Hand Washing Deniers

We do monthly audits of how compliant our hospital personnel are with hand hygiene. Last month, our hospital hit 97% and the month before, 98%.  The policy is that everyone (doctors, nurses, physical therapists, housekeeping, etc.) has to sanitize their hands when entering a patient room and again when exiting a patient room. No exceptions. […]

I Can’t Get No (patient) Satisfaction

Last week, I attended a breakfast that our medical center put on for physicians ranking in the top 10% nationwide for patient satisfaction. The remarkable thing is that last year, no one invited me to breakfast. Not even close. In fact last year, my patient satisfaction scores were abysmal. Did I change my doctor-patient interactions? […]

“The Patient Suddenly Worsened”

Patients who get transferred to the ICU often have transfers notes saying to the effect “The patient’s condition suddenly worsened.” In reality, the patient’s condition didn’t suddenly worsen, it is just that we suddenly noticed. In its extreme, that worsening results in a cardiopulmonary arrest. It goes by different names in different hospitals. Sometimes it […]

The Most Dangerous Procedure In Medicine

Alright, from the title of this post, I’m sure you are trying to guess what it is. Open heart surgery? A craniotomy? Separation of conjoined twins? Wrong. The most dangerous procedure in medicine is the hospital discharge. From the time a patient is admitted to the hospital, the medical resident or the hospitalist has one […]

The Documentation Game

Our hospital finished the last year with an inpatient mortality index of 0.54, a fantastic accomplishment. That means that we provide great care and we play the documentation game well. If the hospital mortality index is 1.0, that means that you had exactly the number of inpatient deaths that other hospitals have on average, after […]

Reducing COPD Readmissions

On average, about 1 out of 5 patients admitted to the hospital with COPD in the U.S. get readmitted within 30 days. There is a wealth of medical literature analyzing COPD readmissions. For example, we know that patients at risk for readmission include: Patients without physician follow-up within 30 days of discharge African Americans Older […]

PrEP Your Hospital To Prevent HIV

I’ve been waiting for 35 years but finally, we have a way to prevent HIV infection. HIV and AIDS has been the defining illness in world health over the course of my career. June 1981: I had just finished my first year of medical school the month that the CDC first reported an outbreak of a rare […]