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• 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

• Why Obama Made the Right Call on Berwick

  The recess appointment of Don Berwick to lead CMS can be seen as a cynical act of political opportunism, sidestepping the Congressional approval process using a tactic worthy of Machiavelli, or Karl Rove. Or it can be viewed as a pragmatic decision by Read More... Posted Thu, Jul 08 2010 6:25 PM by Bob Wachter | 13 Comments Filed under: Quality Improvement, Efficiency, Health Policy, Media/Press Coverage

• 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

• Badness in Baltimore: Can Peer Review Catch Rogue Doctors?

  A couple of months ago, a Baltimore reporter called to get my take on a scandal at St. Joseph’s Hospital in Towson, an upscale suburb. A rainmaker cardiologist there, Dr. Mark Midei, had been accused of placing more than 500 stents in patients who didn’t Read More... Posted Tue, May 11 2010 6:42 AM by Bob Wachter | 15 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Health Policy, Media/Press Coverage, Medical Ethics

• 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

• Glenn Steele at CMS – A "Not So Fast, Schwartz"?

  FYI, Glenn wrote to family and friends last night saying that he is not the new CMS administrator. We'll see...(Lesson – don't believe everything you read in the blogosphere. Yes, even mine.) Turning to more important matters, now I've gotta decide about Read More... Posted Thu, Jan 28 2010 2:33 PM by Bob Wachter | 0 Comments Filed under: Quality Improvement, Health Policy

• Glenn Steele at CMS?

  If you’re in healthcare, the most important announcement today will not be Steve Jobs’ introduction of the iPad (thrilling as that is). Rather, it will be President Obama’s expected announcement of the appointment of Dr. Glenn Steele as the new director Read More... Posted Thu, Jan 28 2010 1:38 AM by Bob Wachter | 1 Comments Filed under: Quality Improvement, Health Policy, Media/Press Coverage

• 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

• 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

• My Interview on The Health Care Blog

  If for some reason you haven't gotten enough of me on Wachter's World, I just did a long, fun interview with Matthew Holt on the always-interesting THCB. We cover patient safety, the future of IT, the demise of primary care, Death Panels, and more. I Read More... Posted Wed, Aug 19 2009 3:48 PM by Bob Wachter | 2 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Efficiency, Medical Education/Academia, Hospitalists/Hospital Medicine, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Health Policy

• Gawande Nails It on Healthcare Costs

  I just finished reading Atul Gawande’s June 1st New Yorker piece – it's the Talk of the Health Policy Town – on healthcare’s “Cost Conundrum.” Like most of Atul’s work, the article is lyrical, powerful, insightful, and correct.As you’ve probably heard, Read More... Posted Fri, Jun 05 2009 10:55 PM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Hospital Care, Efficiency, Health Policy, Media/Press Coverage, Medical Ethics

• A Remarkable Interview: Obama on Healthcare

  I hope you had a chance to read David Leonhardt’s interview with President Obama in last Sunday’s NY Times Magazine. The feel was that of hanging out with two really smart friends discussing the issues of the day over beers. What a treat! In addition Read More... Posted Sun, May 10 2009 6:57 PM by Bob Wachter | 7 Comments Filed under: Quality Improvement, Transparency and Reporting, Quality Measurement, Efficiency, Information Technology, Health Policy, Media/Press Coverage, Medical Ethics

• On Quality Measurement, Babies, and Bathwater

  Quality Measurement mavens are reeling these days, as a result of the air being let out of high-profile measures such as tight glucose control, door-to-antibiotic time, and beta-blockers. Some critics have even suggested that we put a moratorium on new Read More... Posted Thu, Apr 16 2009 7:17 AM by Bob Wachter | 6 Comments Filed under: Quality Improvement, Hospital Care, Pay-for-performance, Transparency and Reporting, Quality Measurement, Health Policy, Media/Press Coverage

• “Mr. Obama, Tear Down These (Hospital) Walls”: Readmissions in Context

  I like readmissions. Well, that didn’t come out quite right, did it? What I mean is that I like focusing on readmissions as a potentially actionable quality measure. I believe that it’s possible to prevent many readmissions, thereby improving quality Read More... Posted Sat, Apr 04 2009 12:36 AM by Bob Wachter | 10 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Efficiency, Hospitalists/Hospital Medicine, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Health Policy