A blog for and about medical directors
In medicine, we talk about quality a lot. But most of the time that we are talking about it, we’re really not talking about quality at all. You see, quality means different things to different people and most of the time, we are confusing quality with value. Value = Quality ÷ Cost There are 5 […]
CMS just released its newest star ratings for U.S. hospitals. The ratings were supposed to come out last summer but there was a delay because of problems with the methodology Medicare was using. The rating system attempts to compare hospitals’ performance with common conditions. Hospitals are rated with 1 – 5 stars, with 5 stars […]
The demand for inpatient palliative medicine services is very high and the supply of palliative medicine physicians is rather low. When considering bringing palliative medicine services to your hospital, the real value of palliative medicine is in what does not appear on the basic accounting pro forma. A robust palliative medicine service is a multidisciplinary […]
It is a vexing question that most hospitals and medical practices face eventually: when you have an expected or unexpected physician vacancy, do you bring in a temporary substitute? Locum tenens is a huge business – rarely a day goes by that I don’t get a phone call or an email from a locum tenens company […]
One of our surgeons always has better pain management scores than anyone else. So, I asked our nurses why and they told me. Every month, I review our hospital’s HCAHPS survey scores that measure patient satisfaction about their inpatient hospital stay. Two of the questions on the survey are about inpatient pain management: During this […]
Saline has been the go-to intravenous solution for decades. Every year in the United States, more than 200 million liters of saline are given to patients. Two studies presented at this week’s American College of Chest Physicians meeting indicate that we may have it all wrong and that we should NOT be using saline for […]
One of the casualties of Hurricane Maria was the Baxter Healthcare. Baxter makes supplies and fluids for intravenous therapy and also makes products for dialysis. One of Baxter’s manufacturing plants is in Puerto Rico. When the hurricane knocked out power to the island, the plant was not able to make products. The products that they […]
The HCAHPS survey measures patient satisfaction with various aspect of their hospitalization. One of the sections of the survey is about doctor communication with the patient. Because a hospital’s HCAHPS results are publicly available, hospitals want to do everything they can to keep their scores up. As a hospital medical director, one of my jobs […]
Epinephrine is the most common drug used to resuscitate patients in cardiopulmonary arrest. EMS squads keep it on hand during every emergency run and hospitals contain it in their code carts. Epinephrine comes in a variety of strengths and dosing sizes but during cardiopulmonary resuscitation, the most commonly used size is the pre-filled 10 ml […]
Telemedicine. It is an idea that just seems to make so much sense but it has had a hard time getting much traction in the United States. But recently, economic forces are causing telemedicine to become a viable option in a number of areas. Here is how we are using telemedicine in our hospital: Prison […]