That's "informed" consent
My friend and colleague, Doug Hanto (a world class transplant surgeon) reports on Facebook about the birth of his grandson at St. Vincent Carmel Hospital in Indiana:Interesting. Lindsay is about to have a C-section this morning, and we will welcome John Douglas into the world. The nurse handed Lindsay informed consent for C-section, anesthesia, blood transfusion, circumcision, and HBV vaccine with no explanation. Like signing the agreement you have to sign when updating your OSX or windows software. They all say "Your physician has explained ..." No one has explained anything. Trust is alive and well in the real wor...
Source: Running a hospital - August 8, 2014 Category: Health Managers Source Type: blogs
Maybe the AG could help
Bruce Mohl at Commonwealth Magazine reports:Steward Health Care is refusing to turn over to state officials its audited financial statements, setting off a behind-the-scenes tug of war that could lead to fines being assessed on the for-profit company. Steward, which is owned by the New York private equity firm Cerberus Capital Management, is notoriously tight-lipped about its finances. The only reliable source of information on the company's overall performance and its financial relationship with Cerberus has been its audited statements. For the past two years, Steward filed the statements with st...
Source: Running a hospital - August 8, 2014 Category: Health Managers Source Type: blogs
What residents teach us about residency programs
Medscape has issued its 2014 Residents Salary and Debt Report. Here are some interesting charts, along with their associated description and my commentary: Although 25% of residents have no debt, over a third (36%) still owe more than $200,000 after five years in residency. The Association of American Medical Colleges (AAMC) reports that the median four-year cost to attend medical school for the class of 2013 is $278,455 at private schools and $207,868 at public ones. Given these high tuitions, resident indebtedness has risen much more rapidly than inflation or resident compensation. According to the AAMC...
Source: Running a hospital - August 7, 2014 Category: Health Managers Source Type: blogs
Safety is joy
Brian Daily is a medical student (class of 2017) at Georgetown University School of Medicine. After attending our Telluride-East summer patient safety camp, he saw this construction truck on campus at Georgetown the other day and sent it to several of us faculty members because he thought we’d appreciate the bumper sticker.And indeed we do. Safety in the clinical setting, too, is joy. At heart, it is result of a collegial work environment with excellent communication among the clinical staff and a true partnership with the patient and family. When all that occurs, it feels really good! (Source: Running a hospital)
Source: Running a hospital - August 7, 2014 Category: Health Managers Source Type: blogs
What Mona learned
Mona Beier attended last week's patient safety camp in Maryland (aka, Telluride East) and posted some deep thoughts after the experience. Here's an excerpt:I have had some really negative realizations of myself during these past few days. I hate to admit this, but during a lot of the talks and the videos, I saw things that I had done, and I have seen my colleagues do time and time again. It is almost a daily occurrence that I hear people labeling patients as “high maintenance” if they ask questions about their healthcare or if they “challenge” our decisions and our actions. I have replayed imagery...
Source: Running a hospital - August 5, 2014 Category: Health Managers Source Type: blogs
How to make RI a healthier state. Any takers?
Richard Asinof at Convergence RI challenges people in the state to map a future of sustainable health care. Will anyone step up to the challenge? (Source: Running a hospital)
Source: Running a hospital - August 4, 2014 Category: Health Managers Source Type: blogs
Hooper's Store
A now for a totally different subject, a little bit of Americana:Many of us with children--and our children--recall Hooper's Store on Sesame Street. Wikipedia summarizes:The fictional store was said to be founded by Mr. Harold Hooper in 1951 as a general store. The food menu was extensive and suited to the different characters that lived on Sesame Street, a fictional Manhattan street. Along with traditional American diner-type food, the store sold a wide range of goods from dry goods to soap dishes and stranger goods such as empty cigar boxes (in Christmas Eve on Sesame Street) and birdseed milkshakes for Big Bird.I rec...
Source: Running a hospital - August 3, 2014 Category: Health Managers Source Type: blogs
They said what?
The health care world is full of companies that make outrageous unsupported assertions as they pursue profitability. Generally, the media accept what is said and don't ask hard questions.Now somebody is asking.Al Lewis has started a blog called They Said What?, on which he posts the assertions made by companies and asks questions that probe the accuracy. He offers the company an advanced chance to respond. Here's the summary:TheySaidWhat? asks questions that identify possible mistakes in high-visibility contexts and offers those who committed the mistakes the opportunity to correct, apologize for or ret...
Source: Running a hospital - August 1, 2014 Category: Health Managers Source Type: blogs
Summation
A reminder from David Mayer to medical students participating the Telluride East Patient Safety program. (Source: Running a hospital)
Source: Running a hospital - August 1, 2014 Category: Health Managers Source Type: blogs
On pain
Janice Lynch Schuster offers first-hand advice on ways of managing chronic pain, here. She notes:I am not my pain. I am a wife, mother, worker, writer, sister, daughter and friend. My world is rich and rewarding. I want for nothing – save pain relief. In fact, although the pain may be a permanent fixture, the sensation is impermanent. Some days are better than others. I must choose how much I want to let it control my experience—or how much I want to control it.Powerful and helpful, both, for you or a loved one. (Source: Running a hospital)
Source: Running a hospital - August 1, 2014 Category: Health Managers Source Type: blogs
Tom's Reason to Ride is back
With great disappointment, I sadly announce that “A Reason To Ride’s” founder, Tom DesFosses’ cancer is back. While Tom started to "A Reason to Ride" because he wanted to give back and raise funds for research he never made the Ride about himself. Tom founded the ride because many of us have reasons to ride. His energy and enthusiasm persuaded me to give full logistical support to the ride when I was running the hospital. Now, the ride is run solely by Tom and his friends, with tremendous support from Fuddruckers restaurants and the other firms noted below.We still have reasons to ride, and i...
Source: Running a hospital - July 31, 2014 Category: Health Managers Source Type: blogs
Them's fighting words!
Gary Schwitzer offers a front-row seat to some conflicting claims. It all starts with a news release from robotic surgeon David Samadi at New York's Lenox Hill Hospital that was picked up by the American Urological Association (AUA):According to a new study from Detroit, Michigan, robotic prostatectomy yields highly successful long-term prostate cancer results. In fact, nearly all — 98.8% — of the patients remained prostate cancer survivors at ten years post-surgery; results comparable to the more invasive surgical method used in the past. Oncologist Richard Hoffman replies:“The AUA does misrepresent the da...
Source: Running a hospital - July 31, 2014 Category: Health Managers Source Type: blogs
So you think you can multi-task
A friend of mine was excitedly discussing her job with a high-tech firm. "Our meetings are so great and vibrant. While the sessions are going on, we are all on our computers multi-tasking. It's so efficient!"Well, no. There's a lot of evidence that constant interruptions do not improve efficiency and that they also impair quality. Here's a recent example, published in Human Factors. It focused solely on interruptions during the course of writing and concluded:Our research suggests that interruptions negatively impact quality of work during a complex, creative writ...
Source: Running a hospital - July 30, 2014 Category: Health Managers Source Type: blogs
Observing observation status
Brad Flansbaum offers this interesting post about the ambiguities and uncertainties inherent in the current Medicare "two-midnight rule." He refers to a recent white paper prepared by a group of hospitalists:Months of work have led us to our white paper, entitled, The Observation Status Problem: Impact and Recommendations for Change. The release utilizes a multidimensional data set of significant size and includes a finding synthesis. It is our hope to use the information we collected to inform Congress, CMS, media, and members on the somewhat chaotic understanding of observati...
Source: Running a hospital - July 30, 2014 Category: Health Managers Source Type: blogs
Fire!
Earlier this month, Modern Healthcare published a story about the slow movement by hospitals to prevent operating room fires. An excerpt:Despite a slew of news accounts about patients being set on fire in operating rooms across the country, adoption of precautionary measures has been slow, often implemented only after a hospital experiences an accident. Advocates say it's not clear how many hospitals have instituted the available protocols, and no national safety authority tracks the frequency of surgical fires, which are thought to injure patients in one of every three incidents. About 240 surgical fires occur ever...
Source: Running a hospital - July 30, 2014 Category: Health Managers Source Type: blogs
