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SPOTLIGHT CASE AND COMMENTARY: Adolescent Diabetes: A Routine Visit?
February 2010
An overweight teenaged girl came to the pediatrics clinic for routine follow-up of her type 2 diabetes, complaining of nonspecific, intermittent abdominal pain and worsening acne. The physician prescribed topical acne cream and increased her diabetes medications. The next day, an obstetrician notified the pediatrician that this patient had delivered a healthy infant via Caesarian section overnight.
CASE AND COMMENTARY: Medication Reconciliation Pitfalls
February 2010
An elderly woman presented to the emergency department following a hip fracture. Although the patient's medication bottles were used to generate a medication list, one of the dosages was transcribed incorrectly. Because the patient then received four times her regular dose, her surgery was delayed due to cardiac side effects.
CASE AND COMMENTARY: Defensive Medicine: "Glowing" with Pain
February 2010
Over the course of 2 years, a patient who frequently came to the emergency department complaining of abdominal pain underwent 12 CT scans of the abdomen and pelvis. All of them were completely normal.
PERSPECTIVES ON SAFETY: In Conversation with...
February 2010
Thomas J. Nasca, MD, is the executive director and chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME). Prior to joining the ACGME in 2007, Dr. Nasca, a nephrologist, was dean of Jefferson Medical College and Senior Vice President for Academic Affairs of Thomas Jefferson University. We asked him to speak with us about the role of the ACGME in patient safety.
The Role of Graduate Medical Education (GME) in Improving Patient Safety
February 2010
Over the last decade, the patient safety movement has dramatically increased public and professional awareness of the safety hazards of hospitalization. Although public concerns about being cared for by "student doctors" may persist, evidence suggests that teaching hospitals have improved patient care outcomes. Nonetheless, all hospitals have room to improve.
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Verb-alizing
Mar-04-2010
One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge....(read more)
Substituting Coffee Cake for Journal Articles: Another Unforeseen Consequence of IT
Feb-24-2010
Late February is the pits for interns – the novelty of being a real-live MD is long gone, and the rebirth of residency is too far beyond the horizon to see. The other day, my wonderful resident Anna brought a coffee cake to my ward team's post-call rounds,...(read more)
Gawande’s “Checklist Manifesto”
Feb-08-2010
Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The...(read more)
Glenn Steele at CMS – A "Not So Fast, Schwartz"?
Jan-28-2010
FYI, Glenn wrote to family and friends last night saying that he is not the new CMS administrator. We'll see...(Lesson – don't believe everything you read in the blogosphere. Yes, even mine.) Turning to more important matters, now I've gotta decide about...(read more)
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Health Updates
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