Browse by Tags

• Ambulatory/Primary Care
• Diagnosis/Clinical Reasoning
• Efficiency
• Health Policy
• Hospital Care
• Hospitalists/Hospital Medicine
• Industry/Pharma
• Information Technology
• Media/Press Coverage
• Medical Education/Academia
• Medical Ethics
• Nurses/Nursing
• Pay-for-performance
• Quality Improvement
• Quality Measurement
• Transparency and Reporting

• Berwick, Pronovost, and the Non-Scalability of Charisma

  Early on, many social movements depend on a charismatic leader to focus attention, build a burning platform, and inspire people to action. You know when the movement has made it when it no longer needs such a leader for fuel.The safety and quality movements Read More... Posted Fri, Jul 23 2010 5:10 PM by Bob Wachter | 13 Comments Filed under: Quality Improvement, Transparency and Reporting, Patient Safety/Medical Errors, Health Policy

• Today’s Big ACGME and Joint Commission Announcements: The Courage To – and Not To – Change

  One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations?A few moments ago in the on-line version of the New England Read More... Posted Wed, Jun 23 2010 7:18 PM by Bob Wachter | 9 Comments Filed under: Quality Improvement, Hospital Care, Pay-for-performance, Transparency and Reporting, Quality Measurement, Medical Education/Academia, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors, Health Policy

• The New Joint Commission: Much Improved, With Room for More

  Until about 8 years ago, inspections by the Joint Commission (TJC) were predictable and fairly silly. Hospitals were given a couple of years' notice of the week that “The Joint” would be visiting. Everybody scurried around preparing – waxing the floors, Read More... Posted Fri, Apr 23 2010 6:06 AM by Bob Wachter | 6 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Patient Safety/Medical Errors, Health Policy

• Is Don Berwick The One?

  The Blogosphere Rumor Factory is heating up with reports that Don Berwick, the world’s most prominent advocate for healthcare quality and safety, will be the next administrator of the Centers for Medicare & Medicaid Services (CMS). (Take this with Read More... Posted Fri, Mar 26 2010 9:02 PM by Bob Wachter | 5 Comments Filed under: Quality Improvement, Pay-for-performance, Transparency and Reporting, Efficiency, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Gawande’s “Checklist Manifesto”

  Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Read More... Posted Mon, Feb 08 2010 3:26 AM by Bob Wachter | 5 Comments Filed under: Medical Education/Academia, Patient Safety/Medical Errors, Health Policy

• Why I Refused to Let Our Medical Grand Rounds Die Off

  Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, Read More... Posted Mon, Jan 11 2010 8:21 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Medical Education/Academia, Information Technology, Patient Safety/Medical Errors

• A Q&A With Me in Today's New York Times

  The interview, by Pauline Chen, the surgeon and NY Times author who writes the terrific "Doctor and Patient" column on-line, is here -- it mostly focuses on my thoughts about patient safety 10 years into the movement. The story and topic were also picked Read More... Posted Fri, Dec 18 2009 1:44 AM by Bob Wachter | 5 Comments Filed under: Patient Safety/Medical Errors

• How UCSF’s Root Cause Analysis Process Became Our Most Useful Patient Safety Activity

  Hospitals face so many urgent tasks in safety – computerize, promote teamwork, implement evidence-based safety practices, discover unsafe conditions – that it’s hard to know where to start. If you’re struggling, I recommend that you put your Root Cause Read More... Posted Thu, Dec 17 2009 6:33 AM by Bob Wachter | 16 Comments Filed under: Hospital Care, Transparency and Reporting, Patient Safety/Medical Errors

• December 1, 2009: The Patient Safety Field Turns Ten

  On December 1, 1999, the Institute of Medicine released a report entitled To Err is Human: Building a Safer Health System. Although its authors hoped to spark a national movement, they had little cause for optimism. After all, early efforts by advocates Read More... Posted Tue, Dec 01 2009 7:22 AM by Bob Wachter | 4 Comments Filed under: Hospital Care, Information Technology, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Jail Time for a Medical Error, Redux: The Case of Eric Cropp

  Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.Along comes another case involving Read More... Posted Thu, Nov 26 2009 4:47 AM by Bob Wachter | 23 Comments Filed under: Patient Safety/Medical Errors, Health Policy, Media/Press Coverage, Medical Ethics

• NY Times Magazine on Brent James’ Quest to Transform Healthcare Quality

  Just a quick heads up on an article in next weekend’s New York Times Sunday Magazine by my friend David Leonhardt. David profiles Intermountain Healthcare’s Brent James, capturing Brent’s (and Intermountain’s) unique and increasingly influential philosophy Read More... Posted Thu, Nov 05 2009 6:16 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Quality Measurement, Information Technology, Patient Safety/Medical Errors, Media/Press Coverage

• Is Healthcare IT Ready for its Big Coming Out Party?

  In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided Read More... Posted Sun, Oct 25 2009 9:15 PM by Bob Wachter | 7 Comments Filed under: Hospital Care, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Industry/Pharma, Health Policy

• Can Patients Help Ensure Their Own Safety? More Importantly, Why Should They Have To?

  Sticking with my recent hand hygiene theme, an interesting study came out last week demonstrating that outpatients were willing to help audit their providers’ hand hygiene practices. The patients felt that snooping on their docs didn’t poison the physician-patient Read More... Posted Wed, Oct 14 2009 5:38 AM by Bob Wachter | 5 Comments Filed under: Hospital Care, Ambulatory/Primary Care, Patient Safety/Medical Errors, Health Policy, Medical Ethics

• 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 Read More... Posted Wed, Sep 30 2009 7:51 AM by Bob Wachter | 27 Comments Filed under: Hospital Care, Patient Safety/Medical Errors, Health Policy, Medical Ethics

• 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 Read More... Posted Mon, Sep 28 2009 7:44 AM by Bob Wachter | 2 Comments Filed under: Medical Education/Academia, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors