“They need you in room 13,″ she said when I answered the phone and I ran back to the ICU.  The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her.  She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, in the end, she died. Running a code, as we call it, means that someone is ...

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You can find reviews on almost anything; we “Yelp” restaurants before we try them, we scrutinize customer feedback when we purchase products on Amazon and we check out how many stars a dry cleaner or car mechanic has. Medicine is, for better or for worse, becoming the same way. You can Google a hospital or physician and find comments or reviews, and this worries many doctors. Most physicians don’t like the ...

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141012-usnews-dallas-ebola-hospital-gv-620_9d8c02abc7847247bf62b2d621b6a8e4 The first “wild” Ebola case in the United States has occurred in Dallas, Texas. The patient, who is from Liberia and had contact with a pregnant Ebola victim in his native country, was initially sent away from the emergency department (ED) of a Dallas hospital after reporting there with viral symptoms. He told the triage nurse that he had just arrived ...

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Around the country, for every health system that is successfully navigating the early years of value-based health care, there are several others that are failing -- even though many don’t yet realize it.   These failing organizationscan’t or won’t restructure themselves to deliver effective, efficient and affordable care. I’ve come to the conclusion, after observing struggling systems, that two basic characteristics are necessary for systems to transform themselves in response to external pressures: execution and motivation. Successful systems have ...

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It’s funny to think that the internet and the online world, so entrenched in our modern day lives, is still a relatively new phenomenon. When I first started medical school (not really that long ago) we hardly used the internet and the concept of a web search barely existed. It only became widely available on home computers shortly after that. The invention of social media is newer still. If any of ...

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As part of the admission process for a hospice patient, the admission team will ask the patient about their spiritual orientation and/or religion. Because there is so much information and education to convey at the admission, the discussion of a patient’s spiritually may only be minimally discussed. It is important for the hospice team to be aware of a patient’s spiritual orientation because it can affect their choices regarding treatment ...

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shutterstock_168769238 Ebola is in the United States!  Everybody (please don't) panic!  Quarantine all Texans!  Though that might be a good idea anyway (just kidding).  More on Ebola in general in another post if I have time. First off though, we've found out more information about the sequence of events leading to the hospitalization of the patient, Thomas Duncan.  Apparently, he came ...

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Earlier this year, our hospital staff was weighing a new 24/7 family presence policy to allow immediate family members to stay with  patients 24 hours a day. We knew this was a step in the direction of delivering patient- and family-centered care. We presented the proposal at a meeting of our patient and family advisory council.  One of the members of the council told a story that drove home the importance ...

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Not long ago, the Joint Commission established that patients with pneumonia should receive antibiotics within four hours of diagnosis. Timely diagnosis and treatment can be the difference between life and death in patients with this illness. In fact, some people believe this kind of quality measure should play a large role in how we pay for medical care. After all, doctors should not be paid solely on the basis of ...

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We recently had a readmission -- a straightforward case, really.  Mr. Jones, a 64-year-old homeless veteran, intermittently took his diabetes medications and would often run out.  He had recently been discharged from our hospital (a VA hospital) after admission for hyperglycemia.  The discharging team had been meticulous in their care.  At the time of discharge, they had simplified his medication regimen, called him at his shelter to check in a few ...

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