Archive for May 2016

VISTA: The Future of Hospital Medicine Is in Healthcare Delivery Sciences

Eleven years ago, I remember being a junior faculty member attending the first “Quality Fair” at the University of Chicago, and presenting my work among roughly 20 posters on how to measure quality for hospitalized older patients. While I am proud to say this poster actually won an award, I am also embarrassed to say that I did not improve anything. That is perhaps where the state of the science was; we were still talking about how to measure quality and where the safety problems were as opposed to the science of actually improving it. Fast forward, this past week, I attended the 11th annual University of Chicago Medicine’s Quality and Safety Symposium. Over 120 posters were presented on a wide range of innovations, including how to improve patient transport times, predict the next heart attack in the community, as well as proactively screen patients before they develop hospital-acquired infections.…

Superbugs, Medical Errors and Safety Rankings in Hospital Medicine News

by Brett Radler
SHM & Hospital Medicine in the News: May 12 – 26, 2016 This issue of SHM & Hospital Medicine in the News features: The first case of a superbug in the U.S. that is resistant to antibiotics of last resort Suggestions to reduce the number of medical error-related deaths in hospitals, including work performed by SHM member Peter Pronovost, MD, PhD The possible lack of usefulness of hospital report cards and safety rankings to consumers Physicians’ lack of comprehension of medical costs that affect their daily practice The growing trend of healthcare providers and payers working together amicably after many years of adversarial relationships A recent blog post from Dr. Brett Hendel-Paterson on The Hospital Leader blog that was republished by Medscape   The Superbug that Doctors Have Been Dreading Just Reached the U.S. For the first time, researchers have found a person in the United States carrying bacteria resistant…
Brett Radler is the Communications Specialist at the Society of Hospital Medicine (SHM). He is responsible for managing the day-to-day social media engagement across SHM’s social media platforms, including Facebook, Twitter, LinkedIn and YouTube, and assists in the management of SHM’s blog, The Hospital Leader. In addition to his social media roles, Brett develops content for SHM’s monthly newsmagazine, The Hospitalist, and monitors media coverage relevant to the hospital medicine movement. Brett holds a bachelor’s degree in Communication from Rutgers University in New Brunswick, NJ and also serves as on-air talent at a New Jersey radio station in his spare time.

Reflections on Palliative Care: Clinging to Life

by Dr. Allison Schneider
By Dr. Allison Schneider My first day on the Palliative Care service ended with me in a heap on my couch sobbing into my husband’s shoulder. That day I attended family meetings for two patients in their 40s dying of cancer and leaving young kids behind. I also sat at the bedside with the mother of a young man dying of AIDS. As a fourth year medical student, I had experienced hard days; that day was one of the hardest. Yet, it was also beautiful. The interdisciplinary palliative care team navigated each conversation with inspiring empathy and grace. They worked together seamlessly to support and honor the goals of each patient and their families. The team also made it a priority to support each other. Through frequent check-ins, debriefs and formal talks about self-care, the rotation created a truly safe space to express and work through the raw emotion that…
Dr. Allison Schneider grew up in Washington, D.C., and received a BA in Public Policy and American Institutions from Brown University. She then worked for the Kaiser Family Foundation Commission on Medicaid and the Uninsured prior to entering medical school at the University of California, San Francisco. She graduated this month and will be starting her residency training in Obstetrics and Gynecology at Kaiser Oakland Medical Center in July.

What Kind of Car Will A Specialist Be Driving in 2030?

(Something I sent along to my PGYs.  Thought you might enjoy.  And think about where hospitalists fit into all of this) A Porsche or a Prius? Have a look at the two figures below and see if you can spot the dilemma: See it? I knew that you could. Here's the thing.  We have lived with an arrangement that reimburses specialists more than generalists for greater than fifty years.  You would think because that is so, the progenitors of the system knew what they were doing and assigned the right amount of compensation to each type of physician.  Specialists and proceduralitsts do stuff so pay them more. On one level, that makes sense.  After all, you can see the results specialists achieve quickly given all those high tech thingies they use that come with instruction manuals.  They produce big levels of patient satisfaction and often, get that instant cure.  Folks…

Next Step in Sustainability: Re-Thinking How Hospitalists Organize Their Work

Do we really need another commentary on the shortcomings of the 7-on/7-off work schedule?  My colleague John Nelson has written and spoken about this extensively, most recently in his January 2016 column in The Hospitalist.  And while I’ve been planning to write this post for a while, Bob Wachter got the jump on me by famously declaring at his HM16 closing presentation in March that “I think one thing we got wrong was a 7-days-on/7-days-off schedule.”  Nevertheless, I can’t resist weighing in. When I first started working with hospitalist groups more than a dozen years ago, hospitalists routinely told me that the 7-on/7-off schedule was one of the main reasons they chose to go into this specialty.  But too often when I visit groups today there are at least a few more experienced doctors who say they are thinking of leaving the field if they can’t find an alternative to…
123