Hospital rankings: I wasn't cynical enough.

Whenever I think I am too cynical about the business of health care, I learn something that makes me understand that I am not cynical enough.  You may recall my 2011 column about the silliness of the hospital rankings published in one of the national magazines. I said:US News needs to stop relying on unsupported and unsupportable reputation, often influenced by anecdote,...

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They should have been given a Miranda warning

Sometimes the exact words that people use to blame others serve as the most powerful indictment of their own ineptitude and culpability.  Imagine if you were to read the following statements from the owner/governing body of any non-profit hospital in America, describing a situation that lasted almost a decade:[The hospital owner's president] blamed the facility’s debt on administrators who were not forthcoming. “We were not getting full disclosure....

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In Sickness As In Health

I've just read an excellent book called In Sickness As In Health: Helping couples cope with the complexities of illness, by Barbara Kivowitz and Roanne Weisman.  I recommend it highly. It serves an an excellent reference to people who find they have to deal with the acute or chronic illness of one of the partners in a marriage or other close relationship.  Beyond...

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SNFs on WIHI

Madge Kaplan writes:The next WIHI broadcast — Mobilizing Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations: New Imperatives and New Models — will take place on Thursday, February 27, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Laurie Herndon, MSN, GNP-BC, Director of Clinical Quality, Massachusetts Senior Care FoundationDavid...

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Mayhew's "Wounded" as finalist for the Wellcome Book prize 2014

You no longer have to take just my word for it.  Now Emily Mayhew's book Wounded is on the short list for the Wellcome Book Prize for 2014.  For those not familiar with this prize, here's the description:The Wellcome Book Prize is an annual award, open to new works of fiction or nonfiction. To be eligible for entry, a book should have a central theme that engages...

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There is a non-zero chance of problems

In contrast, in a under-performing hospital, they would say, "The data are wrong," and "Our patients are sicker," and then give up.Back in 2009, I wrote: The fear of transparency clouds all. That still applies in all too many plac...

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Is there an app for this?

An article in Nature reports:The publishers Springer and IEEE are removing more than 120 papers from their subscription services after a French researcher discovered that the works were computer-generated nonsense. Over the past two years, computer scientist Cyril Labbé of Joseph Fourier University in Grenoble, France, has catalogued computer-generated papers that made it into more than 30 published conference proceedings...

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MedStar maintains the focus on transparency

MedStar's David Mayer addresses an important process improvement imperative--transparency--in this recent post and gives an example of how his institution is trying to overcome inertia and fear on the matter:An important part of this journey includes creating a learning culture built on transparency that many in healthcare are still uncomfortable with....

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Not "Not Running a Hospital"

For those interested, I have gradually copied posts related to transparency and Lean process improvement to my other blog (aka, "Not Not Running A Hospital") to serve as an archive and resource to people in hospitals who might want to review the experience at Beth Israel Deaconess Medical Center and other hospitals and apply lessons to their own institutions.  I've also included stories from training programs I've conducted around the world...

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Hope is on its way

As we consider the imperatives for a health care system that Gene Lindsey espouses, we have to wonder who will get us there.  Clearly it will not be the government, for the government is paralyzed by the conflicting interests of those who seek to extract their share (or more) from the 18% of GDP represented by the health care system.  Legislators and presidents are...

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Why should our industry expect success?

Several of us are lucky to be on a weekly email message list from Gene Lindsey, former CEO of Atrius Health, the largest multi-specialty group in Massachusetts. Drawing on a variety of life situations, Gene is always able to make connections and comments about the state of our health care system. Although he generally refers to issues in the US, his comments are applicable to other jurisdictions as well. This week, he asks and then answers a question,...

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Medicine for Managers and Entrepreneurs at MIT

I was pleased to be invited by Dr. Richard J. Cohen, Whitaker Professor in Biomedical Engineering, to address a new class he is offering at MIT, called "Medicine for Managers and Entrepreneurs." The goal of the course is to teach a bit about medicine to individuals who have a career interest in starting or managing a biomedical company.  The students in the course are...

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Nominations for the John Q. Sherman Award for Excellence are Now Open

Jim Rattray wrote and asked me to let you know:Here's your opportunity to spotlight the exceptional work that your organization is doing to advance patient and family engagement! Nominations are now open for the John Q Sherman Award for Excellence in Patient Engagement. Full details are available here. Visit now to review award criteria and to download the official award...

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MITSS Tweet Chat

Medically Induced Trauma Support Services, Inc. (MITSS) is a non-profit organization whose mission is to support healing and restore hope to patients, families, and clinicians who have been impacted by adverse medical events.  They invite us all to the following:Join us for a live Tweet Chat on Thursday, February 27th, from 6:30 to 7:30 pm ESTSupporting patients...

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A commendable record in dealing with conflict of interest issues

I received the following message today from Bill Burton, Interim Associate Chancellor for Public Affairs at the University of Illinois, presumably in response to my blog post concerning the propriety of the Dean of Medicine being on the board of Novartis, and specifically my question: How can this person exercise a proper duty of care and loyalty to both institutions, not only in terms of time commitment, but also in terms of the overlapping scientific...

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The Chicago Tribune reports on the University of Illinois

Karisa King and Jodi Cohen at the Chicago Tribune have published an excellent story about how some doctors and admininstrators decided to use the name and reputation of the University of Illinois in support of a medical device company.  With access to internal emails, it becomes clear that an explicit decision was made to do so by very high-ranking officials:Benedetti,...

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Zack Berger explains what noncompliance means

Dr. Zackary Sholem Berger offers a pithy definition of patient noncompliance.  Excerpts:Noncompliance means I think the patient should do it this way and the patient didn’t do it this way. “Noncompliance” makes no effort to figure out why the patient did what they did, or what alternatives they might have selected instead.“Noncompliance’ makes no effort to figure...

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She refuses to say "bibbidy-bobbidi-boo"

While the overall goals of the Affordable Care Act are spot on, there are various unintended consequences.  As the Administration tries to fix some of these, others are left standing.  I think what people find frustrating is that there seems to be little transparency about the process and the standards by which some changes are permitted and some are not.  As is often the case, complaints arise not so much because of the decision that...

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Helping the underdog

We all like to support the underdog, and Patricia Salber, host of The Doctor Weighs In, gives us a chance.  She writes:I am trying to support some Hopkins engineering undergrads who are competing in the Qualcomm Tricorder XPrize against the big well-funded guys, like Scanadu:  They are trying to raise a small amount of money (10K) on Indiegogo.  If you could...

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25 days to go in Illinois

In 25 days, the president of the University of Illinois is due to receive the report from the Vice President for Research that will evaluate the circumstances surrounding the use of the University's name and reputation in support of a private medical equipment supplier.  Recall that the VP was charged to "conduct a methodical assessment of policies, guidelines, procedures and practices, and where corrective changes are required we will take...

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Jim Dougherty emphasizes culture as part of the business model

Here's a very nice blog post by entrepreneur Jim Dougherty about the importance of cultural issues in a firm.  He titled it "Company Culture is Part of Your Business Model."  Key point:Culture, in my mind, is the single most important attribute to successful companies.  Inevitably, when things don’t go well for a company, the culture is what has a lot to say...

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Tile will find your lost keys, or whatever

Every now and then, a really clever device hits the market.  I just saw this one, Tile.  It is a small plastic square that can be attached or hooked onto something you don't want to lose--keys, computer, backpack, bicycle.  When you need to find the item, your iPhone acts as a homing device--visual and oral.You can also use the gizmo to report a lost item, at...

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An open letter to the Israeli government

Dear friends and colleagues,With everything else you face, the last thing you needed on your agenda was the financial collapse of the country's major academic medical center, Hadassah (comprising two hospitals in Jerusalem.)  That the disruption in patient care, research, and education--not to mention the financial hardship of the doctors, nurses, and other staff--might have been avoidable is of little solace right now.  It will take weeks...

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Follow-up to the white coat issue: Enclothed cognition

A few weeks ago, I wrote that the robotic surgery advertisement acceded to by the University of Illinois in support of a private company made inappropriate use of the image of white coats.  I argued that it did so to bring greater credibility to the advertisement: The public . . . views that symbol as emblematic of that sacred trust.  We look up to and respect people wearing the white coats.  We know they have devoted themselves...

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Lean-ing nicely in Den Bosch

I had a chance today to visit one of my favorite hospitals, Jeroen Bosch Ziekenhuis in the Netherlands, and spend time with a number of managers who have been exploring a wider application of the Lean process improvement philosophy.  Frans van de Laar, who runs the blood and urine laboratory, recently introduced one of the simplest and most effective examples of standard...

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Equity on WIHI

Madge Kaplan writes:The next WIHI broadcast — February 13, 2014: Working Toward Health Equity — will take place on Thursday, February 13, from 2 to 3 PM ET, and I hope you'll tune in.Our guests will include:Tessa Kerby, MPH, Manager, Measurement and Organizational Improvement, HealthPartnersYvonne Coghill, OBE, Senior Program Lead – Inclusion and Coaching, NHS...

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