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When will patients start reviewing quality data before choosing their doctors and hospitals? The answer has been “soon” for several years, but “soon” may finally be the right answer. If you doubt it, check out the Commonwealth Fund’s new site, “Why Not Read More...
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I’m on clinical service now and my patients are dying left and right. And I’ve never been prouder of my own care, and that delivered by my colleagues and hospital.When I was in training, a patient’s death was invariably considered a medical failure, and Read More...
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In responding to dysfunctional systems, America instinctively turns to “more regulation” (Exhibit A: today’s Wall Street). But regulation can, and often does, go too far, and – in patient safety – I believe that it now has.Note that this comes from someone Read More...
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Medicare is now reporting actual risk-adjusted mortality rates for pneumonia, MI, and heart failure. The topic must be important, since "Talk of the Nation" spent 30 minutes yesterday interviewing Don Berwick and me about it… on the day of Hillary’s speech! Read More...
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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...
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In today’s Annals of Internal Medicine, my colleagues and I describe the saga of the four-hour measure of door-to-antibiotics time for pneumonia – the first truly dangerous measure in the era of public quality reporting. It is an important cautionary Read More...
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In his five years on the job, Dr. Ernie Ring taught me why the Chief Medical Officer role is crucial, and how to do it right. Since Ernie is retiring at week’s end, it seems like an opportune time to share what I’ve learned.A bit of background. UCSF Medical Read More...
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As I mentioned in my last post, these should be the best of times for "Infection Preventionists" (formerly known as Infection Control Officers). After years of trying to get someone – anyone – to pay attention to their work, their day in the sun has finally Read More...
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The Joint Commission just released its 2009 National Patient Safety Goals, and – no surprise – they focus on infection prevention. While this seems natural today, it wasn’t always so. In fact, the conflation of infection control and patient safety is Read More...
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Of all the structural (how care is organized) “evidence-based markers of high quality care,” perhaps the most ironclad has been the involvement of critical care physicians in the care of ICU patients. That is, until now. In a sophisticated study in today’s Read More...
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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...
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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...
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Last week, Medicare proposed nine additional “do not pay” conditions, several months before implementing the first eight. I like the concept of not paying for preventable adverse events, but this new list is a case of too far, too fast. In my previous Read More...
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Last week, Medicare added patient satisfaction data to its hospital reporting website. This is progress, but it raises an interesting question: should patient satisfaction scores be case-mix adjusted? The motivation to include patient satisfaction data Read More...
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In this week’s JAMA, Dr. Don Berwick, CEO of the Institute for Healthcare Improvement, argues that evidence-based standards should be relaxed for quality improvement practices. Ironically, a few pages away, a Swiss study finds than an IHI-endorsed MRSA Read More...
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