Posts by Jordan Messler

Navigating a Near Miss

When my daughter was around 5 years old, she disappeared. We were outside, my wife and I doing some work around the house, and our 5-year-old playing on the driveway. She was deeply engrossed in some colored chalk, creating an infinite hopscotch board. I stepped inside to grab something, and my wife went to grab something else on the side of the house. We both returned to the driveway to find chalk rolling down towards the sidewalk – and no daughter. She couldn’t have run into the house; that’s where I was. Nor the backyard, where my wife had been. We call her name, look around, and then realize she must have run off down the sidewalk. But we don’t see her. Images flash by. She runs into the street and gets struck by a car. She turns towards a backyard and vanishes in the next neighborhood. She hides behind…

Da Vinci Wuz Here

Waiting to enter, the history began to unfold. As I glanced past the modern idle ambulances, the beauty of the porticoed walkways conveyed its antiquity. This entrance is a mere 400 years old, a recent upgrade to the 1286 facility. Once inside, through the automatic doorways, the lobby was not unlike many others. Couches framed the main hallway, busied with the crossing of staff in scrubs, wheelchairs whizzing by and staff using their badges to disappear behind doors as quickly as they appeared. Some were walking with heads high on their way out; visitors were walking in with nervous and blank looks with slumping shoulders. If it wasn’t for the Italian speech floating around, I could have been at my home hospital. I am about to walk through Santa Maria Nuova, in the heart of Florence. The tour will travel back in time 731 years, transporting me from hospice to…

George Carlin Predicts Hospital Planning Strategy

My wife and I are planning to add square footage to our house. We want more space. We are considering an office expansion, a guest room, and making the master bedroom more master and less bedroom. The kids are growing, the family is always visiting, and we have no plans to relocate. We also need more space for our stuff. "Everybody's gotta have a little place for their stuff. That's all life is about.  Trying to find a place for your stuff." — George Carlin We added a shed, stuffed the closets, and overloaded the garage. How did we get so much stuff? The average US household has 300,000 things in it. In addition, houses in the US have tripled in size since the 1950s, yet fewer people live inside these homes. We're one of the 25% of American households that have a two-car garage but don't put both cars in there.…

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…

The Essentials of QI: It Starts with Leadership — A Conversation with Dr. Eric Howell

SHM’s Center for Quality Improvement is the hospitalist’s home for quality improvement (QI). QI became a foundational theme for SHM early in the growth of hospitalists. It’s not a coincidence that many of our leaders, such as Bob Wachter, Win Whitcomb, Greg Maynard, and Mark Williams are QI leaders as well.  As hospitalists, we were and are best positioned to impact quality in the hospital. The Center provides a comprehensive set of resources and programs to support hospitalists and other hospital clinicians as they work to improve quality and safety in their hospital. SHM’s Mentored Implementation (MI) is one example of how hospitalists are supported to facilitate systems change and improving hospital outcome, in which SHM pairs a hospital team with a physician mentor. The MI model is an evidence-based framework developed to support QI teams via planning and implementation of interventions. Mentored Implementation programs and resources have been implemented…
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