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• Resident Duty Hours and Patient Safety: Did The IOM Get It Right?

  The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins.Let’s start with a little background, Read More... Posted Sat, Dec 06 2008 5:23 PM by Bob Wachter | 10 Comments Filed under: Hospital Care, Medical Education/Academia, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Is it “Macaca” Time in Healthcare?

  August 11th was the 2nd anniversary of the epic implosion of George Allen's presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering whether healthcare has also Read More... Posted Tue, Aug 19 2008 8:00 AM by Bob Wachter | 1 Comments Filed under: Hospital Care, Transparency and Reporting, Information Technology, Patient Safety/Medical Errors, Media/Press Coverage

• Post-Vacation Potpourri: Items Interesting, International, and Ineffably Sad

  Just returning from a work-acation, including a talk in Buenos Aires. Today I’ll briefly cover a few items: Medicare’s final “no pay” list; patient safety in Argentina; a great post on hospital finances; and one of the saddest things I’ve ever experienced. Read More... Posted Thu, Aug 14 2008 3:07 AM by Bob Wachter | 0 Comments Filed under: Quality Improvement, Hospital Care, Transparency and Reporting, Quality Measurement, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Another Case of Wrong Site Surgery: Are We Averting Our Eyes From Some of the Root Causes?

  Yet another case of wrong-side surgery, this one at Boston’s Beth-Israel Deaconess Hospital. Though CEO Paul Levy does a nice job discussing the case on his blog, I’ll focus on two aspects Paul neglects: the role of production pressures in errors, and Read More... Posted Wed, Jul 09 2008 7:52 AM by Bob Wachter | 12 Comments Filed under: Hospital Care, Patient Safety/Medical Errors, Media/Press Coverage

• Why Diagnostic Errors Don’t Get Any Respect… And What Can Be Done About It

  I gave a keynote yesterday to the first-ever meeting on “Diagnostic Error in Medicine.” I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo would say, the experts and advocates in the audience have some ‘splainin’ to Read More... Posted Mon, Jun 02 2008 4:20 AM by Bob Wachter | 5 Comments Filed under: Quality Measurement, Medical Education/Academia, Diagnosis/Clinical Reasoning, Information Technology, Patient Safety/Medical Errors, Industry/Pharma, Health Policy, Media/Press Coverage

• The “Technology Hype Cycle”: Why Bad Things Happen to Good Technologies

  Fresh on the heels of my recent bar coding epiphany comes another “unintended consequences” article. It turns out that the whipsawing that accompanies the adoption of new technologies is completely foreseeable, the “why doesn’t this thing work right?” Read More... Posted Tue, May 13 2008 1:50 AM by Bob Wachter | 2 Comments Filed under: Information Technology, Patient Safety/Medical Errors, Industry/Pharma, Media/Press Coverage

• Oprah, Obama, Putin, Springsteen… and Pronovost

  Last week, Time Magazine named the 100 most influential people in the world. Among the luminaries was Dr. Peter Pronovost of Johns Hopkins. I thought it was an inspired choice. The modern patient safety field has been blessed with a number of important Read More... Posted Sun, May 11 2008 7:28 AM by Bob Wachter | 2 Comments Filed under: Quality Measurement, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Should Hospitals Install Bar Coding or CPOE First? Why I’ve Changed My Tune

  This is one of the most commonly asked questions in IT World, and my answer has always been “CPOE first” – largely because that has always been David Bates’s (the world’s leading IT/safety researcher) answer. But I’ve changed my mind. Here’s why. Before Read More... Posted Fri, May 02 2008 9:00 PM by Bob Wachter | 9 Comments Filed under: Hospital Care, Information Technology, Patient Safety/Medical Errors, Industry/Pharma, Nurses/Nursing, Health Policy, Media/Press Coverage

• Snooping At Britney’s Chart: Why Should Docs and Nurses Have Different Rules?

  Should doctors and nurses be subject to different penalties for precisely the same infraction? Of course not. Are they? Sure. Just ask Britney Spears. Britney was hospitalized at UCLA at least twice in the past few years – once when she gave birth to Read More... Posted Sun, Apr 20 2008 8:53 PM by Bob Wachter | 2 Comments Filed under: Hospital Care, Information Technology, Patient Safety/Medical Errors, Nurses/Nursing, Media/Press Coverage, Medical Ethics

• Is Medicare’s “No Pay for Errors” Plan a Good Idea?

  In this month’s issue of the Joint Commission Journal of Quality and Patient Safety, I (with UCSF’s Adams Dudley and the American Hospital Association's Nancy Foster) tackle this provocative question. The answer may surprise you: yes (probably). The devil Read More... Posted Mon, Feb 11 2008 7:34 AM by Bob Wachter | 2 Comments Filed under: Quality Improvement, Hospital Care, Pay-for-performance, Quality Measurement, Medical Education/Academia, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors, Nurses/Nursing, Media/Press Coverage

• Did I Violate Federal Regulations Today? (I Hope So)

  The patient safety and quality movements are precious and fragile. Just as IOM reports I and II spawned these modern, life-saving revolutions, the Federal shutdown of the Hopkins/Michigan checklist program may help extinguish them. After all, Tipping Read More... Posted Wed, Jan 16 2008 7:39 AM by Bob Wachter | 8 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• Bureaucracy Run Amok: Can Checklists Kill?

  As you may know, I’ve argued that that the quality and safety of healthcare have traditionally been underregulated. But regulators are like patients with Parkinson’s: it’s hard to get them unglued, but once they’re moving, it’s hard to stop them. Welcome Read More... Posted Fri, Jan 11 2008 4:16 AM by Bob Wachter | 10 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Medical Education/Academia, Patient Safety/Medical Errors, Health Policy, Media/Press Coverage

• A Nordstrom To-Do List: Tie, Slacks, a Little V. Tach?

  Great quote by USC cardiologist Leslie Saxon (a reporter reached her on her cell phone as Leslie was shopping) on this week’s NEJM study on delayed defibrillation: “You’re better off having your arrest [here] at Nordstrom [than in a hospital]… because Read More... Posted Mon, Jan 07 2008 4:09 AM by Bob Wachter | 0 Comments Filed under: Quality Improvement, Hospital Care, Medical Education/Academia, Hospitalists/Hospital Medicine, Information Technology, Patient Safety/Medical Errors, Industry/Pharma, Nurses/Nursing, Media/Press Coverage

• Adventures in Bizarro Land: My Don Imus Interview

  I had mixed emotions this morning when I heard that radio shock-jock Don Imus had returned to the airwaves. My 2004 interview with Imus was perhaps the wackiest experience of my life. It also made Internal Bleeding into a bestseller. Here’s the story: Read More... Posted Tue, Dec 04 2007 6:30 AM by Bob Wachter | 0 Comments Filed under: Patient Safety/Medical Errors, Nurses/Nursing, Health Policy, Media/Press Coverage