Quality Efficiency Utilization

Hospital Capacity Management and the Enlightened Hospital Leader

June 11th, 2013
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Nearly every hospital leader in America will tell you their hospital is all about patient-centered care. Of course, we know this isn’t true in many cases, especially when it comes to hospital capacity management. Though many institutions will deny to its last dying breath that they have any priorities that supercede patient care, nearly all […]

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Posted in Quality Efficiency Utilization

“In Good Hands” – Bristol Hospital ED in the News!

March 17th, 2013
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The Bristol Press today published a great front-page story about the remarkable turnaround our team has managed in patient satisfaction scores at Bristol Hospital, our newest hospital partner. Last month, Press Ganey scores were at 95%, making Bristol Hospital one of the top Connecticut Hospitals for patient satisfaction. We have a mindset and culture to […]

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Posted in Quality Efficiency Utilization

60 Minutes Segment Gets at Crux of Healthcare Failings

January 16th, 2013
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In some ways, last month’s explosive 60 Minutes segment, “Hospitals: the cost of admission,” gets at a central crux of the healthcare problem in America. The segment accuses Health Management Associates (HMA), a hospital system with 70 locations mostly in the southeast, of pressuring its emergency physicians to admit patients regardless of medical need in […]

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Posted in Future of Healthcare, Quality Efficiency Utilization

Thoughts on Choosing Wisely and Overuse

August 2nd, 2012
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About five months ago nine physician specialty groups got together and decided to examine specific tests and procedures that are commonly used but not necessary in their respective fields.  They named their organization “Choosing Wisely”, and compiled a list of over 45 specific recommendations on practices that should be curtailed.  Examples included “lumbar series in […]

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Posted in Quality Efficiency Utilization

The Decline and Fall of Triage in the ER

April 13th, 2012
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The national trend toward overcrowding in emergency rooms is having an interesting effect on a process that was conceived to handle a large number of injured patients: triage. One might expect that as more and more patients flow into the ER, the process of triage would become even more central to the smooth flow and […]

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Posted in Quality Efficiency Utilization

We Want Our Healthcare Like We Want our Fast Food

February 24th, 2012
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With due respect to those patient souls among us, America is, in general, an impatient nation. That includes how we think about our healthcare. This is why I read with some interest, and some amusement, stories like “A real ‘doc fix,’” published this week in the New York Times. Basically it says we need to […]

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Posted in Quality Efficiency Utilization

Sometimes the Best Emergency Medicine is No Medicine at All

February 3rd, 2012
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I was recently reminded by a patient experience that the best medicine sometimes is no medicine at all. I cared for a young woman who had been seen the last few nights complaining of shortness of breath. When it was obvious that she had normal breath sounds, no wheezing and normal oxygen level I started […]

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Posted in Quality Efficiency Utilization

After 20 Years in Emergency Medicine, The Worries and Tools I Take to a New ER

January 24th, 2012
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When I completed my training nearly 20 years ago, I always wondered what type of emergency department I would work in. Two decades later I can say I’ve worked in a lot of different emergency departments, seven of them to be specific. They range from bustling suburban hospitals to small rural facilities to busy trauma […]

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Posted in Life in the ER, Quality Efficiency Utilization

Madness, Death, and the Real Solution to Over-Prescribing Prescription Narcotics

October 21st, 2011
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Last month, the LA Times chronicled the stunning rise of deaths attributed to prescription drug overdose, particularly narcotics meant to manage pain. The push to control or manage all pain regardless of the legitimacy of the pain has made overdose from prescription drugs a bigger killer than heroin and cocaine combined, the story reported.  Incidentally, […]

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Posted in Life in the ER, Quality Efficiency Utilization

Incorporating Kaisen in Everyday Practice and the rise of LEAN in Emergency Care.

October 12th, 2011
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As a child, I remember my father would come home with stacks of spreadsheets, charts and graphs with the words “throughput”, “bottlenecks” and “LEAN” on them. Growing up in Detroit and being the son of a “Big Three” employee, I just assumed this was normal jargon in the automotive world. My father made many an […]

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Posted in Quality Efficiency Utilization