Archive | September, 2009

Physician Accountability for Violation of Safety Rules: The Time For Excuses Has Passed

In this week’s New England Journal, Peter Pronovost and I make the case for striking a new balance between “no blame” and accountability. Come on folks, it’s time. At most hospitals, hand hygiene rates hover between 30-70%, and it’s a near-miracle when they top 80%. When I ask people how they’re working to improve their […]

Read full story Comments { 28 } 1,196 views

An Overlooked but Dangerous Handoff… of One Million Patients at a Time

A quick heads up on an article written by a very talented UCSF psychiatrist named John Young, which I had the opportunity to co-author. John observed that, despite all the recent literature about handoffs (such as here and here), no one has given much thought to the Mother of all Handoffs: the transition of outpatient […]

Read full story Comments { 2 } 45 views

Board Certification for Hospitalists: It’s Heeeere!

In a little over a decade, the field of hospital medicine has achieved most of the milestones that characterize a specialty: the field is the fastest growing specialty in medical history, it has achieved wide recognition and acceptance, and there are textbooks, journals, conferences (including my 13th annual CME conference in SF beginning tomorrow, with […]

Read full story Comments { 10 } 1,603 views

Hospital Incident Reporting Systems: Time to Slay the Beast

When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, […]

Read full story Comments { 15 } 4,984 views

Could This Be What He Planned All Along?

A conventional look at the The Speech: Obama over-learned the lessons of Hillary-care; he gave Congress too long a leash; he lost control of the message; the wacko’s attacked with a barrage of Socialist/Nazi/Plug-Pulling-on-Grandma-isms; not only was health reform on the ropes but the entire Obama Presidency was in danger of imploding (taking the Dems […]

Read full story Comments { 9 } 35 views