Extreme unusualness
I'm in Toronto to meet with the staff about quality and safety progress at Southlake Regional Health Centre and Mt. Sinai Hospital and am very much looking forward to that. Meanwhile, I get to read the Toronto Star, which has a story about the return to work of Mayor Rob Ford, "who ignited a firestorm last week when he admitted to smoking crack cocaine" and "will try to go back to business-as-usual."Here's the quote of the day, the best I have seen about a leader in a long time:"There's no 'business as usual' with Rob Ford. In a way there hasn't been for awhile, but now it's at the point of extreme unusualness," said...
Source: Running a hospital - November 11, 2013 Category: Health Managers Source Type: blogs
Learning from the sewers
The Fowl Meadow todayThe basic stages of building infrastructure--plan, design, build, and maintain--apply equally well to information systems and physical infrastructure like pipes, roads, and power systems. Over the years, the science of project management has developed many tools to help such projects stay on schedule and on budget, yet many projects fail to their timelines and their financial milestones. Why a project fails is often viewed as a sui generis combination of internal management and technical glitches and external forces. But there is often one common factor: A failure of the organization's leadership to ad...
Source: Running a hospital - November 10, 2013 Category: Health Managers Source Type: blogs
Helping in Haiti
My good buddy Cherie Abbanat is CEO of Haiti Projects, Inc., a 501(c)(3) corporation with a mission to empower women in rural Haiti to lift themselves out of poverty, become self-sufficient and build community. Haiti Projects is located in the town of Fond des Blancs, where it is the second largest employee in the region where over 35,000 people live with no electricity or public services.They run an artisan cooperative that employs 95 women; a health clinic that conducts over 4000 patient consultations; a library with 700 members, daily newspaper, and Cyber Café, and many educational programs for adults and young ...
Source: Running a hospital - November 10, 2013 Category: Health Managers Source Type: blogs
Justin still teaches us all, thanks to Dale's generous spirit
Dale Ann Micalizzi started Justin's Hope Project in memory of her 11-year-old son who died as a result of medical errors. It took her nine years to learn why.Dale now gives scholarships so that young people involved in pediatric care can attend the IHI Annual Forum and learn more about quality and safety and be among thousands of other people who likewise are committed to these ends.Here's a video she recently produced that tells her story. It begins, "The code blue was called," and then the story unfolds. The video has already prompted some lovely comments on Facebook and is being shared on that platform...
Source: Running a hospital - November 9, 2013 Category: Health Managers Source Type: blogs
Mixed feelings
On the one hand, kudos to Lenox Hill Hospital’s Chair of Urology Dr. David Samadi, who highlighted the importance of early screening and prevention by performing prostate exams live on NBC Today Show anchors Matt Lauer and Al Roker. Helping people understand the ease of this screening test is a public service.On the other hand, this is the same Dr. Samadi who permitted himself to appear in a testimonial video produced by Intuitive Surgery (posted on August 28, 2013) to support its marketing campaign for use of the daVinci robotic surgery machine, specifically by playing on men's fear of impotence and incontinence. His ...
Source: Running a hospital - November 8, 2013 Category: Health Managers Source Type: blogs
What you can't do directly . . .
. . . you do indirectly.The country's labor unions tried hard to exempt themselves from the "Cadillac" tax on expensive (and generous) health insurance policies when the Accountable Care Act was being debated. Whatever you might think about that tax, Congress wisely decided that labor unions were no different from companies on this matter.But now Jay Hancock at Kaiser Health News reports that the unions may getting their way, through quiet, back-door administrative changes:Buried in rules issued last week is the disclosure that the administration will propose exempting “certain self-insured, self-admini...
Source: Running a hospital - November 7, 2013 Category: Health Managers Source Type: blogs
Another chance to vote
No, I'm not suggesting that you vote "early and often," but I am requesting you to vote on one more ballot.My friends and colleagues Gilles Frydman and Roni Zeiger explain:We are Smart Patients, a new online community of cancer patients and caregivers, for the era of molecular medicine. Our mission is simple; improve medicine, one story at a time.We're here to help people get optimal care by sharing with other informed patients everything they need to know about any aspect of their disease.To do so, we have created a new platform, designed to tear down silos that have stopped people from sharing with others who know ...
Source: Running a hospital - November 7, 2013 Category: Health Managers Source Type: blogs
Focus on ambulatory care on WIHI
Madge Kaplan writes:The next WIHI broadcast — Improving Safety and Satisfaction in Ambulatory Care — will take place on Thursday, November 7, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Gordon Schiff, MD, Associate Director, Brigham Center for Patient Safety Research and Practice, Brigham and Women's Hospital Nicholas Leydon, MPH, Director, PROMISES Project, Massachusetts Department of Public Health Frank Federico, RPh, Executive Director, Strategic Partners, Institute for Healthcare Improvement (IHI) Damian Folch, MD, Family Practice and Lifestyle Medicine (Chelmsford, MA) ...
Source: Running a hospital - November 7, 2013 Category: Health Managers Source Type: blogs
It's time for NHS Change Day 2014 to begin.
What happens when the third largest organization in the world decides to change? We'll see in a few months.Today starts the countdown to NHS Change Day, set for March 3, 2014.This is a grass roots approach to change, not something ordered from the top down.How it works is remarkably simple and engaging.First, you make a pledge and post it for all to see.All you need is an idea of what you could do to make a positive difference. Then you make a pledge - a simple promise to yourself and others that you will act on that idea and become a 'changemaker'.If a pledge inspires you, you hit "like."The more likes you give, the mor...
Source: Running a hospital - November 6, 2013 Category: Health Managers Source Type: blogs
Dammit, take credit for the good!
Many of us who support the primary goal of the Affordable Care Act--to provide access to insurance for many more Americans--get frustrated by the inability or unwillingness of the administration to create a powerful narrative for the law. A story earlier this week in the New York Times provides an unfortunate example.The headline is a winner: Under Health Care Act, Millions Eligible for Free Policies.The lede is more qualified:Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama...
Source: Running a hospital - November 6, 2013 Category: Health Managers Source Type: blogs
A top ten list that indicts an industry
Cheryl Clark over at HealthLeaders Media summarizes the annual ECRI report on the top 10 health care technology hazards. It is tempting to think of this as a report on technologies, but let's remember it is actually a report on how people use technologies.Here's the (drum-roll) list:1. Alarm hazards2. Infusion pump medication errors3. CT radiation exposures in pediatric patients4. Data integrity failures in EHRs and other health IT systems5. Occupational radiation hazards in hybrid ORs6. Inadequate reprocessing of endoscopes and surgical instruments7. Neglecting change management for network devices and systems8. Ris...
Source: Running a hospital - November 5, 2013 Category: Health Managers Source Type: blogs
How to give positive reinforcement
It was a soccer practice session with my team of 12-year-old girls. I was explaining that we were going to work on a particular skill because they had not done very well with it in the game the day before."Well, that's not a very positive way to put it," noted one child, who knows well my penchant for positive reinforcement rather than criticism."Ok," I said. "How about: You positively did not do this well during the game. Is that better?""That will do," she replied. (Source: Running a hospital)
Source: Running a hospital - November 5, 2013 Category: Health Managers Source Type: blogs
In memoriam: Dr. Michael Palmer, healer
Photo by Gregory Rec in the Boston GlobeStrength from adversity might best describe Dr. Michael Palmer. This obituary by Bryan Marquard begins:A physician who nearly lost his career to drug and alcohol dependency, Dr. Michael Palmer found his way back to his calling partly by helping heal other doctors, and by replacing his daily pills with a page of writing every night.“By the end of the 1970s, I was in solid recovery, and by 1981, I began to reach out to find doctors whom I could help,” he told the Globe in 2008. “It coincided with the beginning of writing. In retrospect, having a book to write was one o...
Source: Running a hospital - November 4, 2013 Category: Health Managers Source Type: blogs
What's in a name? Not much, sometimes.
Over the years various sectors of the economy have gone through structural change, often from a regulated, price controlled environment to a more deregulated environment. This has happened with electric utilities, natural gas companies, water and wastewater companies, telecommunications, and, now, hospitals. The first step is to merge and/or acquire and/or be acquired. Scale is viewed as way to achieve economies of scale and scope and to gain market power. (As we now know, scale also brings its own set of problems, and such mergers often fail under their own weight. So very few ever achieve th...
Source: Running a hospital - November 4, 2013 Category: Health Managers Source Type: blogs
Some wars were different back then
Yesterday, Nov. 3, was the 110th anniversary of the Panamanian war of independence from Colombia, greatly aided and abetted by Theodore Roosevelt. Here's a summary of the event from El Tiempo:Eran las 9 de la noche cuando retumbaron los primeros cañonazos, parece que seis en total durante media hora: seis balas perdidas que fueron a estrellarse contra lo primero que se les atravesó, unas casas y unos gritos, dando de baja así a los dos únicos mártires que se conocen de la gloriosa gesta emancipadora de la República de Panamá: un chino y un burro. El primero se llamaba Wong Kong Yee, fumador de opio, el bur...
Source: Running a hospital - November 4, 2013 Category: Health Managers Source Type: blogs
