Posts by Vineet Arora

Rounds: Are We Spinning our Wheels?

As a Johns Hopkins undergraduate, I used to run the Welch lecture series in medical history. Through this role, I learned about an interesting tidbit – the origin of the word “rounds.” Johns Hopkins Hospital had a circular ward where the infamous and quotable Dr. Osler made his “rounds” to see patients. While medicine has come a long way since Osler’s days, have rounds? This is the crux of a paper in the Journal of Hospital Medicine by led one of our former Pritzker students Olliver Hulland along with mentors and hospitalists Dr. Jeanne Farnan and Dr. Barrett Fromme. In a 3-site study with UCSF and Georgetown, they conducted focus groups with attendings and medical students to ask the quintessential question, “What is the purpose of rounds?” Interestingly, the answers were markedly similar and revealed the multi-faceted nature of rounds: Communication, which included coordination of patient care team, patient/family communication,…

Cultivating Women Leaders in Healthcare #WIMmonth #ThisIsWhatADoctorLooksLike

On my way home from Scotland, I had a moment to watch a movie while my daughter was caught up in the encore adventures of Moana. I stumbled upon Hidden Figures, the story of the African American women at NASA who helped launch John Glenn into space, relaunching the nation’s space program. These women were true heroes and patriots – they lived in a man’s world and a white world, and they still managed to overcome and lead when needed. Yet, their story was “hidden” from the public until years later when popularized into this screenplay. On the plane, I realized I needed a fresh take to start my women in medicine webinar for this month’s American Medical Association Women in Medicine webinar. Instead of exploring the ‘leaky pipeline’ resulting in 1 in 5 professors who are female, I wondered whether were there hidden figures – women leaders among us…

We Have a Voice. It’s Time We Use It. #DoctorsSpeakOut

Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a trainwreck in progress. You may have thought about saying something, but paused and wondered, “Is this professional? What will this say about me as a doctor? What would my colleagues/supervisors think? What would my patients think?” You are not alone. I get stopped, emailed, and messaged frequently by others wondering if they should enter the fray. Something interesting happened with the recent Repeal and Replace or Repeal and Delay or Repeal and whatever roller coaster: Doctors did speak up! One group that was truly impressive was the pediatricians on Twitter, known as “tweetiatricians” who all recorded short…

Is Patient-Centered Care Bad for Resident Education? #JHMChat Explores #meded & #ptexp

The term “patient-centered” has become a healthcare buzzword and was certainly popularized by the creation of the patient-centered medical home in ambulatory care. In the inpatient world, patient-centered rounds symbolizes this effort to improve patient experience and is the subject of a new study in this month’s Journal of Hospital Medicine, which we'll discuss on next Monday's #JHMChat at 9 p.m. EST on Twitter. In a randomized trial, Brad Monash and UCSF colleagues explored the impact of patient-centered rounds on patient experience. Patient-centered rounds was a bundle of 5 evidence-based practices: 1) pre-rounds huddle; 2) bedside rounds; 3) nurse integration; 4) real-time order entry; and 5) whiteboard updates. The control group continued with routine practice of attending rounds. The study was impressive for several reasons, but one in particular caught my attention – an army of 30 pre-med students volunteered to be observers (and also get shadowing experience?) to monitor…

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…