A recent story in U.S. News & World Report described how a Seattle hospital is taking a systems approach in improving health care quality and cutting costs. It said, "Virginia Mason Health System ... has looked to adopt many of the much-admired and often-emulated business philosophies from Toyota." The best-known of those philosophies is the so-called lean methodology which is based on eliminating waste and focusing on things that ...

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The wrong body was cremated by the county coroner’s office in Los Angeles. Jorge Hernandez died of an overdose, and the body of another Jorge Hernandez, an indigent patient, scheduled for cremation, was also present in the morgue. The distraught family of overdose victim Jorge Hernandez had planned a funeral with a viewing and were shocked when they were told his body had been cremated by mistake because a morgue attendant ...

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It was an interesting fortnight for the debate about the treatment of appendicitis. On November 1, David Agus, a medical oncologist, and director of the University Of Southern California's Center for Applied Molecular Medicine, had some thoughts about how appendicitis should be treated. He cited the Finnish randomized trial of antibiotics vs. surgery and said a 70 percent cure rate was good enough. In a brief article on the Fortune magazine website, ...

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What is one of the rules that medical people comply with the least? My vote goes to "translation." The rule is that you must use a qualified medical interpreter for any interview or discussion with a patient who does not understand English. How is “lack of understanding” defined? It is usually fairly obvious. If you aren't sure whether the patient gets it, he probably doesn't. Why can't family members act as translators? There is ...

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Speech recognition errors occurred in 71 percent of emergency department notes, and 21.1 percent of notes with errors were judged as critical with potential implications for patient care says a recent study in the International Journal of Medical Informatics. Investigators looked at a random sample of 100 dictated notes and found 128 errors or 1.3 errors per note. More than half of the errors were ascribed to speaker mispronunciation. Although ...

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A South Carolina jury awarded a woman $4,618,500 for a needlestick injury she sustained in the parking lot of a Target store. She had parked her car, and while walking to the store, her daughter picked up a hypodermic needle. As she swatted the needle out of the child’s hand, it punctured the woman’s palm. She went into the store and notified an employee. HIV post-exposure prophylaxis medications were prescribed which she ...

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By now you've probably heard about the hospital that charged $39.35 for a woman who just had a cesarean section to hold her baby. The baby's father posted a copy of the bill on Reddit, and it drew over 11,800 comments. The story was also widely circulated on Twitter. At least one labor and delivery nurse on Reddit and a spokesperson for Utah Valley Hospital where the baby was born stated that ...

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This foreign body was removed from a non-healing abdominal wall incision in an elderly lady with many comorbidities and previous operations. It was a rigid plastic tube which was 7 cm long and 2 to 3 mm in diameter. There were four transverse grooves at either end. foreign-body Physicians caring for her were unable to identify it. One of them emailed me the photos ...

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“The unintended consequences of these seemingly well-intentioned laws are doctors who can’t apologize for harming their patients even if they want to …” A recent JAMA article about disclosing medical error described a hypothetical situation involving a dermatologist who, after completing skin biopsies on two patients, discovered that the instruments had not been sterilized. He wondered if he should tell the patients and what he should say. The authors of ...

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"I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today, and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say, I'm disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, ...

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