Archive for September 2008

The Color-Coded Wristband Saga

Last week’s New York Times front-page piece on colored wristbands highlighted an issue I’ve been fretting about for years. We can achieve consensus on a $700B bailout in 3 days (well, perhaps not), but can’t agree on what color a DNR wristband should be? Wow.My interest in this subject began with a remarkable case I first described in Internal Bleeding and later in Understanding Patient Safety. The story went like this:A young nurse in a teaching hospital goes in to visit her patient, an elderly man on the ortho floor, and finds him not breathing. She calls for a Code Blue, and the cavalry soon arrives and begins CPR. As the Code proceeds, the team leader repeatedly asks whether anybody knows the patient’s history, to no avail.A young resident, trying to be helpful, dashes off the nurse’s station and grabs the patient’s chart. A moment later, he slides into the…

Big Brother Arrives: Monitoring Patient Safety Compliance By Remote Video

Today 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 Commission.The report, in today’s Modern Healthcare, describes the process this way:Video auditing refers to a system in which cameras are mounted in targeted locations to continuously capture specific clinical processes, such as observing handwashing and hand-sanitizing stations. [Using video] fed through a Web-based link, independent, third-party observers audit the recordings and provider reports on safety incidents.Did you ever doubt this was coming? Virtually every other industry with compliance standards has long used video to monitor compliance and to goose workers into following the rules. If video surveillance is good enough for Vegas croupiers and Kansas meat packers, why wouldn’t it be good enough for neonatal nurses and ER docs?Consider hand hygiene. Until a few…

Why the Medical Record Needs to Become More Like Facebook

The explosive growth of Facebook and MySpace illustrates the market for electronic tools to enhance communication and collaboration. Could there possibly be another workplace more in need of social networking tools than the modern hospital?If you are not familiar with Facebook, find yourself a teenager and take a look over his shoulder while he is using it (mine are available for rent if you get desperate; the best time to catch them is when they should be doing homework). In one thrilling, chaotic electronic e-universe, the site allows users to exchange instant messages with dozens of friends, to post pictures and videos, and to link to virtually everything on the Web – all at the same time. John McCain would be flabbergasted.Now, take a look at today’s medical record, and ask yourself whether – if we could start fresh – this is the tool you would have constructed if your…

The Latest JibJab Campaign Satire

My Olympics addiction has been replaced by "All Conventions, All The Time." If you're a politics junkie like me, you'll love the latest hilarious campaign satire from the folks at JibJab, the ones who brought you the groundbreaking "This Land" knee-slapper in 2004.Check out the face on the guy who gets goosed by the politicians toward the very end of the video.Thanks to my colleague, UCSF hospitalist and IT-guru Russ Cucina, for bringing this new JibJab offering to my attention, and for the surprise ending.Back to more weighty healthcare matters soon, but this is worth a couple of minutes.