Maybe you've had this experience: You attend a workshop or conference to build your skill set, you pick up new strategies and tools, and you leave energized and excited to put them to use in your hospital or clinic. Yet when you return to work, you find it hard to get the ball rolling. Colleagues(...)
To Engage Physicians in Cost Savings, Start with Quality
Posted by | Organizational and Cultural ChangeLike a pro golfer swears by a certain brand of clubs or a marathon runner has a chosen make of shoes, surgeons can form strong loyalties to the tools of their craft. Preferences for these items — such as artificial hips and knees, surgical screws, stents, pacemakers and other implants — develop over time, perhaps out of habit(...)
Potential Bias in U.S. News Patient Safety Scores
Posted by | Measurement of Safety and Quality, Preventing Patient HarmIn this post, I present the case that U.S. News & World Report’s patient safety score, a component of its annual Best Hospitals rankings, has a bias against Maryland hospitals. Two editors at U.S. News respond to my position at the bottom of the post. Hospitals can get overwhelmed by the array of ratings, rankings(...)
The Patient Wish List
Posted by | Patient-Centered CareSince undergoing a double-lung transplant at The Johns Hopkins Hospital in December 2011, Podge Reed Jr. has had four medical admissions, two surgical admissions, eight outpatient procedures requiring anesthesia, more than 100 outpatient appointments, and 700 labs and other tests. He's amassed enough experiences with the health care system to write a book. So far,(...)
Weighing the Need for Surgical Volume Thresholds
Posted by | Preventing Patient HarmIn May, three academic medical systems turned up the heat on a long-simmering debate about the link between surgical volumes and quality of care. Leaders from Dartmouth-Hitchcock Medical Center, the University of Michigan Health System and the Johns Hopkins Health System declared that their surgeons would need to meet annual volume thresholds for 10 high-risk(...)
The Surgeon Scorecard and the Need for Measurement Standards
Posted by | Measurement of Safety and Quality, Preventing Patient HarmMost of us would agree that there aren't enough valid and meaningful health care quality measures to guide patients' choices of hospitals and physicians. While the federal government has steadily expanded the number of publicly available measures on its Hospital Compare website, it still falls short of what many patients, payers and providers would like.(...)
Walking in Another Caregiver’s Shoes
Posted by | Organizational and Cultural Change, Preventing Patient HarmHow many of our conflicts could be handled better or averted if we had the opportunity to spend some time in the shoes of the person on "the other side"? When we experience a situation through another's eyes, and when we understand their work and world, true empathy, understanding and trust can emerge. This is(...)
Patient Safety Perils at 36,000 Feet
Posted by | Designing Safer Systems, Preventing Patient HarmThere are more than 50 in-flight medical emergencies a day on commercial airlines — or one for every 604 flights, according to a study published in 2013. What are the odds that two emergencies would occur on the exact same flight, above the Atlantic Ocean and hours from the nearest airport? My colleague Mark, a critical(...)
Learning from the Leaders in Patient Experience
Posted by | Organizational and Cultural Change, Patient-Centered CareHospitals across the country are searching for ways to create the "always positive" patient experience. For example, we want our patients to tell us that their pain was always addressed, that clinicians were always responsive to their needs and that our communications at discharge time always helped prepare them to take care of themselves once(...)
Blood Clots Show Limits of Quality Care Penalties
Posted by | Measurement of Safety and Quality, Preventing Patient HarmIn the world of medicine, blood clots during hospitalization have become synonymous with imperfect care. As many as 600,000 patients per year experience a blood clot, and more than 100,000 die as a result, accounting for between 5 and 10 percent of hospital deaths. Regulatory agencies have taken clots as signals that safety and quality(...)