When I was a med student, the Beating Heart of the Hospital of the University of Pennsylvania (HUP) was not the CEO’s suite, the neurosurgeon’s OR, or the Dean’s lair. It was the seat of one Wallace Miller, Sr., in the decidedly unglamorous Chest Reading Room. Do you even know where the chest reading room [...]
Archive | January, 2008
How Clinical IT is Transforming Hospital Care – For Better and Worse
My friend Mark Smith, who runs the California HealthCare Foundation, once wryly observed, “Have you ever noticed that the doctors who talk about how much fun primary care is only practice it one afternoon a week?” I may have become the hospitalist version of Mark’s Ivory Tower internists, but I’ll take my chances. I just [...]
Did I Violate Federal Regulations Today? (I Hope So)
The patient safety and quality movements are precious and fragile. Just as IOM reports I and II spawned these modern, life-saving revolutions, the Federal shutdown of the Hopkins/Michigan checklist program may help extinguish them. After all, Tipping Points can tip both ways. I laid out the issues in this prior post. Those of you who [...]
Bureaucracy Run Amok: Can Checklists Kill?
As you may know, I’ve argued that that the quality and safety of healthcare have traditionally been underregulated. But regulators are like patients with Parkinson’s: it’s hard to get them unglued, but once they’re moving, it’s hard to stop them. Welcome to Exhibit A. Last month, I described Atul Gawande’s thrilling New Yorker article recounting [...]
A Nordstrom To-Do List: Tie, Slacks, a Little V. Tach?
Great quote by USC cardiologist Leslie Saxon (a reporter reached her on her cell phone as Leslie was shopping) on this week’s NEJM study on delayed defibrillation: “You’re better off having your arrest [here] at Nordstrom [than in a hospital]… because there are 15 people around me.” You’ve probably seen the study, a detailed analysis [...]
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