Down the Vegas Rabbit Hole: SHM in Wonderland

“Curiouser and curiouser.” Alice, from Alice in Wonderland, 1st printing 1864

It’s time to think about Vegas.

A line spoken by many a bachelor, gambler, Rat Pack aficionado, or Cirque du Soleil fan. And now it is what you, our favorite SHM member, are thinking about. The glitz and glam of Las Vegas await and here are the daily questions you ask in anticipation.

Which featured speakers will dazzle me? Will Wellikson perform magic tricks during the presidential address? Did I hear Wachter might toss chainsaws while juggling patient safety, cost cutting, and quality? Do I watch Britney Spears or the update on hospital medicine?

Here’s where I convince you that it will be worth stopping by the quality track talks while taking you down the rabbit hole known as Las Vegas.

SHM’s HQPS committee helped put together an exciting,  quality set list. The stage is set for some great performances this March.

Choosing Wisely: Copperfield vs Terry Fator? Celine Dion or Blue Man Group? Craps or Blackjack? Best Vegas movie: Hangover or Ocean’s 11(the 1^st not the 2^nd)? Siegfried or Roy?

The real magic of Choosing Wisely (adults and peds lists) lies in getting the hospital to stop putting a telemetry monitor on every patient with a funny twinge between their jaws and their knees.  Or placing proton pump inhibitors on everyone who wears a gown. Enjoy watching our HQPS expert, CW committee chair John Bulger, review the lists, and discuss the $10,000 CW competition. That’s Vegas-style winnings!

Or perhaps you will gamble on updates in quality medicine? Nasim Afsar and team will dive into the latest patient safety and quality improvement literature updates.

Are you wondering how to make your small Vegas motel shine in the shadow of Mandalay Bay? Listen to Jason Stein and Tait Jones explain leadership in a clinical microsystem: the hospitalist unit.

What’s the difference between quality improvement and research? Kevin O’Leary, Andy Dunn, and Josiah Halm will break it down, perhaps to orchestral music with fountains in the background.

Greg Maynard, SHM’s CMO and leading quality guru, will help you use your QI measurement tools to maximal efficacy. Situational awareness, real time measurements and interventions: tools that may help at the craps table as well?

Can you navigate from the conference, to the slots, to the all you can eat buffet, a nightly show, and then somehow return to the 8 AM talk on transitions of care? Mark Williams and Jeff Greenwald know all about safe transitions, and will let you in on the latest BOOST info to help safely navigate your patients through the healthcare system.

Nate Spell was one of my mentors at Emory and is their current chief quality officer. See the inside story from an internist turned CQO. It will be like hearing the scoop on Texas Hold’em from the pit boss. That should help you turn some chips into cash.

The MARQUIS rat pack will help you make sense of medication reconciliation. And Shannon Phillips adds tips to engage leaders in quality.

Finally, have you wanted Aguilera, Cee Lo Green and Blake Shelton as your coaches? Catch the next best thing as yours truly teams up with Maynard and Cheryl O’Malley on tips for mentoring quality.

As part of the planning for the line up we dug up an old agenda for the 1864 Hospital Medicine Conference in Nevada. Down any good rabbit hole we find curiouser things. Fittingly, 1864 serves as the entry of Nevada into statehood and when the pioneer hospitalists celebrated with a little known meeting. Handouts included the newly published Alice in Wonderland.

Alice in Wonderland. Drawing by Jessie Wilcox Smith 1915. From Wikipedia Commons.

SHM 1864 Course Highlights:

• Procedures Precourse: from leech application to perfect cupping technique, ways to master bloodletting, purging and blistering.
• How to reduce your length of stay: going from 50 days to 49
• What’s the perfect hospitalist rounding number? Is it 200 or 300 patients per day?
• Hospitalism 101: how to make sure your patient succumbs to only 2-3 hospital acquired infections
• Civil War Medicine for the internist: 5 second amputation techniques
• Ventilation and cross ventilation. Miasma Management or how to air out a stagnant ward
• Resurrectionists: strategies to retrieve a corpse in the middle of the night without anyone noticing
• Bloodletting: it’s really all we got

None of this compares to the actual AMA committee listing for the June 7^th, 1864 meeting, in New York. Select Commmittee topics from the 16^th meeting, including:

• On the morbid and therapeutic effects of mental and moral influences
• On mercurial fumigations in syphilis
• On medical ethics
• On the entrance of air into the circulation through the uterine sinuses
• On compulsory vaccination
• On the hygienic relations of air
• On quarantine
• On the relations which electricity sustains to the causes of disease

Interesting sampling. Times have changed, but some topics never change. And some topics sound ridiculous. What will seem relevant from our conference 150 years from now in 2164? Wait, hospitalists? What are those? Our hospitals are staffed by androidists.

Well, you can’t choose from the 1864 SHM meeting, or the AMA 1864 meeting, but you do have great choices for 2014 SHM Las Vegas. I hope you choose wisely. Look out for the Mad Hatter, use your queen of hearts wisely at the poker table, and don’t be late. It’s a very important date.

Remember, what happens in vegas, stays in Vegas, and what happens at SHM, will likely be forgotten by Monday so take lots of notes.

Alice: I think I should understand that better, if I had it written down: but I can’t quite follow it as you say it.

(Give us comments! Now’s a great time for you to let us know what future quality courses you want, or if you know of any other long-lost 1864 SHM courses.)