“How would you design a great hospital quality improvement program?” A distinguished gentleman who looks to be in his 60s is asking the question. He and I are sitting across from each other at the end of a long, dark mahogany conference table. I don’t remember how I came to be here. I probably look a bit confused. “John. Tell me… How would you do that?” […]
I was sitting in a small conference room. Having worked full-time as hospital Chief Medical officer, I was now interviewing for a position in a larger institution. Midway through my interviews, I was talking with the hospital board chairman. He brought up the topic of hospital sentinel events. Apparently there had been a sentinel event at his organization and the chair and his board were quite concerned. He explained that it was something they had not experienced before. They [...]
For this post, I'm going to “nerd out.” I love using data. And I love monitoring, improving and discussing quality and safety. That was one of the fun things I did as hospital CMO. I also enjoy playing around with ways to display data, especially for lay people with a limited understanding of statistics. So today we will make our way to the “popular” Bubble Graph (well – it's popular with me at least), as I demonstrate how to prepare [...]
Each hospital CEO must determine which departments should logically report to each senior executive. Historically, the vice president for medical affairs or chief medical officer was hired to address the medical staff and its governance, continuing medical education and quality improvement. But there is another department head that should report to the senior physician executive of a hospital: the hospital pharmacy director. Pharmacy Medication administration is one of the most important functions of a hospital. Safe, effective and [...]
Every year, the health system pharmacy director and I would sit down and review the latest Institute for Safe Medication Practices (ISMP) list of best practices. These are practices based on reports of medication errors from hospitals across the country. When the ISMP identifies a trend, it seeks the root causes. It then compiles preventive strategies and publishes them as ISMP Best Practices for Hospitals. I found these best practices to be a good source of goals for the pharmacy [...]
I was walking towards the cafeteria one morning when I recognized one of our hospital board members. I recalled seeing him at one the meetings where I had presented hospital board reports addressing quality. We stopped to chat for a minute. He had been on the board for several years, and had an intimate knowledge of the performance of the hospital. He knew many of the local medical staff. His wife had once worked for the hospital. [...]
I started this series describing an approach to execution of management goals described in the book The 4 Disciplines of Execution (4DX) by Chris McChesney, Sean Covey and Jim Huling. The design of the WIG (wildly important goal) was described in detail. But what comes next? Let’s imagine that your team has selected a WIG. And the goal is written in the format of “from X to Y by when.” According to the authors of 4DX, the next [...]
I remember the first time our CEO announced to our board of directors that we had received the Top 100 Hospital designation. I believe the award was “owned” by Solucient at the time. It actually came as a shock because we were not expecting it. I was VPMA back then. We were just vaguely aware of the hospital performance measures it used. The CEO and board were very proud of the designation. We all were. It was a welcome [...]
patient safety Patient safety can sometimes be a nebulous concept. Like quality, it is difficult to define, but most of us recognize it when we see it. I was standing in a conference room, trying to explain to a group of vocal physicians why we needed to approve a Code of Conduct for the medical staff. It was one of our quarterly medical staff meetings, so there were a good number of physicians present. Some of the physicians [...]
