--30--
With 4646 blog posts dating back to August 2006, it's time to end this adventure. After over 9-1/2 years of almost daily output, I will cease adding new posts to this blog.Why? The main reason is that it is simply time to move on to other pursuits. The time and effort spent conceiving, researching, writing, and editing articles has pushed off other projects that I've had in mind for several years. I'd like to focus on those.I'm deeply appreciative of my loyal and engaged readers.  They commented directly on the blog over 22 thousand times, and many have also sent private emails with their observations.  The reade...
Source: Not running a hospital - March 15, 2016 Category: Hospital Management Source Type: blogs

How to get patient opinions: Ask.
Michael Greco and his mates at Patient Opinion have developed a simple and useful way to collect opinions about medical care from patients and provide a lovely forum for interactions back and forth with the hospital and providers.  The purpose is simple: To enable and enhance issue resolution, relationship restoration, and improvement. An easy-to-use website makes it possible.The folks at Eastern Health in Victoria have had PO in place for some time.  Here are some stories from their health system.  As you can see, things go in both directions in a helpful, direct, and friendly fashion.  In fact, this f...
Source: Not running a hospital - March 15, 2016 Category: Hospital Management Source Type: blogs

Callahan tells about stories
With a plethora of books about the value and importance of storytelling, we might wonder if another could offer any value. Well, the answer is yes, emphatically.Shawn Callahan's about-to-be released book Putting Stories to Work: Mastering Business Storytelling, is a must-have for your actual or digital library.  It is available now on pre-order and will be on the "bookshelves" on March 20.Shawn is the founder of Anecdote, the world’s largest business storytelling company.  His book is engaging and wise, and yes, replete with useful stories. His advise is concise and helpful, and--unsurprisingly--h...
Source: Not running a hospital - March 14, 2016 Category: Hospital Management Source Type: blogs

US News rankings reward transparency
Regular readers will know that I am no fan of hospital rankings and have been quite critical over the years at the ones at US News and World Report.  But let's give credit to where it is due:Check out this news release. Excerpts:Patients and families who've used our rankings tell us they want more from hospitals. What they want is meaningful transparency.U.S. News will implement two closely related methodology changes this spring that could drive broader transparency. Both will affect only our rankings of Best Hospitals in Cardiology & Heart Surgery. In that specialty, we will award credit to hospitals that public...
Source: Not running a hospital - March 14, 2016 Category: Hospital Management Source Type: blogs

Meanwhile, back in Massachusetts
It's been some time since I commented on issues of market dominance in Massachusetts, but a recent story by Bruce Mohl at Commonwealth Magazine caught my interest. He writes about a petition being supported by a health care union, SEIU, and Steward Health Care that would mandate a flattening of rate disparities among the state's hospitals.The Massachusetts Hospital Association opposes the ballot question.  Mohl notes:All but one of the hospital association’s board members head institutions that would benefit financially from the ballot question, but nevertheless they have formed a united front against it. Their ...
Source: Not running a hospital - March 13, 2016 Category: Hospital Management Source Type: blogs

Getting past denial in Victoria
You have to be willing to acknowlege your problems before you can remedy them.  If I were to characterize the state of public and private hospital care in the state of Victoria, Australia, I'd have to say that this first step is lacking.  Both the public and private hospital systems and the goverment regulators who oversee them are in a state of denial with regard to the level of harm being caused to the public by inadequate attention to quality and safety deficiencies. The health system as a whole, also, is characterized by an uwillingness to engage patients and families in the appraisal and improvement of care....
Source: Not running a hospital - March 12, 2016 Category: Hospital Management Source Type: blogs

Time for a " no dickheads " rule
This article notes: Much of the polarization dividing American politics was fueled not just by gerrymandering or money in politics or the other oft-cited variables, but by an unnoticed but surprisingly large electoral group — authoritarians. This trend had been accelerated in recent years by demographic and economic changes such as immigration, which " activated " authoritarian tendencies, leading many Americans to seek out a strongman leader who would preserve a status quo they feel is under threat and impose order on a world they perceive as increasingly alien. There was never a more important time f...
Source: Not running a hospital - March 9, 2016 Category: Hospital Management Source Type: blogs

Time for a "no dickheads" rule
This article notes: Much of the polarization dividing American politics was fueled not just by gerrymandering or money in politics or the other oft-cited variables, but by an unnoticed but surprisingly large electoral group — authoritarians.This trend had been accelerated in recent years by demographic and economic changes such as immigration, which "activated" authoritarian tendencies, leading many Americans to seek out a strongman leader who would preserve a status quo they feel is under threat and impose order on a world they perceive as increasingly alien.There was never a more important time for people...
Source: Not running a hospital - March 9, 2016 Category: Hospital Management Source Type: blogs

Mateship
You can't be here in Australia for very long before hearing about the concept of "mateship."  Here are some explanations:Wikipedia says: "Mateship is an Australian cultural idiom that embodies equality, loyalty and friendship."But it goes further than that.  This government site says:'Mateship' is a concept that can be traced back to early colonial times. The harsh environment in which convicts and new settlers found themselves meant that men and women closely relied on each other for all sorts of help. In Australia, a 'mate' is more than just a friend. It's a term that implies a sense of shar...
Source: Not running a hospital - March 9, 2016 Category: Hospital Management Source Type: blogs

What can I do? May Wong answered the question.
The most common question I get--worldwide--after I give a talk or seminar on creating a learning organization to improve clinical processes in hospitals is:  "I really like what you are saying, but what can I do if those above me in the organization have not adopted the philosophy you espouse."  I respond by saying, "Start small, and just try to get something fixed in your area, working with other like-minded people. Maybe the ideas will spread organically. Maybe they won't, but at least you will have made things better for some."Well, May Wong from Sydney didn't need my advice.  My buddy...
Source: Not running a hospital - March 9, 2016 Category: Hospital Management Source Type: blogs

Staff at work
One of the great pleasures of being ex-CEO of a hospital is to visit other places around the world and see the staff in action.  Whatever you might have heard about the stresses and problems faced by doctors and nurses and others, there remains an underlying sense of purpose and commitment that often shines through.Here's a example, from the theatre in which young patients at Royal Children's Hospital receive lumbar punctures and bone marrow tests to receive chemotherapy and/or to assess their progress with regard to leukemia treatments.  I offer the explanation totally in pictures, which pretty well tell the sto...
Source: Not running a hospital - March 4, 2016 Category: Hospital Management Source Type: blogs

What will their legacy be?
A danger of being "Thinker in Residence" for several months here in the state of Victoria, Australia, is the danger of diagnostic anchoring--too quickly reaching conclusions about the state of the health care system--followed by confirmation bias--valuing only those observations that support the conclusion you've reached, while ignoring other data.  With cognitive errors of this sort, the best defense in avoiding them is to be aware of their existence.  So, I've tried assiduously to be careful during my visit here.  But the time has come to offer my considered view on several matters.In a recent bl...
Source: Not running a hospital - February 29, 2016 Category: Hospital Management Source Type: blogs

Hear me. Do you know me?
It isn't often that I can report that I was honored to see a play, but such was the case recently when I was invited to view the showing of a short four-person drama at West Gippsland Hospital in Warragul and especially because I was permitted to attend the staff discussion that followed the performance.  Here's the background:The Australian Institute for Patient and Family Centred Care was established a few years ago by Catherine Crock and colleagues to promote just what its name implies.  As noted:We aim to to transform people’s experience of healthcare through a three-fold approach:Develop partnerships b...
Source: Not running a hospital - February 27, 2016 Category: Hospital Management Source Type: blogs

Towards zero on the roads in Oz
In America, drivers don't try to kill other drivers. In Australia, drivers try not to kill other drivers.After almost three months here, I've decided that this difference in attitudes is the biggest thing that separates these two cultures.America was built on a culture of individualism, sometimes called "rugged individualism."  In Australia, society is characterized by a much greater degree of communitarianism.The place of traffic fatalities in the two countries provides a nice example.There are about 32,000 traffic-related fatalities in the US per year, about 10 per 100,000 population.  I think if you ...
Source: Not running a hospital - February 27, 2016 Category: Hospital Management Source Type: blogs

Ultimate advice
When I was growing up, ultimate (originally known as ultimate frisbee) had not yet been invented.  While we played with frisbees, it was mainly just a lot of tossing them around.  Since then, the sport has developed and highly skilled players and teams compete worldwide.I've had a forced sabbatical from playing soccer here in Melbourne (no one plays during the summer apparently), but have been lucky to be invited to join a local co-ed division three ultimate team.  It's been great fun to play a sport which in which the rules are self-enforced, i.e., without referees, and where the "spirit of the game&qu...
Source: Not running a hospital - February 22, 2016 Category: Hospital Management Source Type: blogs

Sea spurge, compacts, and other descendants of Wipe off 5
Today's story is about how to implement a cultural change among a large group of people.  Stick with me, as this will take a moment.Back in 2001 the Victoria Transport Accident Commission wanted people to slow down just a bit while driving.  They understood that "Speeding just 5km/hr over the speed limit can mean the difference between a close call and a serious accident."  The question was how to get people to do it, and do it consistently.  Of course, you could have police and traffic cameras trying to enforce the speed limit, but that is resource intensive and can never be pervasive en...
Source: Not running a hospital - February 17, 2016 Category: Hospital Management Source Type: blogs

Correlation ≠ cause and effect
I was recently directed to a lovely example of how an observation of correlation can be misinterpreted with regard to cause and effect.*  It comes from Mind of the Raven by Bernd Heinrich.  Here's the excerpt:At dusk on September 7, 1997, a cougar crept up on Ginny Hannum as she was working at the back of her cabin at the head of Boulder Canyon in Colorado.  The cougar crouched low among the rocks, facing her from about twenty feet, and it was ready to pounce.  Although Mrs. Hannum was unaware of the cougar's presence, she had become "somewhat annoyed" by a raven "putting on a fuss l...
Source: Not running a hospital - February 14, 2016 Category: Hospital Management Source Type: blogs

" A good way for doctors to let patients know they are antiquated and unfriendly "
A friend here in Melbourne visiting a doctor in the community took this picture from the bulletin board in the doctor's waiting room.   I posted it on Facebook with the comment: " I know some doctors feel frustrated about this issue, but even if they do, is the waiting room a really good place to put up a sign like this? " Within hours, I received a slew of comments, and I repeat a few of them here. Condescending, much? Gotta fight snark with snark! My search engine spends more than 2 minutes with me, doesn't disregard my input, and is available for follow up...so it'd be hard to confuse with...
Source: Not running a hospital - February 11, 2016 Category: Hospital Management Source Type: blogs

"A good way for doctors to let patients know they are antiquated and unfriendly"
A friend here in Melbourne visiting a doctor in the community took this picture from the bulletin board in the doctor's waiting room.  I posted it on Facebook with the comment:"I know some doctors feel frustrated about this issue, but even if they do, is the waiting room a really good place to put up a sign like this?"Within hours, I received a slew of comments, and I repeat a few of them here.Condescending, much?Gotta fight snark with snark! My search engine spends more than 2 minutes with me, doesn't disregard my input, and is available for follow up...so it'd be hard to confuse with a real doc. It is...
Source: Not running a hospital - February 11, 2016 Category: Hospital Management Source Type: blogs

Ask, instead, why they would want to leave
It isn't often that I am surprised in a negative way by something relating to an Ohio pediatric hospital.  Indeed, the hospitals in that state have been at the forefront of working together to enhance quality and safety for their patients.But this recent story in the Columbus Dispatch caught my eye. An excerpt:Non-compete agreements built into contracts help ensure that doctors can’t join a hospital’s crosstown rival or enter private practice across the street — at least for a while.The choice to relocate elsewhere to practice medicine is especially limited for pediatric specialists employed by Natio...
Source: Not running a hospital - February 9, 2016 Category: Hospital Management Source Type: blogs

In memoriam: The Boston Courant
In the end, The Boston Courant did not shut down because of the oft-discussed pressures on the print media.  No, it was because of legal fees and a judgment made against the newspaper from a former employee's lawsuit.David Jacobs and Gen Tracy and their loyal crew worked hard to provide neighborhoods of Boston with relevant, current news--well written and clearly presented.  Advertisers rewarded the paper with their business because it was widely and consistently read.The owners and staff deserve to feel proud about their contribution to the City, which will be diminished by the absence of their newpaper. (Source...
Source: Not running a hospital - February 9, 2016 Category: Hospital Management Source Type: blogs

Cruelty and enlightenment
I don’t know if the following observations are profound or trite or somewhere in between. They are prompted by a recent visit to the Cascades Female Factory in Hobart, Tasmania.Every country, it seems, has something to be ashamed of in its history. Certainly, among other things, the US bears blame for its treatment of native Americans, slaves imported from Africa, and forced detention of Japanese descendants during World War II.And yet, those same countries have often made contributions to political systems that are truly noteworthy in the advancement of human society.  Think of the principles espoused in the Ma...
Source: Not running a hospital - February 8, 2016 Category: Hospital Management Source Type: blogs

There is no Holy Grail, just small chalices
Given the stakes to society and the persistent growth in health care delivery costs throughout the developed nations, there is an understandable desire to achieve the “breakthrough” technological solutions that will result in a substantial disruption in diagnostic and treatment practices and patterns that have evolved over the decades.  Well intentioned and intelligent people with thoughtful ideas are focused on ways to achieve these solutions.  Investors, seeing the large (and growing) percentage of each nation’s GDP that is devoted to health care, likewise hunger for the opportunity to grab ev...
Source: Not running a hospital - February 7, 2016 Category: Hospital Management Source Type: blogs

There is no billing code for compassion
I am borrowing a line from Dr. Amy Ship, the 2009 recipient of the Campassionate Caregiver Award from the Schwartz Center, to remind folks that nominations are now open for this coming year's award. The award recognizes health care professionals who display extraordinary devotion and compassion in caring for patients and families.  It is open to health care professionals who work in any U.S. health care setting. The nomination deadline is March 31, 2016. Here's the link.There's no better way to express your appreciation to a friend, colleague, or caregiver than to nominate them for this honor. (Source: Not running a hospital)
Source: Not running a hospital - February 4, 2016 Category: Hospital Management Source Type: blogs

Plus ça change
I mean no disrespect to my Australian hosts when I say that I've seen this all before.  The details differ, but the same underlying themes emerge. And when stories are placed side by side, it can be confusing to the public.In Australia, the government strongly encourages private health insurance coverage for a portion of the population, a policy that was designed to reduce overcrowding in the public hospitals.  There are a whole series of regulations that influence both corporate and individual behavior in this arena.  These rules have essentially created the private health insurance market in the country. A...
Source: Not running a hospital - February 3, 2016 Category: Hospital Management Source Type: blogs

Mind the step!
One of my "thinker in residence" sponsors here in Australia is VMIA, the Victoria state government insurance agency.  I had just finished having a lovely cup of coffee and conversation with one of the agency's executives, where our topic had been risk assessment and mitigation.As I started to leave the coffee shop (not a state agency facility!), I stumbled and looked back to see a drop in the floor levels between two parts of the restaurant.  While I can be clumsy (just ask my soccer buddies!), usually I'm pretty adept at walking out of restaurants without suffering harm.  So, I looked back to reco...
Source: Not running a hospital - January 31, 2016 Category: Hospital Management Source Type: blogs

A canary in the coal mine?
How should we think about medical malpractice claims against doctors?  Are they indicative of something about those doctors who've been sued? Are they a symptom of underlying quality and safety issues in a hospital, a kind of canary in the coal mine that suggests there might be deeper problems?  These are long-standing questions.Perhaps part of the answer is provided in a new article in the New England Journal of Medicine, "Prevalence and Characteristics of Physicians Prone to Malpractice Claims," by David Studdert and colleagues.  (The article has a theme that is somewhat consistent to one I discu...
Source: Not running a hospital - January 27, 2016 Category: Hospital Management Source Type: blogs

Don't forget to floss . . . and take your drugs
An MD friend is a substance abuse counselor here in Massachusetts.  She reported to me that a substantial percentage of her clients have been able to maintain their addiction through supplies of opiates prescribed by dentists. In all the recent talk about excessive use of opiates, I had never heard about this source.So I wondered if there has been any study of this by the profession or coverage of this issue by the media.  After a search, I found this 2010 report from the Tufts Health Care Institute Program on Opioid Risk Management.  Excerpts:The top specialty prescribing IR [immediate release] opioids in t...
Source: Running a hospital - February 1, 2015 Category: Health Managers Source Type: blogs

Help the snowbirds: Transparency as an enforcement tool
Elisabeth Rosenthal at the New York Times has a gift for taking what is right in front of us and unnoticed and making it evident.  She does it again in this story about elderly "snowbirds" in Florida who are persuaded by doctors there to undergo unnecessary tests. The lede:Like many retirees, one couple from upstate New York visit doctors in their winter getaway in Florida. But on a recent routine checkup of a pacemaker, a cardiologist there insisted on scheduling several expensive tests even though the 91-year-old husband had no symptoms.“You walk in the door, and they just start doing things,” ...
Source: Running a hospital - February 1, 2015 Category: Health Managers Source Type: blogs

Do you know you're in my lane?
An excellent video about texting while driving: (Source: Running a hospital)
Source: Running a hospital - February 1, 2015 Category: Health Managers Source Type: blogs

Success in Ipswich
Back in 2012, my colleague and I ran some workshops for senior management and clinical leaders introducing the Lean philosophy and some of its practices at Ipswich Hospital NHS Trust.  As noted at the time:We started with an introduction based on the Toast Kaizen video produced by and featuring GBMP president Bruce Hamilton.  Then it was off to gemba, the "factory shop" floor, where the class members shadowed a member of the staff. The idea was to practice observation skills and try to identify the various types of waste found in all organizations. The class members gained a new appreciation for th...
Source: Running a hospital - January 31, 2015 Category: Health Managers Source Type: blogs

The judge saw through the lie
In a Boston Globe story, here's how Priyanka Dayal McCluskey reports on how the outgoing CEO of Partners Healthcare System described the deal that was turned down today by Suffolk Superior Court Judge Janet L. Sanders:“The judge has said ‘no’ to an agreement that we believe would have paved a pathway to delivering high-quality care closer to home for patients and their families in a lower cost community-based setting."Well, no.  First of all, there was no need for PHS to acquire these hospitals to achieve proper care management for patients.  All it takes is an agreement to coordinate care ...
Source: Running a hospital - January 30, 2015 Category: Health Managers Source Type: blogs

Marching, but where? Moscow, I fear.
Melanie Evans and Bob Herman at Modern Healthcare report that "a new task force made up of providers, insurers and employers has committed to shift 75% of its members' business into contracts with incentives for health outcomes, quality and cost management by January 2020."What's up? Well, the theory is that risk-based payment mechanisms like "accountable care, bundled payments and other contracts with the potential for rewards or penalties based on quality performance and better cost control" will bring about greater efficiency and higher quality in the health care system.  It is argued that the c...
Source: Running a hospital - January 29, 2015 Category: Health Managers Source Type: blogs

Lynne: Initial CMS Evaluations of Readmissions Have Serious Flaws
Joanne Lynn M.D., Director of the Center for Elder Care and Advanced Illness at Altarum Institute, wields a scalpel and a battle axe in her recent criticism of initial CMS evaluations of readmissions. The lede:The Centers for Medicare and Medicaid Services (CMS) has quietly put out two evaluations of the readmissions work– and both documents are remarkable for their failure to evaluate the programs fairly or to provide insights as to what works in what circumstances.Excerpts:The readmissions/discharges metric that CMS and its evaluators use for categorizing success or failure is seriously flawed.  There is no re...
Source: Running a hospital - January 29, 2015 Category: Health Managers Source Type: blogs

John Q. Sherman Award for Excellence in Patient Engagement
It's time again for the John Q. Sherman Award for Excellence in Patient Engagement.This year’s award will be conferred by Standard Register Healthcare in partnership with the National Patient Safety Foundation’s (NPSF) Lucian Leape Institute at the 2015 NPSF Patient Safety Congress in Austin, Texas on April 30 and the award-winning program will be featured on EngagingPatients.org.Last year the award was given to the Open Notes Collaborative and Dr. Nasia Safdar, hospital epidemiologist for the University of Wisconsin Hospital. Who was Mr. Sherman?  Here's background:Founder of Standard Regis...
Source: Running a hospital - January 29, 2015 Category: Health Managers Source Type: blogs

Sampson engages through Chop Chop
I love Sally Sampson's enthusiastic persistence with regard to teaching kids about tasty good food.  She has been publishing Chop Chop magazine for some time now, and each issue is a treasure of ideas and stories.  The magazine is widely endorsed by pediatricians and is distributed through children’s hospitals, health centers, public schools, afterschool programs, Indian reservations, and community organizations. ChopChop is also available at newsstands and by subscription.Here's the latest set of blog posts. I like this one on knife skills, with this introduction:Slicing, dicing, chopping, and cutting: it&...
Source: Running a hospital - January 29, 2015 Category: Health Managers Source Type: blogs

WIHI on identifying patients with complex needs
Madge Kaplan writes:The next WIHI broadcast — When Everyone Knows Your Name: Identifying Patients with Complex Needs — will take place on Thursday, January 29, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Catherine Craig, MPA, MSW, Independent Consultant; Faculty, Better Health and Lower Costs for Patients with Complex Needs, IHIMatt Stiefel, MPA, MS, Senior Director, Center for Population Health Care Management Institute, Kaiser PermanenteEleni Carr, MBA, MSW, Senior Director of Care Integration, Cambridge Health AllianceKathy Weiner, MHSA, Regional Executive Director, Medicare, Ka...
Source: Running a hospital - January 28, 2015 Category: Health Managers Source Type: blogs

Would you have guessed this percentage?
A friend of mine with small children, on advice of his pediatrician, inquires of the parents of playmates whether they have a gun in their house.  (This is also the advice of the Brady Center.)  If so, he respectfully asks that the play date take place in his home instead of theirs.  Here's the surprise (at least to me):  30% of families he has talked to have guns.  This, in my hometown, one of the highly educated, affluent, low-crime rate suburbs west of Boston. (Source: Running a hospital)
Source: Running a hospital - January 28, 2015 Category: Health Managers Source Type: blogs

Change Day in Oz
A lovely note from Oz, from my buddy Mary Freer.  I'm happy to share worldwide so people can join in directly or vicariously--and perhaps share it further:I wanted to share with you the gorgeous little film that we have just made for Change Day Australia. Here's the link.It's 4 minutes of wonderful inspiration. If you are encouraged by it you might like to share it with your colleagues.Change Day in Australia is growing and providing this incredible platform for health and social care professionals to put forward the best version of themselves.We are making Change Day work through sheer determination and passion. We c...
Source: Running a hospital - January 28, 2015 Category: Health Managers Source Type: blogs

Not ambulance chasers, bus chasers!
Remember this story about an out-of-town bus that crashed into a too-low bridge underpass in Boston?Well, in the category of a story that takes on its own life, the Bucks County Courier Times reports:Eleven Bucks County residents seriously injured when the charter bus they were riding on hit an overpass in Boston almost two years ago have filed a more than $15 million civil suit alleging the GPS improperly routed the bus driver onto the height-restricted road.“Faulty directions by GPS systems have resulted in numerous bridge collisions throughout the U.S. The systems do not take into account the height of the vehicle...
Source: Running a hospital - January 27, 2015 Category: Health Managers Source Type: blogs

Good step by AG Healey. Next steps?
Brava to the new Massachusetts Attorney General, Maura Healey, for indicating her displeasure with the Partners Healthcare System deal submitted by her predecessor.  I'm guessing that the Court is now very unlikely to appprove the proposed settlement.  That's good.What next?  It would be tempting to view this question of system expansion as solely a Partners issue.  After all, they have extensive market power.  But the fact is that all of the major systems in the state are acting to expand their reach through mergers and acquisitions.It's time to put a stop to all such anti-competitive activities.T...
Source: Running a hospital - January 27, 2015 Category: Health Managers Source Type: blogs

Against the grain
There was a session at the Jaipur Literature Festival that I found surprisingly close to home in the health care world.  It was titled “Against the Grain” and was summarized as follows: Voices of individual courage and conviction examine strategies of steadfast truth telling in the face of social pressure and mass opinion.The panelists comprised a Who’s Who of writers who have taken a stand and engaged in acts of conscience in their work.Swapan Dasgupta, an Indian conservative columnist, says he is labeled as “contrary because I betray my class, “ a group that has “a self-image of b...
Source: Running a hospital - January 26, 2015 Category: Health Managers Source Type: blogs

Frankopan offers a view from the East
It is often said that you cannot understand the politics, acrimony, and wars of Asia Minor and the Middle East without understanding the place of the Crusades in the region's history.  In a marvelous pairing with that thought, Peter Frankopan has written a book that suggests that you cannot understand why the First Crusade occurred without an understanding of what was happening in the Byzantine Empire, and especially the region extending east from Constantinople.I met Peter after he gave a marvelous talk at the recent Jaipur Literature Festival.  Now I've finished the book and am pleased to highly recommend it.It...
Source: Running a hospital - January 25, 2015 Category: Health Managers Source Type: blogs

A view from Rajasthan
I'll be reporting soon on some observations from the Jaipur Literature Festival held this past week in Rajasthan, India.  The festival was created by author William Dalrymple (seen here during the opening session) several years ago.  He jokes that 14 people attended the first year, many of whom were a group of Japanese tourists who had lost their way and walked into the venue in error!  Now, thousands attend and hear presentations from and mingle with many of the leading authors from Asia and around the world.  The event is a non-stop five day affair, with parallel sessions from 10am to 6pm every day.&n...
Source: Running a hospital - January 25, 2015 Category: Health Managers Source Type: blogs

On holiday
I'll be taking a blogging break for several days.  See you in a while. (Source: Running a hospital)
Source: Running a hospital - January 19, 2015 Category: Health Managers Source Type: blogs

Where are the medical associations?
Over the last several years, many of us have raised issues concerning the propriety and appropriateness of doctors receiving funding from medical device companies.  For my part, I consider such payments as harmful, violating the trust between doctors and patients.  In some cases, they clearly influence the clinical behavior of doctors.  In other cases, they simply raise doubts about doctors' loyalty to patients' interests at a time when we should be enhancing that partnership, rather than eroding it.  When I make these points--in general or in specific--many US doctors respond by saying, in essence, &qu...
Source: Running a hospital - January 15, 2015 Category: Health Managers Source Type: blogs

ACO: Let's start with organized
Dartmouth's Eliott Fischer once asked whether accountable care organizations would be accountable, caring, and organized.  For this concept to succeed, things are going to have to work a lot better than set forth in a friend's recent note about her elderly parent:After Mom spent the night in the ER a week ago, I asked the hospital to send the assisted living place the discharge summary (which they had requested, to their credit.)  The hospital said they would when it was dictated.  I got the fax number for them and, of course, it never happened.So now the assisted living place, which has its own physician, w...
Source: Running a hospital - January 14, 2015 Category: Health Managers Source Type: blogs

End-of-Life Conversation Ready on WIHI
Madge Kaplan writes:The next WIHI broadcast — End-of-Life Care and How Communities Can Become “Conversation Ready” — will take place on Thursday, January 15, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Jean Abbott, MD, MH, The Conversation Project, Boulder County; Faculty, Center for Bioethics and Humanity & Professor Emerita, Emergency Medicine, University of ColoradoDiana Silvey, MA, Program Director, Winter Park Health FoundationKimberly Flowers, MSW, LICSW, Senior Outreach Social Worker, Elder Services of the Merrimack Valley (Northeastern Massachusetts) Kate De...
Source: Running a hospital - January 14, 2015 Category: Health Managers Source Type: blogs

More on fast food in Melbourne children's hospitals
My post on fast food in children's hospitals received a lot of comments.  Here's the latest chapter from Melbourne, an opinion piece in The Age written by Alessandro Demaio.  He says, in part:As a medical doctor and as a public health scientist working internationally, I can assure Victorians that there is good scientific evidence to support our concerns. This is not about banning or taking away choices in a nanny state. Excluding a US multinational from selling junk food inside our public hospitals is simply sound health policy. It is about sending a clear and consistent message to the community, and particularl...
Source: Running a hospital - January 12, 2015 Category: Health Managers Source Type: blogs

Time to think about Telluride
The deadline for applying to the Telluride Patient Safety camps has been extended to February 15.Repeating my earlier post here:Here's a lovely video summary of the Telluride Summer Patient Safety Camps that are conducted for residents and medical students.  The official name is now: Academy for Emerging Patient Safety Leaders: The Telluride Experience.  If you know anyone who might be interested, please have him or her apply, here. (Source: Running a hospital)
Source: Running a hospital - January 12, 2015 Category: Health Managers Source Type: blogs