Quality Improvement (QI)

This Football Season, Watch out for This Teammate

Fall means football. Even in Florida where it’s still 90 degrees, we can pretend autumn has arrived, with football on the lawn as a rite of passage. Recently, I was in the front yard playing with my 2 daughters, 7 and 9 years old. We decided to play some 2 on 2, with myself as automatic quarterback, just like the good ole days of backyard football. (Although as a kid there were always fights on who would be QB. I often lost. One of the benefits of being a Dad, I just tell them I’m automatic QB and no one argues. “...because I said so.”) Shayna, the older one, and I drew up a play on her shirt, tracing it out with my finger, hidden from the eyes of the youngest, Lyla. We created some complicated play with a little razzle-dazzle, some goofy faces to distract the opponent, and then a…

Tackling Costs of Care on Twitter: Join the First #JHMChat on October 12th

On October 12th at 9 PM EST I will be hosting the first #JHMChat, a twitter chat dedicated to talking about the newest research coming out of the Journal of Hospital Medicine (@JHospMedicine), SHM’s journal of peer reviewed research. If you are unfamiliar with what a Twitter Chat is, you can read more about it here. For this first #JHMChat we will be discussing Dr. Chris Moriates’ recent Things We Do for No Reason article, “Nebulized bronchodilators instead of meter-dose inhalers for obstructive pulmonary symptoms.” Why should you, a busy hospitalist with lots of demands on your time, do this? Well, for starters, this is a great opportunity for you to learn, ask questions about the research and interact with the author! More importantly, unlike other types of events, there is no guilt associated with being on a Twitter chat. After all, Twitter is like a cocktail conversation that you…

Mourning the Morning Lab

by Christopher Moriates, MD
By Chris Moriates, MD There is something oddly comforting about those morning labs: a ritual that I wrapped myself in during residency. Like swirling the milk into my cup of coffee, it is something that I do deliberately but only half-consciously each morning - make a list of my patients for the day, look over their vitals, and review their morning labs. I became a ninja at repleting potassium, hitting a “K=4.0” precisely, playing that game many play when filling their car with gas, trying to get the numbers to stick on a round amount (this potassium repletion more often than not was likely just as meaningless). Now nearly everybody – including me – is agitating for us to lose this part of our morning routine. No longer are there always lab results magically waiting for me when I arrive at the hospital. (During my residency, did I ever stop…
Christopher Moriates, MD is a hospitalist and assistant professor at the University of California at San Francisco, Director of the Caring Wisely program for the UCSF Center for Healthcare Value and Director of Implementation Initiatives at Costs of Care. He co-authored the book Understanding Value-Based Healthcare (McGraw-Hill, 2015), which Atul Gawande has called “a masterful primer for all clinicians,” and Bob Wachter said is “essential reading for everyone who care about making our system better.” This post is part of a series for The Hospitalist highlighting topics or lessons from this book.

Are Hospitals Turning into Hotels?

“The idea that hospital patients might benefit from redemptive surroundings is far from new.”—Robert Cork, The Healing Presence of Art My last blog post reimagined a hotel stay through the eyes of a patient. I received numerous responses about the post(ok one person queried me about the post. And that person was actually looking for Flansbaum) regarding the difficulty of comparing hospitals and hotels. Hospitals are matters of life and death, and it can be seen to belittle their missions by comparing life saving hospitals to consumer driven hotels. Patient satisfaction incentives and competitive business practices seem to be transforming hospitals into 5 star atmospheres. This has been written about in several posts here and here. Last year, the NY Times nailed this sentiment in a short quiz aimed to spot differences between hotels and hospitals. Have we gone too far in transforming our bulwarks of illness into bastions of comfort? Or as my post alluded,…
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