Archive for December 2016

Equal Time for Hospital Execs

Last month, I wrote a letter to hospital executives, urging them to deliberately invest their own personal time and effort in fostering hospitalist wellbeing. I suggested several actions that leaders can take to enhance hospitalist job satisfaction and reduce the risk of burnout and turnover. Following publication of that post, I heard from several hospital executives and was pleasantly surprised that they all responded positively to my message. Several execs told me that they gained valuable new insights about their hospitalists’ challenges and needs or that they planned to take action on one or more of my suggestions that had never occurred to them before.  Especially useful to them was the idea of a hospitalist “hierarchy of needs,” in which basics such as well-designed work (including adequate staffing), belonging, and esteem must be addressed before expecting hospitalists to undertake “self-actualizing” work, such as engagement in organizational performance improvement initiatives. Their…

Creating Value through Crowdsourcing & Finding “Value” in the New Year

Earlier this month, I took a day trip to the University of Michigan Frankel Cardiovascular Center for their inaugural value challenge. Little did I know that when I arrived, I would be part of an all-star judging team that would be giving away $100,000 (a.k.a. real money) complete with a “big check”, a la Publisher’s Clearing House, to the best idea to improve value! Given that I do not see patients on our cardiology service, I was starting to wonder if I was in over my head. The good news is that value was defined quite broadly by different stakeholders; I was able to follow along, even though I wasn’t up to date with the latest in intra-aortic balloon pumps. We heard from 5 finalists. Interestingly, 3 of the ideas centered on specialized teams to improve care coordination for specific conditions such as atrial fibrillation, pulmonary embolism, or cardiogenic shock. While…

Big Win for NPs, QI Stigma & JHM VTE Study in HM News

SHM & Hospital Medicine in the News: December 8 – December 22, 2016 Check out the latest hospital medicine and SHM-related stories in mainstream and healthcare-centric news. For the full stories, click on the links below: The U.S. Department of Veteran Affairs is increasing veteran access to healthcare by allowing nurse practitioners to provide primary care. Chris Moriates, MD’s blog post, “How I Realized QI Could Be a Dirty Word,” in which he discusses the resident view on QI efforts, was reposted on Medpage Today’s KevinMD. Prominent SHM member and JHM deputy editor Vineet Arora, MD, MPP was quoted in an article about female vs. male doctors in The Washington Post. The CMS released new Alternative Payment Models to qualify under the MACRA Quality Payment Program. A study shows that hospitalists are able to identify and address early post discharge problems by holding a structured phone call with patients 2…

Male Versus Female Hospitalists

If you have paid attention to the news, you picked up the study out in JAMA concerning how male versus female physicians deliver inpatient care.  Not just any inpatient docs, though, but hospitalists. The investigators were meticulous in their analysis of over a million Medicare beneficiaries and looked at readmit and mortality rates.  They examined various diagnoses and adjusted for the usual doctor and hospital characteristics. Across the board, males took a drubbing and the NNT for both outcomes of interest hovered around 200 (0.5% absolute difference). Ashish Jha, one of the investigators and a leader in the study of hospital quality and safety (who really needs to speak at an SHM annual, incidentally) goes into more depth over at his blog: (more…)

BREAKING NEWS: “Physicians Deemed Unnecessary”; “Social Worker Promoted to Hospital CEO”

“Physicians deemed unnecessary, ½ of all hospitals expect to be using artificial intelligence technology by 2020. Medical schools begin to shutter.” (See New England Journey of Medicine 2016.) “Social worker of inner city hospital found to be the most cost effective position in the system, promoted to CEO.” “Patients HCAHPS surveys determined to be filled out by their pets 90% of the time. Industry chief states this improves surveys have never been more accurate and recommends tying 100% of salary to Rover’s results.” (See webofliesmd.com for those last two.) So ran some Facebook headlines from my Macedonia buddy. Makes me long for the days of getting duped by The Onion. Fake news, as opposed to satirical news, is the latest virus infecting the web. They travel online faster than Usain Bolt. We are passed the era of truthiness and into the realm of post-truth. With newspaper subscription rates declining faster than ever, the search for real news gets harder and harder. Truth…
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