• Why is everyone so upset about the VA APRN proposed rule?

    The best outcome of research in healthcare quality and safety would be to make the practice of medicine and healthcare systems so safe and so good that we essentially make ourselves obsolete. Are we there yet? Some think so. Within the VA system, a new rule has been proposed: “expanding the pool of qualified health care professionals who are authorized to provide health care… without the clinical supervision of physicians” and “to exercise Federal preemption of State nursing licensure laws…regardless of individual State restrictions that limit such full practice authority”. Let’s look at the details…

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  • Medical error is #3 cause of death – what does this mean?

    Recently, a paper written by researchers at Johns Hopkins and published by the British Medical Journal estimated that medical error was the third leading cause of the death in the United States. This received – as you might imagine – considerable coverage in the media. The researchers proposed that death certificates should include a qualifier or indicator that medical error was linked to the death, if in fact it was, so that better statistics could be obtained. I certainly can’t argue with the fact that we do not have good data about how frequently medical error occurs, or how frequently such errors contribute to serious disability or death. However, the paper also offered a case illustration which did show how un-illuminating the death certificate is, but in my view, did not actually demonstrate a preventable error.

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  • Are mentors missing in academic medicine?

    Are we (the establishment of academic medicine) doing a good job of providing mentorship to the next generation? What is the “path” or “formula” – is there one? Can we improve faculty development for those who have dedicated their professional careers to academic pursuits – those who will make the big discoveries and leaps forward in patient safety and quality healthcare? If you are an academic, I hope you’ll…

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  • Collaboration in Patient Safety: SPA and AAP lead by example

    While I’m sure that all physicians and other healthcare professionals want to collaborate in order to achieve the highest quality of medical care and enhanced patient safety, the Society for Pediatric Anesthesia and American Academy of Pediatrics are really leading by example. They hold a jointly sponsored academic meeting, and I had the privilege of speaking at one of the plenary sessions this year on quality and safety. This was a very special invitation, since I am not a pediatric specialist. The meeting was designed to focus on topics of pediatric anesthesia and sedation, as well as pain management and critical care services for infants and children.

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  • Innovations in patient safety: let’s consider a nudge

    A nudge is a form of social engineering to help people make the best decisions by also making the easiest, laziest choices – the defaults – the “right” choice. Example of success stories include helping people to save for retirement, increasing organ donation status for people who want to be organ donors, and healthier food choices by school kids in their cafeterias – even when the unhealthy choices were still readily available. The nudge represents an untapped source of innovation in patient safety efforts. How can we apply this concept to healthcare? First, let’s look at some serious nudge fails:

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  • Happy Friday! Play is the new work.

    By Marjorie Stiegler on February 26, 2016 in Framing, Resilience
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    There’s a subculture in healthcare that seems to resent all expressions of delight that the weekend is coming. This is probably because so many of us don’t have traditional weekends. We work – maybe just a “regular” day, maybe 48 hours straight. We may or may not earn any extra money for this time, and we may or may not get a day off during the week as our consolation prize for weekend or holiday duty. So when the world is abuzz with weekend joy, some healthcare professionals are “celebrating” like this:

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  • What Dr. Laura knows about why doctors should be active online

    “The reason I do this show on the radio is so that other people can benefit from what I’m saying. I don’t have a fix for you, but I’m glad you called, so that other women out there listening to this can avoid the decisions and mistakes you made.”

    I believe that healthcare leaders and medical experts have a professional obligation to be present on the internet, so that they can…

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