Posts by Michael Radzienda


Transitions, schmanzitions, potato, tomato, ACO, PHO, let's call the whole thing......really complicated.  Is anyone getting it right? Well, Jim Henson did....(check out this clip). For the past 3 months I have been working on a project that aspires to understand the link between the hospitalist/inpatient team and the PCP/ patient centered medical home. In particular, we want to understand the barriers to effective, closed-loop, timely communication between these two entities at the point of transition from inpatient to post-acute-care setting.  We have held a think tank, consulted with leading experts in the field, and have started to amass some data in order to understand how we hospitalists can be more integrated with the primary care team especially in settings where that relationship does not otherwise exist. We have asked hospitalists to take this brief survey about their perspectives: (please click here to answer 10 simple questions and then return to my…


I believe healthcare is a right, and that doctors should treat patents who need care. Period. How about you? So, it was with some amazement and disbelief that I listened to a physician address the SHM body last week in Dallas.  He is the leader of a large organization.  I am not a member of this association, and an unscientific poll taken by fellow blogger Brad Flansbaum suggests that the vast majority of HM11 attendees are not members either. If my instincts are correct, this physician made no inroads with the SHM membership in Dallas.  And this is why: (more…)


"Clinical microsystems are the small,  functional frontline units that provide most health care to most people. They are the essential building blocks of larger organizations and of the health system. They are the place where patients,  families, and careteams meet. The quality and value of care produced by a large health system can be no better than the services generated by the small systems of which it is composed. A seamless, patient centered, high-quality, safe and efficient health system cannot be realized without the transformation of the essential building blocks that combine to form the care continuum." Quality By Design-A Clinical Microsystems Approach, E. Nelson et al (ed). I submit to you that this is our task:  To create, manage and refine the hospital microsystems in which we and our colleagues care for patients--to lead the team. (more…)


I fondly remember attending the Local 17 insulators union hall meetings with my dad when I was a young boy. The scene was similar to what one might expect: a smokey, comfortably packed, dimly lit and musty room in a small red brick building in Chicago's "Back of the Yards" neighborhood.  My father  introduced every "Brother" to me as "Mr. Jones, or Mr. Murphy, etc..." My dad seemed very comfortable in that environment as did I.  Those memories validate a sense of feeling very safe and very welcomed... taken care of, if you will. Later in life, I worked  my way through college and medical school by removing the same asbestos insulation that my father and his Brethren of Local 17 installed decades earlier. (Local 17 ironically boomed in the 80's during the asbestos abatement era). I frequently heard that many of those "Misters" I had met in my youth…


Like a UN cargo plane dropping a crate of rice into a Sudanese refugee camp, so goes the conundrum of the ARRA payment for EHR meaningful use. The rush to grab the dough will result in some casualties. For the ARRA program, those yet to be known casualties may result in rethinking whether dropping the crate was a good idea in the first place. (more…)