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, "We...
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 physicia...
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 DeBartolo, Nati...
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 parti...
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
True transparency in hospital PR campaigns
GOMER blog, which modestly refers to itself as the earth's finest medical satire news site, provides the ultimate in hospital transparency in this recent post, Hospitals Unleash New, Brutally Honest Slogans.Here are excerpts:Forget the days of the compassionate and uplifting slogans like “A Passion for Healing,” “Because Your Life Matters,” or “Every Day, a New Discovery.” With record numbers of nurses and doctors burning out and hospitals busting at the seams with sicker and sicker patients, hospitals are waving their white flags and this is being reflected in new, brutally-honest slogans to deter patient...
Source: Running a hospital - January 12, 2015 Category: Health Managers Source Type: blogs
Lightning goes to ground
I respect and admire Lucien Engelen, the spirit behind the REshape Center for Innovation at Radboud University Medical Center in the Netherlands, so when he recently posted an article entitled, "10 TED talks that change(d) healthcare," I was intrigued. Who doesn't love TED talks, after all?But then I concluded that he was off base.Not because the talks aren't great. They are great. They are stimulating, well presented, thoughtful, and challenging.But they have not changed health care. Look through the talks and see what's imagined in them. Now, compare them to what's happening on the ground in most...
Source: Running a hospital - January 10, 2015 Category: Health Managers Source Type: blogs
Don't drive home wet
We all expect our car’s airbag to work in the case of emergency. So what happens when it has been automatically shut off without warning?We thought something was wrong with the airbag shutoff switch in our 2012 Subaru Impreza. We’d be driving along, and all of a sudden the passenger airbag would shut off, leaving the passenger unprotected.So we called the dealer and had the switch checked. No problem, we were told. Maybe the passenger shifted her weight and the switch turned off.Then, this week, a service attendant mentioned that the on-off switch had nothing to do with weight. It was based on the amount of...
Source: Running a hospital - September 1, 2014 Category: Health Managers Source Type: blogs
Why pay for end-of-life conversations?
A story by Pam Belluck in the New York Times left me with mixed feelings. Here's an excerpt:Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. Some states, including Colorado and Oregon, recent...
Source: Running a hospital - September 1, 2014 Category: Health Managers Source Type: blogs
Playing politics
Here's a very clever ad from Don Berwick, who is running for governor in Massachusetts. Even if you are voting for someone else--or live out of state--it's worth a smile! (Source: Running a hospital)
Source: Running a hospital - August 30, 2014 Category: Health Managers Source Type: blogs
Oops, too much morphine
A resident noticed a human factors problem that led to an accidental overdose of morphine to a patient. It wasn't fatal, but it led to some concern, and as he notes could be more problematic in other cases. A good catch for sure by an alert young professional!The problem is with this drug choice given on the Epic electronic ordering system at his hospital:What the problem? He explains.It is understandable that the nurse gave 20mg of morphine to the patient, since the first number in big blue letters after the word morphine is "20". The actual dose, 10mg, comes after "20MG/ML concentrated oral solution"...
Source: Running a hospital - August 29, 2014 Category: Health Managers Source Type: blogs
Factoring in human factors
This article in Crain's Detroit Business (originally from Modern Healthcare) notes:Recent studies have found that rapid implementation of new medical technology — electronic health records, patient monitoring devices, surgical robots and other tools — can lead to adverse patient events when it is not thoughtfully integrated into workflow. The right processes require understanding the devices and the users. Testing in controlled environments often does not adequately consider the “human factor,” or how people interact with technology in high-pressure, real-life situations.From 2011 to 2013, human-factor issue...
Source: Running a hospital - August 29, 2014 Category: Health Managers Source Type: blogs
Union attacks one buyer, supports private equity firm
The plot thickens. Remember my story from yesterday about an SEIU corporate campaign against a health system? Now, Beth Kutscher at Modern Healthcare adds a new report:The Service Employees International Union-Healthcare Workers West is stepping up its campaign to block the sale of Daughters of Charity Health System to Prime Healthcare Services, which is accusing the union of racketeering and extortion. The media campaign comes one day after Prime Healthcare Services filed a lawsuit in U.S. District Court in San Francisco against the California-based union. Prime contends that the SEIU's efforts represent a s...
Source: Running a hospital - August 28, 2014 Category: Health Managers Source Type: blogs
