Change Is In The Air

It’s nearly Springtime here in Ohio.  Nearly time to pack away the heavy coats and (thankfully) wash the last of the road salt off of our winter-weary cars. I love Spring. The days grow longer and the air warmer; colorful floral bouquets begin to determinedly push their way through not-quite-thawed soil.

Growth, change, potential.  In Springtime, anything seems possible.

Change is certainly in the air for me.  For the past 15 years I’ve worked in professional staff administration; credentialing, privileging, medical staff management, meetings, bylaws, etc.  The field has changed considerably in that time, largely due to advances in technology. 

It wasn’t all that long ago that we licked the stamp, sealed the envelope, and waited two weeks for verification of a medical license to be returned via the U.S. Postal Service.  Now in most states that verification is available on line with the click of a mouse. 

Technology has provided challenges as well as benefits.  New medical techniques, increasingly complex equipment, and greater demands on the time and resources of our volunteer medical staff leaders, to name a few.  Add to that the ever-changing rules and regulations of accrediting bodies, governmental agencies, managed care payers, and hospitals, and the role of the medical staff service professional is to say the least, a challenging one. 

It is also an invaluable safeguard for patient safety. 

One of the reasons you so rarely hear of impostor physicians gaining access to patients is because nearly every hospital, managed care organization, ambulatory surgery center, etc. employs one or more careful, thorough, knowledgeable, MSSP’s who work as part of the organization’s leadership team to assure that only qualified, competent providers gain access to patients.

It has been wonderful to be a part of something so important, and so valuable.

But a new door has opened for me, and I’ve decided to walk through it.  As of Monday, I will be the Program Manager for the Department of Clinical Risk Management, a component of the Cleveland Clinic’s Quality & Patient Safety Institute.  I’m really looking forward to the challenge of learning something new and becoming part of the Clinic’s vital, energetic, clinical risk team.

I hope that my years of experience working with medical staff and hospital leadership will prove to be an asset in this new role. 

I can hardly wait to find out what happens next!

Stay tuned…

Cavalcade of Risk #20

Cavalcade of Risk #20, a bi-weekly collection of posts on the topic, is up at

This edition’s submissions have been categorized into:

  • Investor & Economic Risk
  • Political & Regulatory Risk
  • Personal & Professional Risk

The next edition of Calvacade of Risk, which will be posted on March 14th, will be here at the MSSPNexus blog. Submissions can be sent via Blog Carnival or via email to   If you submit by email, please be sure to include Calvacade of Risk in the subject line.

Grand Rounds 3.23

Grand Rounds 3.23 is up at Musings of a Dinosaur, a self-proclaimed “old” family physician blogger who reveals his US location as a “malpractice crisis state.”  Unfortunately, that doesn’t narrow it down too much does it?  Stop by for a review of the best of this week’s medical posts.

An International Audience

Musings of a Dinosaur is hosting Grand Rounds this week and has asked for submissions on the topic of change.  For example, “what’s new in your world that you never in your wildest dreams could ever have imagined?”

I’m not always a big fan of themed Grand Rounds, sometimes I just don’t feel very knowledgeable about the designated theme. However, I figure we’re all pretty much experts on change, as one popular television commercial reminds us, “life comes at you fast.”

One big change that’s come about in my life over the past two years is blogging.  I’ve always enjoyed writing, but using the electronic medium of Internet blogging to disseminate my musings is a new experience. How has it changed my writing?

The most amazing facet of blogging is the international scope of one’s audience.  A quick check of this site’s statistics reveals that people from 83 nations have visited this blog at some point or another since January 1st.  I try to think about that when I write.  I try to remember that not everyone reading these words lives in the part of the world in which I live, speaks the language that I speak, or in the case of healthcare administration, works within the regulatory boundaries in which I work.

A recent SitePro Article reminds us that while English is the primary language of the web, it is the native tongue of only 30% of it’s users.  And even English has its variants as Wikipedia points out.

So Dear Dinosaur, writing for an audience (albeit a small one) in Qatar, Germany, and Japan, is certainly something I couldn’t have imagined just a few years ago. 

“Our true nationality is mankind.” - H.G. Wells

Explore Manhattan Starting at Times Square

 At the end of September, members and associates of the National Association Medical Staff Services  will gather at the Marriott Marquis in Times Square in the heart of Manhattan for our 31st annual Conference & Exhibition.

Watch for tips on how to get the most out of your visit to New York City from members of the New York State Association Medical Staff Services (NYSAMSS). Tips will be published on the NAMSS web site.

In the meantime, just to get you in the mood for a New York experience, here are some links to a few of the attractions around the hotel. All mileage from the hotel is approximate. (Thank you MapQuest).  Bring your walking shoes and prepare to explore!

Broadway Theaters / Times Square
You’re there!
Carnegie Hall
154 W 57th St
New York, NY 10019
1 mile
Central Park
1.25 miles

Canal Street & Baxter St (Information kiosk)
New York, NY
5 miles

Ellis Island
Tours for the Statue of Liberty and Ellis Island leave from Battery Park at the southern tip of Manhattan
5.5 miles
Empire State Building
350 5th Avenue
New York, NY 10001
1.6 miles
FAO Schwarz Toy Store

767 Fifth Avenue
(Fifth Avenue at 58th Street)
New York, NY 10153
1.5 miles

Good Moring America – ABC Studios

7 Times Square
New York, NY 10036
Across the street

Guggenheim Museum of Modern Art
1071 Fifth Avenue at 89th Street
New York, NY 10128
5 miles
Lincoln Center for the Performing Arts
Broadway at 64th Street
New York, NY 10023
1.5 miles
Madison Square Garden
4 Pennsylvania Plaza
New York, NY 10001
1.5 miles
NBC Studio Tour – Rockefeller Center
30 Rockefeller Plaza
New York, NY 10019
0.5 mile
Radio City Music Hall Tour
1260 Avenue of the Americas
New York, NY 10036
0.5 miles
Statue of Liberty
Tours for the Statue of Liberty and Ellis Island leave from Battery Park at the southern tip of Manhattan
5.5 miles
United Nations
1st Avenue at 46th Street
New York, NY 10017
1.6 miles
World Trade Center Memorial Site
120 Liberty St
New York, NY 10006
5 miles
Additional information: Lower Manhattan:

The Marriott Marquis
1535 Broadway
New York, New York 10036
  Watch the NAMSS web site for updates about the Conference. 

Hospital Found Liable for Negligence of Contracted Perfusionist

At the age of 2 months Gary Juliana was diagnosed with a heart murmur, and his parents consented to open-heart surgery to correct the defect. Unfortunately, Gary suffered severe permanent injury when the flow of oxygen to his brain was interrupted during the procedure due to critical mistakes on the part of the contracted perfusionist.

The Juliana’s filed suit against the hospital. The hospital filed a request for summary judgment, arguing that it could not be held liable for the perfusionist’s error because the perfusionist was the employee of a contracted group, not an employee of the hospital.

However, the trial court found, and the court of appeals affirmed, that the hospital was “clearly liable as a matter of law for the negligence of its sub-contractor.” It also noted that perfusionists could not work at the hospital without the prior approval of the department of surgery, and that they were credentialed in accordance with the hospital’s bylaws.

The court awarded a 10.8 million dollar judgment against the hospital, and the family settled with the perfusionist out of court for 2 million dollars.


Shands Teaching Hospital and Clinic Inc. v Juliana, Case # 1002-1530, Ct of Appeals of Florida, 1st Dist, 2003 Fla. App. Lexis 10157

Law and Ethics for Medical Careers, Fourth Edition, Judson, Harrsion, Hicks

New CEO Blogger – Bill Marriott

The business blogosphere has a new neighbor – Bill Marriott, Chairman & CEO of Marriott International.  Mr. Marriott started his blog Marriott on the Move in January with a post titled Fifty Years in the Hotel Business. He stated in an early post that he figures blogging is a great way to have a conversation with his customers, “I love hearing from all of you. As a busy CEO, I can’t respond individually to all that you ask for, but keep writing, because I’m listening.”  His blog includes audio podcasts, so visitors can listen too.

Welcome to the conversation Mr. Marriott!

Does your organization effectively monitor hand hygene compliance? Joint Commission wants to hear from you.

Hand washing, particularly in healthcare settings, prevents the spread of infection and saves lives; a fact that was first documented well over a 100 years ago in Vienna.

Another well-documented fact?  Healthcare workers are resistant to continuous hand-washing, and usually significantly over-estimate their compliance with standards.

Therefore, the Joint Commission is currently seeking examples of promising practices for measuring compliance with hand hygiene guidelines. Organizations submitting examples are asked to include supporting documentation, such as published studies or summaries of results regarding the use of the method, as well as a sample of data in the manner it is displayed (i.e., charts or graphs).

Submissions will be confidentially reviewed by an expert panel under the direction of Professor Elaine Larson of Columbia University.  If the expert panel determines that a submitted example has potential value to other health care facilities, the organization will be contacted for permission to include it in the monograph.

Examples may be submitted electronically at, with supporting documentation submitted by e-mail, mail or fax.