, important piece of work. Let me try to add a bit of context. First, the What’s What. Using the massive database of the Premier system (which [...]
The UCSF-Kessler Saga and the Press
by Bob Wachter on December 18, 2007 in Health Policy, Media/Press Coverage, Medical Education/Academia
I’ve not been posting regularly on this story (as you might imagine, it’s a bit tricky for me to do so), but for those following it from near and far (I’ve received emails from friends in Europe and Asia) there have been a number of interesting articles, including pieces in the LA Times, Washington Post, [...]
The Termination of UCSF Dean David Kessler
by Bob Wachter on December 14, 2007 in Health Policy, Media/Press Coverage, Medical Education/Academia
Well, today the great Mecca of medical care and innovation that is UCSF all but ground to a halt. Our Dean was just let go under very odd circumstances, and everyone’s flocking to water coolers and Starbucks around the city to find out who knows what. I won’t be giving away any trade secrets here, [...]
More on Quality Reports: Lessons From SAT Scores
by Bob Wachter on December 14, 2007 in Health Policy, Medical Education/Academia, Quality Measurement, Transparency and Reporting
My older son is gearing up to apply to college (:-\ and so I bought him one of the Bibles, the Fiske Guide. The book is cleverly written – enough academic factoids to get parents to spring for it, leavened with enough social scene skinny to get kids to read it. The Guide dutifully lists [...]
Atul Gawande’s "The Checklist"
by Bob Wachter on December 9, 2007 in Hospital Care, Information Technology, Nurses/Nursing, Patient Safety/Medical Errors, Quality Improvement, Quality Measurement
Let’s make this short and sweet. In this week’s New Yorker, Atul Gawande describes Peter Pronovost’s crusade to improve the safety of intensive care through the use of checklists. If it sounds dull, it’s not. In fact, it is thrilling and inspiring. Gawande glides effortlessly from microscopic detail to panoramic view and back again to [...]
Can a Medical Center Be Too Rich?
by Bob Wachter on December 7, 2007 in Health Policy, Hospital Care, Media/Press Coverage, Medical Education/Academia
The University of Pittsburgh Medical Center announced today that it will donate up to $100 million over the next decade to fund college scholarships for Pittsburgh public school students. This is a magnificent gesture, but it left me scratching my head: I thought hospitals were supposed to absorb charity, not dole it out. I already [...]
Adventures in Bizarro Land: My Don Imus Interview
by Bob Wachter on December 4, 2007 in Health Policy, Media/Press Coverage, Nurses/Nursing, Patient Safety/Medical Errors
I had mixed emotions this morning when I heard that radio shock-jock Don Imus had returned to the airwaves. My 2004 interview with Imus was perhaps the wackiest experience of my life. It also made Internal Bleeding into a bestseller. Here’s the story: When Internal Bleeding came out, the book’s publicist, a lovely South African [...]
The Weekly Roundup…
by Bob Wachter on November 30, 2007 in Ambulatory/Primary Care, Diagnosis/Clinical Reasoning, Health Policy, Hospital Care, Hospitalists/Hospital Medicine, Information Technology, Nurses/Nursing, Outsourcing/Medical Tourism, Pay-for-performance, Quality Measurement, Transparency and Reporting
Stuff this week that caught my eye: Does medical tourism harm the natives? Are all those CT scans destroying more than our budgets? Are nocturnalists at risk for more than decubs? Will Medicare need to cut hospital payments to fuel P4P? Answers: yes, yes, probably, and duh. Yesterday, NPR’s All Things Considered described the dark [...]
Rapid Response Teams: Ready for Prime Time?
by Bob Wachter on November 27, 2007 in Health Policy, Hospital Care, Hospitalists/Hospital Medicine, Nurses/Nursing, Patient Safety/Medical Errors, Quality Improvement, Quality Measurement
Last year, I (with Peter Pronovost) wrote the toughest paper of my life – one that critiqued the Institute for Healthcare Improvement’s 100,000 Lives Campaign. This is the healthcare equivalent of criticizing both Mother Teresa and your local food bank in a single sitting (you can also read Don Berwick and his team’s response here). [...]
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The Dangers of Curbside Consults… and Why We Need Them
April 29, 2013
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When I Was In the Final Four
April 5, 2013
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Measuring the Quality of Doctors and Hospitals: When Is Good Enough, Good Enough?
April 1, 2013
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HIT Job: How the New York Times Blew it on Healthcare IT
February 26, 2013
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