Hope Lies with Residents

Paul Levy

Posted 3/1/12 on Not Running a Hospital

I remain relatively new to the health care field, but even in that short time, it has become evident to me that the pace of quality and safety enhancements and front-line driven process improvement in hospitals is inadequate given the scale and scope of harm that occurs to patients.  Indeed, it can be viewed as a paradox that the doctors of America, a group of dedicated, well-intentioned, intelligent, and highly trained individuals, constitute one of the top-ranked public health hazards in the county when as they work together in the nation’s hospitals.  That they collectively have not made much of a dent in the problem of reducing harm is, I believe, a product of their training.

As Brent JamesJay Kaplan, and others have noted, doctors are trained to be artists, to apply their intellect, creativity, intuition, and judgment to the care of each patient. That is well and good when the case is complex, but the vast majority of medical care is not complex.  It calls for standardization, adoption of protocols, and scientific experiments of process improvement to modify those protocols to enhance care and reduce harm.

Continue reading “Hope Lies with Residents”

Flying Blind in Hospitals

Paul Levy

Posted 2/5/12 on Not Running a Hospital

A recent article in Bloomberg Businessweek reminded me about the Commercial Aviation Safety Team, coming out of a commission established by President Clinton, who charged it to come up with a process for reducing the rate of airline accidents by 80% over ten years.  The result:

By 2008 CAST was able to report that by implementing the most promising safety enhancements, the fatality rate of commercial air travel in the United States was reduced by 83 percent.

What’s the current goal?

Reduce the U.S. commercial aviation fatality risk by at least 50 percent from 2010 to 2025 and continue to work with our international partners to reduce fatality risk in world-wide commercial aviation.

Continue reading “Flying Blind in Hospitals”

Teach the Doctors, Please!


Originally published 2/7/11 on [Not] Running A Hospital

If you read the Boston newspapers, you would think that the most important thing going on in health care is a proposal to move from one kind of insurance payment scheme to another. Reporters seem willing to accept relatively unsupported and undocumented assertions that global payments are working. You have to be persistent to find these sentences in this story:

Continue reading “Teach the Doctors, Please!”