Running a hospital: The message you hope never to send

As with many stimulating blog postings, the comments are as interesting as the post itself. Kudos to Paul Levy for doing his best to handle this differently than is the norm in health care - that’s an important role for a CEO who wants to change health care for the better.

I’m particularly drawn to the comment(s) by Ray Poses, MD about doing a “5 Why’s” type exercise to see what is happening upstream (why are teams being pulled in so many different directions regularly) that causes protocols to be slipped.

I also think there’s an opportunity for BIDMC to bring in patients and families to own the solution together. What would care be like if there was a family member in the operating room during surgical prep (Medical College of Georgia does this)? Or if the family had access to the patient’s electronic medical record in real time while in the hospital? Preventing this for another patient may be less about “what” to do in the operating room, but “how” teams (that include patients and families) are involved in the design of the system.

Given the work BIDMC has been doing to be transparent and involve more, rather than less, people in designing and improving their care system, it seems that they’ll do their best for their patients this time, too.

February 18th through February 19th:

• Graffletopia - Nice set of stencils for Mac users of diagramming software
• Lean Manufacturing Blog, Kaizen Articles and Advice | Gemba Panta Rei - Primer on Hoshin and SMART goals
• Life as a Healthcare CIO: Rapid Application Development with Facebook - Looking at innovative consumer technologies as an opportunity in the CIO role is a great thing. I’m a fan.
• Hooked: Ethics, Medicine, and Pharma: Institutional Conflicts of Interest Policies: Some Assembly Required - This tracks back to medical schools’ support of community health…
• Health Care Renewal: Medical Schools to Faculty: “Show Me the Money” - The contribution of medical education to fostering patient centered care is challenged by the current system.

February 15th through February 16th:

The first few links are from the history of diversity in various industries’ and their impact on quality, affordability, and safety.

• “Fly Me” - TIME - National Airlines pleads innocence in 1971 to the “Fly Me” campaign despite flight attendant protests.
• Classic TV Commercial Jingles: Braniff presents “The Air Strip” - A commercial dubbed “outrageously sexist” for its portrayal of flight attendants.
• Coffee, Tea or Tails? - TIME - Article from 1974 about Continental’s “We Move our Tails For You” ad campaign
• Health Care Renewal: GE: We Bring More Conflicts (of Interest) to Light - An example of a purchaser that struggles with supporting an affordable care system, and supporting an un-affordable care system at the same time.
• No Pharma Funding | When Memorial Sloan-Kettering Cancer Center in New York City stopped accepting commercial support for its continuing medical education activities last January, many at the institution had their doubts that the program would survive - CME without industry support is possible. I would tend to favor events that are less fancy and have less bias.
• apophenia: open-access is the future: boycott locked-down academic journals - A more assertive argument around locked down journals.
• Running a hospital: You can take your $15 fee and … ! - I wonder how relevant peer review is in general. I am going to start a tag cloud on this and keep track.

PCHIT links for December 26th through December 27th:

• Early Experiences with Personal Health Records — Halamka et al. 15 (1): 1 — Journal of the American Medical Informatics Association - As reviewed here: http://www.tedeytan.com/2007/12/27/242/
• Patient-centered Applications: Use of Information Technology to Promote Disease Management and Wellness. A White Paper by the AMIA Knowledge in Motion Working Group — Demiris et al. 15 (1): 8 — Journal of the American Medical Informatics Association - Nice description of what we know/don’t know about PCHIT. However, given that the rest of the world uses IT in a more customer centric way, are we going to wait for research?
• PHRs: From Evolution To Revolution by Liz Boehm - Forrester Research - Interesting commentary on health plans, PHRs, and adoption. Are health plans ready?