The Health Care Blog

Another Look: Incident Reporting Systems

By BOB WACHTER When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons...
September 28, 2009 in Bob Wachter, Patient Safety | Permalink | Comments (4)

Op-Ed: Healthcare Reform Lessons From Mayo Clinic

By LEONARD L. BERRY and KENT D. SELTMAN Three goals underscore our nation's ongoing healthcare reform debate:1) insurance for the uninsured, 2) improved quality, and 3) reduced cost. Mayo Clinic serves as a model for higher quality healthcare at a...
July 21, 2009 in Costs, Mayo Clinic, Patient Safety, Quality, Reform | Permalink | Comments (43)

Op-Ed: The Unintended Consequences of “No Pay for Errors”

By BOB WACHTER Medicare’s policy to withhold payment for “never events” – the first effort to use the payment system to promote patient safety – remains intriguing and controversial. To date, most of the discussion has focused on the policy...
July 21, 2009 in Bob Wachter, evidenced-based medicine, Medicare, Patient Safety, Quality | Permalink | Comments (3)

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

Dennis Quaid Overlooks Too Much

By Michael Millenson Anyone who cares about patient safety has to be grateful to Dennis Quaid for the way he and his wife Kimberly reacted to the near-death from a medication error of their twin baby girls. Using his celebrity...
April 6, 2009 in Michael Millenson, Patient Safety | Permalink | Comments (3)

Should the FDA relax in the search for new cures?

By Matthew Holt Over at DiabetesMine #1 health blogger Amy Tenderich has very important post. She and several fellow travelers are appealing to the FDA to strike a balance between safety and progress in allowing new diabetes treatments. The FDA...
January 9, 2009 in e-patients, FDA, Health 2.0, Patient Safety, Pharma, pharmaceuticals | Permalink | Comments (1)

A new year's resolution for greater hospital transparency

By Paul Levy Just thinking, along the lines of a New Year's resolution. What if all of the hospitals in the Boston metropolitan area -- academic medical centers and community hospitals -- decided as a group to eliminate certain kinds...
January 3, 2009 in Hospitals, Patient Safety, Paul Levy, Quality, Transparency | Permalink | Comments (4)

Low tech ways to improve patient care: sleep and manners

By Michael Miller, MD A few recent reports point to ways for improving the quality of physician delivered care that has little to do with technology or complex interventions. The first involves how physicians interact with patients, and the second...
December 17, 2008 in Patient Safety, Physicians, Quality | Permalink | Comments (2)

Dispatches from IHI's quality forum

By Amanda Goltz Don Berwick is one of the leading lights of the health care quality world; an oft-quoted and published visionary who founded the Institute for Healthcare Improvement to spread the gospel of transformation and improvement around the world....
December 14, 2008 in evidenced-based medicine, Hospitals, Patient Safety, Quality | Permalink | Comments (2)

Transforming medicine and saving lives

By Sarah Arnquist This week, Don Berwick will announce the results of the 5 Million Lives Campaign before thousands of people in Nashville attending the National Forum on Quality Improvement in Health Care. Twenty years ago, it was almost heretical...
December 9, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Physicians, public health, Quality | Permalink | Comments (5)

Resident Duty Hours and Patient Safety: Did The IOM Get It Right?

By Bob Wachter The Institute of Medicine just released its long-awaited report on trainee duty hours. It is well researched and balanced, and its recommendations appropriately reflect what we know vs. what we believe. Now the fun begins. Let’s start...
December 9, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians, Quality | Permalink | Comments (1)

Battling MRSA with transparency

By Sarah Arnquist Two weeks ago, I made an emergency trip home to Minnesota because my grandmother fell ill. She went to the emergency room on a Sunday night, complaining of fatigue and shortness of breath. The emergency physician diagnosed...
November 17, 2008 in Hospitals, Patient Safety, public health, Sarah Arnquist | Permalink | Comments (3)

Can a Hospital Afford to Share Its Warts with the Public?

By BOB WACHTER Paul Levy, the blogging CEO at Boston’s Beth Israel Deaconess Medical Center, has staked his – and his hospital’s – reputation on a culture of transparency. Although no doubt partly driven by Paul’s ethical compass, he must...
November 3, 2008 in Bob Wachter, Patient Safety | Permalink | Comments (3)

Pitfalls of VIP Syndrome

By Sarah Arnquist Slate has an article today by two doctors discussing VIP syndrome in health care and how it can lead to worse care for the rich and powerful, such as Sen. Ted Kennedy, who following a diagnosis of...
October 30, 2008 in Patient Safety, Quality | Permalink | Comments (2)

Overregulating patient safey

By Bob Wachter In responding to dysfunctional systems, America instinctively turns to “more regulation” (Exhibit A: today’s Wall Street). But regulation can, and often does, go too far, and – in patient safety – I believe that it now has....
October 21, 2008 in Bob Wachter, Patient Safety | Permalink | Comments (3)

MRIS: The good, the bad and the useless

By Christine Gray Note: This post first appeared at e-patients.net Gina Kolata's must-read article in last week's Science Times points out vast differences in the quality of MRI's as well as vast differences in the expertise of the radiologists who...
October 20, 2008 in Consumers, Patient Safety, Personalized Medicine | Permalink | Comments (4)

Using clinical decision support to get the right diagnosis the first time

By Joseph Britto, MD Joseph Britto is co-CEO of Isabel Healthcare, a clinical software vendor that helps clinicians with diagnosis. He practiced medicine in the UK before joining with co-CEO Joseph Maude to start Isabel, named after Joseph's daughter who...
October 10, 2008 in Electronic Medical Records, Hospitals, Patient Safety, Quality | Permalink | Comments (6)

Big administrator is watching you

By Bob Wachter Last week, came the announcement that Suzanne Delbanco, founding director of the Leapfrog Group, has assumed the presidency of a company that tracks compliance with safety and quality practices via remote video. Big Brother, meet the Joint...
September 29, 2008 in Bob Wachter, Patient Safety, Quality | Permalink | Comments (4)

Mixed reception for hospital ID bracelets

By Sarah Arnquist Color-coded hospital bracelets intending to identify categories of patients and prevent errors by ensuring they receive proper care have received a mixed reception, the New York Times reports. Red bracelets indicate allergies, amber says the patient has...
September 26, 2008 in Hospitals, Patient Safety, Quality | Permalink | Comments (2)

A Genius Shines…And, Where the Light Doesn’t, Hospitals Don’t

By Michael L. Millenson It doesn’t take a genius to figure out that hospitals could dramatically reduce the hundreds of thousands of deaths and injuries they unintentionally cause patients ever year, but it may take a genius to coax change...
September 25, 2008 in Patient Safety, Quality, Transparency | Permalink | Comments (0)

Evidence of a Need for Change

By THCB Staff The Health Care Blog regular Michael Millenson wrote a great piece recently in Miller-McCune Magazine on the necessity of practicing more evidenced-based medicine, and why it's not happening. Here is a powerful snippet but it's definitely worth...
September 24, 2008 in Economics, evidenced-based medicine, Patient Safety, Quality | Permalink | Comments (3)

Health care in the YouTube era

By Bob Wachter August 11th was the 2nd anniversary of the epic implosion of George Allen's presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering...
August 19, 2008 in Bob Wachter, Consumers, Patient Safety, Quality | Permalink | Comments (5)

Communication 101: Shedding power imbalances to protect patients

By Katie Fiebelkorn Westman Katie Fiebelkorn Westman is a registered nurse at an acute care hospital in the Minnesota Twin Cities. She is working toward a clinical nurse specialist degree, focusing on improving patient care quality. The Joint Commission’s recent...
July 24, 2008 in Hospitals, Nursing, Patient Safety, Quality | Permalink | Comments (1)

Should a surgeon be punished for wrong-site surgery?

By Paul Levy During these couple of weeks following our wrong-side surgery, a number of people have asked me if we intend to punish the surgeon in charge of the case, as well as other people in the operating room,...
July 20, 2008 in Hospitals, Patient Safety, Paul Levy, Quality | Permalink | Comments (4)

Another case of wrong-site surgery: are we averting our eyes from the root causes?

By Bob Wachter Yet another case of wrong-side surgery, this one at Boston’s Beth-Israel Deaconess Hospital. Though CEO Paul Levy does a nice job discussing the case on his blog, I’ll focus on two aspects Paul neglects: the role of...
July 10, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians, Quality | Permalink | Comments (8)

A message you hope to never send

By Paul Levy First, an email sent out on Thursday morning. My commentary follows. Dear BIDMC Community, This week at BIDMC, a patient was harmed when something happened that never should happen: A procedure was performed on the wrong body...
July 7, 2008 in Hospitals, Patient Safety, Paul Levy, Quality, Transparency | Permalink | Comments (6)

How preventing infections rose to the forefront of the patient safety movement

By Bob Wachter The Joint Commission just released its 2009 National Patient Safety Goals, and –- no surprise –- they focus on infection prevention. While this seems natural today, it wasn’t always so. In fact, the conflation of infection control...
June 24, 2008 in Bob Wachter, Hospitals, Patient Safety, Quality, The Industry | Permalink | Comments (0)

Why diagnostic errors don't get any respect and what can be done about it

By Bob Wachter I gave a keynote yesterday to the first-ever meeting on "Diagnostic Error in Medicine." I hope the confab helps put diagnostic errors on the safety map. But, as Ricky Ricardo said, the experts and advocates in the...
June 2, 2008 in Bob Wachter, Hospitals, Patient Safety, Physicians | Permalink | Comments (3)

Dennis Quaid takes on hospital errors

By Sarah Arnquist Hospital patient safety has a new celebrity advocate in Dennis Quaid, whose twin newborns received a massive overdose of a blood thinner last year at Cedars-Sinai Medical Center while being treated for infections. While his twins bled...
March 28, 2008 in Hospitals, Patient Safety, Quality | Permalink | Comments (17)

Lessons From a Sad Error

By Paul Levy I think many people have seen this sad story of a wrong-sided kidney removal in Minnesota. We all feel the pain for this poor patient. It is difficult for us non-physicians to understand how this happens, for...
March 20, 2008 in Hospitals, Patient Safety | Permalink | Comments (2)

Loving Our Children

By Brian Klepper Among its many less-noticed accomplishments, this Administration has strangled funding for comprehensive sex education. Instead, it has thrown the immense weight of the US government behind abstinence-based education, an impractical ideological approach rooted in religious zealotry and...
March 14, 2008 in Brian Klepper, Patient Safety, Policy, Policy/Politics, The Industry | Permalink | Comments (1)

Four Big Trends - Brian Klepper

Several events and trends emerged over the last year that will reverberate throughout the health care marketplace in 2008 and going forward. While none of these dominated the trade press like some other issues - electronic and personal health records,...
January 16, 2008 in Brian Klepper, Health 2.0, Health Plans, Hospitals, Medicare Advantage, Patient Safety, Physicians, Policy/Politics, The Industry | Permalink | Comments (9)

Look at How Safe [Fill in the Blank] Is by Bob Wachter

But is it as simple as that really? Perhaps not. In the commentary that follows, Bob Wachter has a very different take on the airline analogy. Analogies are useful things, true, he argues. But perhaps not as useful as the...
December 29, 2007 in Bob Wachter, Hospitals, Patient Safety | Permalink | Comments (2)

HOSPITALS: Dennis Quaid's Kids - Are VIPs Safer? By Bob Wachter

Robert Wachter is widely regarded as a leading figure in the modern patient safety movement. Together with Dr. Robert Goldman, he coined the term "hospitalist" in an 1996 essay in The New England Journal of Medicine. His most recent book,...
November 26, 2007 in Bob Wachter, Patient Safety | Permalink | Comments (6)

When is a Medical Error a Crime? by Bob Wachter

Bob Wachter is one of the nation's leading experts on medical safety and one of the pioneers of the hospitalist movement. And now he's descending into the mire of blogging! So we're pleased to cross post one of the more...
November 16, 2007 in Bob Wachter, Hospitals, Patient Safety | Permalink | Comments (17)