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Waynehttp://goo.gl/COIz2noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-53145297830306759432012-06-05T06:17:46.134-04:002012-06-05T06:17:46.134-04:00I had always thought that I was simply concentrati...I had always thought that I was simply concentrating too hard on what I was going to say, but I really need to work hard on that.memory improvement tipshttp://www.improveyourmemory.com.au/noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-58913551200938734762012-03-19T06:57:36.278-04:002012-03-19T06:57:36.278-04:00Care homes in Kent
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These studies can help avoid any issues along the way.jabroon piecehttps://www.blogger.com/profile/14597394850556558341noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-797017309477015872012-02-10T03:00:17.194-05:002012-02-10T03:00:17.194-05:00I must spread this to worldPerformance Improvement...I must spread this to world<a href="http://sampletemplates.org/performance-improvement-plan.html" rel="nofollow">Performance Improvement Plan Template </a>Bosehttps://www.blogger.com/profile/09850162650223557313noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-55408896845334554522011-12-07T03:26:45.778-05:002011-12-07T03:26:45.778-05:00I think review would be useless if not shown to pe...I think review would be useless if not shown to people. The purpose of review is to tell people what is better or good in terms of category or performance.Diesel Chiphttp://www.bhpplus.co.uk/noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-86711386266461290532011-11-15T11:52:30.572-05:002011-11-15T11:52:30.572-05:00Thanks Lori, Hadn't contemplated the death cer...Thanks Lori, Hadn't contemplated the death certificates angle that you are suggesting. Certainly it could help in improving transparency. Have to ponder this one a bit more.Apurv Gupta, MD, MPHhttps://www.blogger.com/profile/02378953184448661957noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-35173292730481832712011-11-15T11:29:18.188-05:002011-11-15T11:29:18.188-05:00Great post. The culture of secrecy in medicine/ho...Great post. The culture of secrecy in medicine/hospitals deserves this comparison. How do we reduce pt. harm, co-worker bullying, hubris,or secrecy if we don't have honest leaders who value an open, transparent culture? Maybe more awareness, tighter oversight and accountability? How about ensuring the accuracy of death certificates? If we ensure that true causes/contributing factors of death are legally documented, non- disclosure of serious medical errors would become a non-issue...and families would no longer have to suffer the burden of life-long grief from never knowing what happened.Lorihttp://www.nhpatientvoices.orgnoreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-3812643284467997172011-11-15T10:10:22.031-05:002011-11-15T10:10:22.031-05:00Hi Pat, I think that's certainly an added dime...Hi Pat, I think that's certainly an added dimension to this discussion. In my post above, I was mostly thinking of the "failings of human nature" described by David Brooks about why others witnessing wrong actions don't act, and not so much about the "moral depravity of specific bad actors". But that certainly exists as well, and unfortunately also tends to go on without adequate supervision, reporting, and remediation. I think that a properly functioning "healthcare system" needs to be able to deal with this level of behavior as well. As your statement implies, we need more action from the regulators and overseers (e.g., Board of Registration of Medicine, Department of Public Health, The Joint Commission) to ensure that this type of reporting is robust and fair.Apurv Gupta, MD, MPHhttps://www.blogger.com/profile/02378953184448661957noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-5340933442130675812011-11-15T09:54:05.709-05:002011-11-15T09:54:05.709-05:00Well said. Are there not parallels between protect...Well said. Are there not parallels between protecting known bad actors within the medical profession (who go on to harm others and betray the public trust), and failing to report child abuse?Pat Mastorshttps://www.blogger.com/profile/12572742020333587763noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-65441448446876172822011-11-15T08:35:05.245-05:002011-11-15T08:35:05.245-05:00Thanks Jim for taking the time to review and comme...Thanks Jim for taking the time to review and comment. Your efforts, and those of IHI, in driving us forward to improvement are much appreciated.Apurv Gupta, MD, MPHhttps://www.blogger.com/profile/02378953184448661957noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-53916059484088096302011-11-15T08:33:02.624-05:002011-11-15T08:33:02.624-05:00Thanks Pat, I agree with you on the need for inter...Thanks Pat, I agree with you on the need for internal commitment - which is at a low at many institutions because of the complexity of the climate and challenges with leadership. However, what I've experienced is that once the frontline staff are trained to make the right changes, connect them together, and see the results starting to flow, commitment starts to build. One of the outcomes of "performance improvement systems" is improved results, but the other outcomes are increased confidence in "the system" and as a result increased commitment from the staff. Its a culture of improvement that gets created, and we need to figure out how to seed this effectively in our healthcare institutions.Apurv Gupta, MD, MPHhttps://www.blogger.com/profile/02378953184448661957noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-41665042053198297732011-11-15T08:14:21.588-05:002011-11-15T08:14:21.588-05:00The secret sauce that fuels these inroads is inter...The secret sauce that fuels these inroads is internal commitment. Many institutions simply go through the motions of process improvement without the passion or "permission" to do what it takes, or lacking the skills to effectively manage the process. If you study the most resonant successes, you see that achieving success takes hard work, every day...and sustaining these gains is even harder. As new economic realities drive more institutions to seek solutions, the hope is that a greater body of replicable templates and strategies for success will emerge. Commitment may become more commonplace when the road to improvement comes with better mapping. Everyone wins - especially the patient.Pat Mastorshttps://www.blogger.com/profile/12572742020333587763noreply@blogger.comtag:blogger.com,1999:blog-927144950027443310.post-64063507862134539162011-11-12T11:53:02.374-05:002011-11-12T11:53:02.374-05:00On behalf of the IHI team, I’d like to thank you f...On behalf of the IHI team, I’d like to thank you for alerting your readers to the White Paper and related resources. Since the release of the original White Paper, we’ve had over 64,000 views of the content on IHI.org; 20,000 happening in the last month with the release of the 2nd edition. Through your support, and that of many others, we will move forward to achieve our goal: In the aftermath of adverse events, patients, families, staff, organizations and communities will all say “we were treated with respect.”<br />Jim Conway, Senior Fellow IHI, jconway@ihi.orgJim Conwayhttp://www.ihi.orgnoreply@blogger.com