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
• Outsourcing/Medical Tourism
• Patient Safety/Medical Errors
• Pay-for-performance
• Quality Improvement
• Transparency and Reporting

• Dr. Rand Paul: Not All Board Certifications Are Created Equal

  After serving on the board of the American Board of Internal Medicine for the past few years, I’ve come to truly appreciate the value of board certification in demonstrating – and enhancing – our competence and commitment to professionalism. But not all Read More... Posted Thu, Jun 24 2010 9:33 PM by Bob Wachter | 9 Comments Filed under: Quality Measurement, Media/Press Coverage, Medical Ethics

• 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

• Cheating on the ABIM Boards

  As a member of the executive committee of the American Board of Internal Medicine, I can’t provide too much of the inside scoop, so I’ll mainly point you to the published descriptions of a remarkable case: that of one Dr. Arora, who ran an ABIM board Read More... Posted Sat, Jun 12 2010 7:39 AM by Bob Wachter | 10 Comments Filed under: Transparency and Reporting, Quality Measurement, Media/Press Coverage, Medical Ethics

• 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

• 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

• 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 Read More... Posted Sun, Sep 20 2009 10:27 AM by Bob Wachter | 12 Comments Filed under: Hospital Care, Transparency and Reporting, Quality Measurement, Patient Safety/Medical Errors, Health Policy

• 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

• 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

• ICU Glycemic Control: Another Can’t Miss Quality Measure Bites the Dust

  A disconcerting pattern has emerged: a blockbuster study finds that a certain practice leads to improved outcomes. Large national organizations codify the practice into a quality measure, forcing widespread adoption. Later studies prove the practice to Read More... Posted Mon, Mar 30 2009 7:03 AM by Bob Wachter | 6 Comments Filed under: Quality Improvement, Hospital Care, Pay-for-performance, Transparency and Reporting, Quality Measurement, Nurses/Nursing, Health Policy

• Will Academic Medical Centers Show the Love to Their Faculty Quality Improvers?

  When we launched our hospitalist program in 1995, I dreamed that many of our faculty would become leaders in quality and patient safety. That dream has come true, but we now must leap over two hurdles: getting these superb physicians paid and promoted. Read More... Posted Sat, Feb 28 2009 9:52 AM by Bob Wachter | 1 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors

• Are We Mature Enough to Make Use of Comparative Effectiveness Research?

  Thanks to White House budget director Peter Orszag, a Dartmouth Atlas aficionado, $1.1 billion found its way into the stimulus piñata for “comparative effectiveness” research. Terrific, but – to paraphrase Jack Nicholson – can we handle the truth?In other Read More... Posted Sat, Feb 21 2009 5:48 AM by Bob Wachter | 8 Comments Filed under: Quality Measurement, Efficiency, Industry/Pharma, Health Policy, Media/Press Coverage, Medical Ethics

• Checklists (The Sequel), 5 Million Lives, and the Magic of Measurable Results

  Last month’s New England Journal included another astounding checklist study, an international extravaganza that found nearly 50% reductions in mortality and complications after implementation of pre- and post-op surgical safety checklists. Wow. Coincidentally, Read More... Posted Fri, Feb 13 2009 8:22 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors, Health Policy