MedEd

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…

How I Realized QI Could Be a Dirty Word

With the recent election, there has been a new recognition of the various “bubbles” we all seem to be living in. It reminds me of the parable I like to often mention, popularized by the late great writer David Foster Wallace: Two fish were swimming along when an older fish swam by, nodded his head at them and said, “Mornin’ boys, how’s the water?” The two young fish nod back and swim for a bit, then one turns to the other and says, “What the hell is water?” Recently, I read a paper that helped me realize I had been swimming in a different lake from most of the “real world” in medicine. I trained and then spent the first 4 years of my post-residency career at UCSF, where quality improvement (QI) was well established and celebrated. Sure, I suppose there were some eye rolls from a few surgeons, or…

Legacy from the Dying to the Living

by Jamie Yao
By: Jamie Yao Jamie is a fourth year medical student at the University of California, San Francisco entering into the field of internal medicine. She shares how her recent experience on a palliative care rotation at Moffitt Hospital in San Francisco, CA inspired her to express her feelings through poetry. Many of the moments on my palliative care rotation, such as the ones described in the poem, were inspiring. One that particularly resonates is when I had the opportunity to facilitate and witness the video chat exchange between one of our patients and his family, including his young children. It was simultaneously joyful and heartbreaking to see the love shared between him, his fiancee, and children. It was one of the many examples I encountered of the interactions between patients and their loved ones, who were often the crux of what patients derived meaning from in their lives. "Legacy from…
Jamie Yao is a fourth year UCSF medical student entering the field of internal medicine. Prior to medical school, she majored in Microbiology, Immunology, and Molecular Genetics at UCLA and completed a year of AmeriCorps with Hudson River HealthCare in Peekskill, New York. During her time on a palliative care elective at Moffitt Cancer Center, she had the privilege of working with and learning from an interprofessional team that showed her the varied ways that providers can care for patients. After being incredibly impacted by the patients she met and the vulnerability, resilience and love that they shared with her and their loved ones, she wrote her reflections in the poem, "Legacy from the Dying to the Living."

Next on #JHMChat: Ideas from Residents to Root Out Routine Labs

While the saying goes, “you can’t teach an old dog new tricks”, I think we all assume you can teach a new dog new tricks… or at least all of us in medical education believe this! However, new research in the Journal of Hospital Medicine highlights that maybe the old dog is the key to the puzzle after all. In the case of routine labs, a practice that has already been called into question by the Society of Hospital Medicine’s Choosing Wisely list, the majority of medicine and surgery residents at University of Pennsylvania admitted that they engaged in unnecessary ordering of inpatient labs, with over a third of them occurring on a daily basis! Why is this so hard to change? Not surprisingly, one of the key culprits was it was hard-to-break habit. However, several of the top reasons were also related to the “old dog”, also known as…

Taking CME to the Next Level on Twitter with #JHMChat

What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… until now! On Monday, July 11th, the Journal of Hospital Medicine will be hosting its 3rd Tweetchat. For those new to Twitter or to “tweetchats”, it is a block of time (typically an hour) on Twitter during which tweeters use a hashtag to engage in a dialogue about an issue. #JHMChat uses its one hour to engage in a dialogue about a particular article in the Journal of Hospital Medicine. We often choose an article that has implications for Costs of Care or Choosing Wisely and most importantly, could be practice-changing for hospitalists. While we…
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