The explosive growth of Facebook and MySpace illustrates the market for electronic tools to enhance communication and collaboration. Could there possibly be another workplace more in need of social networking tools than the modern hospital?If you are not familiar with Facebook, find yourself a teenager and take a look over his shoulder while he is ...

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 Center didn’t have a Chief Medical Officer until about 8 years ago; indeed, even today ...

A quick heads-up for those of you thinking about attending this year’s Management of the Hospitalized Patient (MHP) conference, October 23-25 in SF… we’re adding a hands-on, small group “Hospitalist Mini-College” pre-course. I think it will be tremendous. This will be our 12th Annual MHP conference (co-sponsored by the Society of Hospital ...

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 prevention strategy doesn't work.What’s a person or hospital to do?A little background on both ...

I must admit, I didn’t hold out high hopes that a ragtag band of committed clinicians and other quality improvers could change federal policy. But we’ve done just that. If the Feds are capable of rectifying this mistake, who knows what might be next!For those unfamiliar with the Hopkins-Michigan-OHRP checklist story, it is described on my prior ...

Thanks to all of you who have taken the time to write, blog, and rant about the OHRP's horrific decision to shut down the Hopkins-Michigan ICU checklist study, a decision that threatens the future of quality improvement and safety efforts in American healthcare. Today, the major hospital-based societies – representing over 100,000 clinicians and ...

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 will be in the details.I hope you’ll have a chance to read the full article (the Joint ...

When I was a med student, the Beating Heart of the Hospital of the University of Pennsylvania (HUP) was not the CEO’s suite, the neurosurgeon’s OR, or the Dean’s lair. It was the seat of one Wallace Miller, Sr., in the decidedly unglamorous Chest Reading Room.Do you even know where the chest reading room of your radiology department is?Everybody – ...

My friend Mark Smith, who runs the California HealthCare Foundation, once wryly observed, “Have you ever noticed that the doctors who talk about how much fun primary care is only practice it one afternoon a week?” I may have become the hospitalist version of Mark’s Ivory Tower internists, but I’ll take my chances.I just finished a two-week stint ...

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 Points can tip both ways.I laid out the issues in this prior post. Those of you who know me know ...