Operations

The Essentials of QI Leadership: A Conversation with Dr. Eric Howell, Part 2

My last blog post, featuring my Q and A with Dr. Eric Howell, Division Director, Collaborative Inpatient Medicine Service (CIMS) at Johns Hopkins Bayview Medical Center in Baltimore, MD, and SHM's Senior Physician Advisor, focused on his early days in Quality Improvement (QI) and advice for training in QI. This next post discusses the Center’s role within SHM and how hospitalists can become involved in quality improvement. How did you get involved in The Center, and can you explain your role in The Center today? It was a lot of luck, good timing and being prepared. I’ve been in The Center for two years. Before that, I was involved with a number of The Center’s successful QI projects. I was reasonably well known in the Project BOOST (SHM's program for improving care transitions) community. Along with Mark Williams and Jeff Greenwald, I was one of the original three who pitched Project…

From SXSW to SHM: Our Tour to Promote Value Conversations Between Doctors & Patients

By Chris Moriates, MD, SFHM and Vineet Arora, MD, MAPP, SFHM At a movie premiere for the new Terrence Malick flick, “Song to Song”, Ryan Gosling, Michael Fassbender, and Rooney Mara walked the red carpet to flashing cameras and screaming fans in front of the famous Paramount Theatre in Austin. The next day, down the street, to a lot less fanfare, our Costs of Care team – Neel Shah and both of us – took the stage at the annual SXSW festival for own version of a premiere. We were about to step out of the normal medical conference crowd (i.e. no screaming fans but some with #pinksocks on) and see for the first time if videos we made depicting scenarios of doctors and patients confronting healthcare costs would translate to the real world. Would it work, or would the critics, like with the “Song to Song” premier, give us…

Vegas Awaits: Hospital Medicine 2017

I’m packing up for Vegas. I always look forward to the yearly conference. And back in Vegas, expectations are high. However, we all know there will be one or two distractions from the conference schedule. Here are few takeaways I hope to obtain from both the conference and Vegas. Building Community The Power of Networking Placing the Right Bets The Importance of Arts AYCE Benefits Building Community While I’m in Vegas, I may wander north of the strip and head for Container Park and the Downtown Project. The Zappos CEO poured $350 million of his wealth into this downtown Las Vegas project, with the goal of rapidly building a community from scratch as start-up city. Health can be impacted by the design of a city, and many cities are taking that cue. The Downtown Project wanted to create a walkable city and a new tech industry while experimenting with city building at the private level.…

We Are Not Done Changing

Recently, the on-line version of JAMA published an original investigation entitled "Patient Mortality During Unannounced Accreditation Surveys at US Hospitals". The purpose of this investigation was to determine the effect of heightened vigilance during unannounced accreditation surveys on safety and quality of inpatient care. The authors found that there was a significant reduction in mortality in patients admitted during the week of surveys by The Joint Commission. The change was more significant in major teaching hospitals, where mortality fell from 6.41% to 5.93% during survey weeks, a 5.9% relative decrease. The positive effects of being monitored have been well documented in all kinds of arenas, such as hand washing and antibiotic stewardship. But mortality? This is an interesting outcome, especially considering a recent ordeal I went through with my dear sister-in-law. She was on vacation in a somewhat remote location and suffers from a chronic illness, which requires her to…

Overcoming a Continued Physician Shortage

Updated statistics from the Association of American Medical Colleges (AAMC) show that the United States will continue to face a physician shortage over the next decade, ranging from a conservative estimate of a shortfall of approximately 40,000 to a pessimistic estimate of about 105,000 by 2030. The statistics are based on modeling a variety of policy and health care scenarios over the next 10-20 years to determine what the physician workforce requirements will be compared to the expected pipeline. Although the current and projected healthcare landscape is complex, dynamic, and uncertain, every estimate projects a shortage that is significant enough to affect patient care in the United States. The US population is both growing and aging, which creates an ongoing need for hospitalists and hospital-based patient care; between 2015 and 2030, the US population aged 65 and older will increase by 55%. Hospitalist groups will not only be impacted by…
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