November 2007 - Posts

• The Weekly Roundup…

  Stuff this week that caught my eye: Does medical tourism harm the natives? Are all those CT scans destroying more than our budgets? Are nocturnalists at risk for more than decubs? Will Medicare need to cut hospital payments to fuel P4P? Answers: yes, Read More... Posted Fri, Nov 30 2007 9:45 PM by Bob Wachter | 0 Comments Filed under: Hospital Care, Pay-for-performance, Transparency and Reporting, Quality Measurement, Hospitalists/Hospital Medicine, Diagnosis/Clinical Reasoning, Information Technology, Ambulatory/Primary Care, Nurses/Nursing, Health Policy, Outsourcing/Medical Tourism

• Rapid Response Teams: Ready for Prime Time?

  Last year, I (with Peter Pronovost) wrote the toughest paper of my life – one that critiqued the Institute for Healthcare Improvement’s 100,000 Lives Campaign. This is the healthcare equivalent of criticizing both Mother Teresa and your local food bank Read More... Posted Tue, Nov 27 2007 9:31 AM by Bob Wachter | 4 Comments Filed under: Quality Improvement, Hospital Care, Quality Measurement, Hospitalists/Hospital Medicine, Patient Safety/Medical Errors, Nurses/Nursing, Health Policy

• Dennis Quaid’s Kids: Are VIPs Safer?

  The Entertainment Blogosphere was atwitter yesterday with the story of actor Dennis Quaid’s twin newborns, who reportedly received a 1000-fold heparin overdose at Cedars-Sinai Medical Center in La La Land. Cedars’ Chief Medical Officer Michael Langberg Read More... Posted Wed, Nov 21 2007 9:11 AM by Bob Wachter | 3 Comments Filed under: Hospital Care, Patient Safety/Medical Errors, Industry/Pharma, Health Policy

• The Surgical Hospitalist

  In an article in this month’s Journal of the American College of Surgeons (with a companion cover piece in the ACS’s Bulletin), four of my surgical colleagues – and this internist, perhaps to add a “cognitive” spin – describe UCSF’s “surgical hospitalist” Read More... Posted Sun, Nov 18 2007 6:04 PM by Bob Wachter | 2 Comments Filed under: Hospital Care, Efficiency, Medical Education/Academia, Hospitalists/Hospital Medicine, Health Policy

• Perioperative Beta Blockers, Redux

  Earlier this week, I discussed the preliminary results of the POISE trial, the blockbuster that showed that perioperative beta blockers may cause more harm than good. I've asked my UCSF colleague Andy Auerbach, one of the nation's experts on this intervention, Read More... Posted Fri, Nov 16 2007 6:40 AM by Bob Wachter | 1 Comments Filed under: Hospital Care, Quality Measurement, Ambulatory/Primary Care, Health Policy

• Three Remarkable Articles Last Week

  As I mentioned when we launched, this blog won’t be your destination for a weekly journal update (there are plenty of sites for that). But I will keep an eye on the literature and let you know when I see something remarkable. And then I’ll try to put Read More... Posted Mon, Nov 12 2007 7:55 AM by Bob Wachter | 1 Comments Filed under: Hospital Care, Transparency and Reporting, Quality Measurement, Ambulatory/Primary Care, Health Policy

• When is a Medical Error a Crime?

  The first commandment of the modern patient safety movement was “Thou Shalt Not Blame.” Old-Think: errors are screw-ups by “bad apples,” and can only be prevented by some combination of shaming and suing the doctor or nurse holding the smoking gun. New-Think: Read More... Posted Mon, Nov 05 2007 7:19 AM by Bob Wachter | 6 Comments Filed under: Hospital Care, Patient Safety/Medical Errors, Nurses/Nursing, Health Policy

• The Shameless Commerce Division

  Sorry, but today is the day for a tiny bit of Shameless Commerce – a quick plug for my new book, Understanding Patient Safety. I wouldn’t normally do this – I’m as brazenly promotional as anybody, mind you, but it does seem a bit cheesy – but then I saw Read More... Posted Thu, Nov 01 2007 11:42 PM by Bob Wachter | 0 Comments Filed under: Hospital Care, Medical Education/Academia, Hospitalists/Hospital Medicine, Diagnosis/Clinical Reasoning, Information Technology, Ambulatory/Primary Care, Patient Safety/Medical Errors, Nurses/Nursing