Effectiveness/Efficiency

Clerk, Scribe, Transporter, Data Manager… a.k.a. the Doctor

We grab some popcorn on the way in. Maybe a drink. The place is bustling, bright lights lead the way, and the kids grab all the new objects at each turn. Another fun Saturday night about to begin. At Target. Yep, spending the weekend evening strolling the aisles of a big box store: family fun at its finest. It is crowded. We are clearly not the only ones who think a night on the town with the kids translates into a stop and shop for milk and new socks. The excursion does have some highlights – in particular, the self-checkout process. The 9-year-old loves to scan the items, bag them, and use the credit card as though she were paying. These machines are enticing, with the promise of efficiency and a way to avoid any chatty cashier – particularly the ones that announce the items as they are scanned. “Hey…

Survey Says…

It’s that time of (every other) year! Once again, your hospital medicine group (HMG) has a unique opportunity to contribute to our collective understanding of the current state of hospital medicine in the United States. SHM’s State of Hospital Medicine Survey kicked off this week and will be open until February 16th. I strongly urge you to take the time to participate. I have been integrally involved in SHM’s survey processes since 2006 and am deeply committed to this important work that SHM does on behalf of its members and the entire specialty of hospital medicine. Here are several reasons why it’s more important than ever that your group participate this year. The information contained in the State of Hospital Medicine Report is used by HMGs – and by hospital and physician enterprise leaders – to justify proposals and make operational decisions. The field of hospital medicine is evolving rapidly…

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,…

The Return of #JHMChat and Choosing Wisely

by Charlie M. Wray DO, MS
By: Charlie M. Wray DO, MS I’ll be honest – I can’t remember who won the 2012 Super Bowl, World Series or any other pop culture phenomenon*, but I do recall stumbling across something called Choosing Wisely® one afternoon while sitting in my clinic. With a burgeoning awareness that much of the care I was providing seemed superfluous and wasteful, the discovery that there was a group of physicians who shared this same sentiment was exciting! Five years in, the Choosing Wisely® campaign has published more than 500 specialty recommendations – with the Society of Hospital Medicine working on the upcoming version 2.0 (all are welcome to contribute!). Just as Choosing Wisely is gearing up for round 2, the Journal of Hospital Medicine’s (JHM) online journal club, #JHMChat, is rebooting as well! After a brief summer hiatus, we’re happy to announce that #JHMChat will be returning to discuss “Against Medical…
Charlie M. Wray DO, MS is an Assistant Professor of Medicine at the University of California, Francisco and the San Francisco VA Medical Center. He completed medical school at Western University – College of Osteopathic Medicine, residency at Loma Linda University Medical Center, and a Hospital Medicine Research Fellowship at The University of Chicago. Dr. Wray’s research interests are focused on inpatient care transitions, care fragmentation in the hospital setting, and overutilization of hospital resources. Additionally, he has strong interests in medical education, with specific focus in evidence-based medicine, the implementation of value-based care, and how learners negotiate medical uncertainty. Dr. Wray can often be found tweeting under @WrayCharles.

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…
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