IHI Open School – Education in Quality and Patient Safety Beyond the Classroom

 What a great idea!

The Institute for Healthcare Improvement is offering free online education in skills like quality improvement, patient safety, teamwork, leadership, and patient-centered care.

The IHI Open School for Health Professions is an interprofessional educational community that gives students the skills to become change agents in health care improvement.  Most health-centered curriculum’s barely touch on these topics.

There are no fees, no applications, no admissions requirements, and no due dates. Each course takes about one hour to complete.

The current course catalog includes

  • Fundamentals of Quality Improvement
  • Fundamentals of Patient Safety
  • The Model for Improvement, Your Engine for Change
  • Human Factors and Safety
  • Measuring for Improvement
  • Teamwork and Communication


The IHI Open School for Health Professions is funded by support fromthe Rx Foundation, the Kaiser Permanente Community Benefit and the John D. and Catherine T. MacArthur Foundation. IHI welcomes funding and other support from a wide array of interested organizations and individuals.

Executive Clout Helps Johns Hopkins Patient Safety Program

Keeping patients safe has been a national focus ever since "To Err is Human" was released in 1999 by the Institute of Medicine.  Every healthcare organization struggles with thorny patient safety issues. 

Johns Hopkins in Baltimore Maryland, a long-time leader in innovative thinking regarding patient safety, established the Johns Hopkins' Center for Innovation in Quality Patient Care  in 2002.  One of the main features of the program is CUSP, the Comprehensive Unit Safety Program, which pairs senior JHM executives with clinical departments or units to serve as “champions” and facilitators of safety programs. These safety executives become a regular part of a clinical unit’s operations, meeting with front line staff on a regular basis to get firsthand knowledge of care and safety issues.

The concept behind CUSP is that executives have the clout to cut red tape quickly, direct needed resources, and speed change. Since CUSP’s inception in 2003, about 35 Hopkins leaders have “adopted” clinical units. 

Team members are given an opportunity to listen to nurses and physicians under actual work conditions, interact with patients, and discuss challenging issues.

Johns Hopkins’ patient safety program was recently awarded second place in Healthcare Informatics magazine’s eighth annual Innovator Awards.

Source:  http://www.hopkinsmedicine.org/Press_releases/2009/05_21_09.html

Congratulations to Memorial Hermann Healthcare, Houston, TX

Memorial Hermann Healthcare in Houston, TX has been awarded The National Quality Forum's 2009 National Quality Healthcare Award, which will be presented this evening in Washington, D.C. 

This year's award is presented in partnership with Modern Healthcare and the Studer Group

Criteria for the 2009 NQF National Quality Healthcare Award included:

  • Effective prioritization of performance improvement goals
  • Well-designed and deployed "dashboard" to measure and manage whole system performance
  • Commitment to transparency
  • Data-driven improvement of chronic care, with an emphasis on care coordination and disparities reduction
  • Demonstrated results on publicly reported performance measures

Modern Healthcare reports on Memorial Hermann's journey to safer patient care: Shortly after Memorial Hermann President and CEO Dan Wolterman took the helm in 2002, he called his top 35 executives together and asked them to write, anonymously, the answers to two questions: What was Memorial Hermann that day? And where would it be in five years?

“I read them after the meeting and was shocked and appalled by the response,” Wolterman says. “They said we were mediocre as an organization and would continue to be mediocre in five years.” And the notes didn’t sound angry or frustrated, just resigned… Shifting the institutional culture became his top priority.

By the next monthly executive meeting, Wolterman had framed his message. “We were going to become known as a leader in the country from a quality and safety standpoint, and there was nothing holding us back,” he says

Previous National Quality Healthcare Award recipients include:

2008 – Baylor Healthcare System, Dallas, TX
2007 – HealthPartners, Minnesota
2006 – Brigham's & Women's Hospital, Boston, MA
2005 – Northwestern Memorial Hospital, Chicago, IL
2004 – Trinity Health, Novi, MI

Career Path Advice – From the Healthcare Executives Association of NE Ohio

This week I was invited to attend a meeting of the Healthcare Executives Association of Northeast Ohio (HEANO). The networking opportunities were wonderful; executives from many area healthcare organizations were present and I came away with a handful of business cards.  

The main program was a panel discussion addressing both career path issues and the future of healthcare. The panel setting was informal and lively; there was even a bit of good-natured teasing among “rival” leadership.  

 There were some dissenting opinions among the presenters about the best way to secure career advancement. One panel member was an advocate of the traditional “plan your career path” model; decide where you want to be in five years and work toward that goal.  I have to admit that concept, which has many supporters, always makes me squirm.  I have trouble being certain about where I want to be in five months, let alone five years.  I’ve always been more comfortable with the “life is an adventure” philosophy, see where it takes you and enjoy the ride.  Happily for me, some of the other very successful panel members felt the same way. One said that her best career tip was to “be curious,” ask questions and keep learning.  Another advised that flexibility was absolutely essential in today’s constantly changing healthcare environment.

The valuable role of mentors was a universal theme; both having mentors and becoming a mentor.  Those of us who are mid-career (or as the moderator so kindly put it, mid-career plus) have worthwhile experience and insight to share with the early-careerists among us. 

All the presenters agreed that it was important to be able to say ‘I don’t know, let’s find the answer.’  A hospital CEO shared that she had asked a twenty-something in her office to explain Linked In and Twitter because she didn’t understand what they were but thought they might be valuable networking tools. 

Audience members were asked if they had career advice that hadn’t been covered during the discussion.  The colleague who invited me to the meeting wisely advised that involvement in professional associations was key to developing national networking contacts.  I wholeheartedly agree.  

I just had to offer one other suggestion; “Connect with people around the globe; become a blogger!”

Thanks HEANO – I enjoyed the evening.

Negligent Credentialing Case Settled in Weirton West Virginia

(See 5/15/09 update below.)

 In a case that appears to reveal multiple credentialing and risk issues, Weirton West Virgina Medical Center settled a negligent credentialing and supervision case in open court just after jury selection. 

The family of Genevieve Haught alleged that urologist Hardev Parihar was wrongfully permitted to operate on Mrs. Haught in 2005 without supervision, despite having only performed the operation once before, ultimately causing her death.

“During the procedure, Dr. Parihar’s assistant perforated Mrs. Haught’s stomach… The procedure, intended to remove a kidney mass, proved to be unnecessary as she was cancer-free.”

“Regan, one of the attorneys, stated that Weirton Medical Center knew that Dr. Parihar had a questionable record of operating without proper informed consent and other incidents of ignoring safety procedures. The family was never even informed there would be two surgeons before the procedure began.”

“The case also involved a claim for outrageous conduct by the hospital in mistreating the family during Mrs. Haught’s care.”

Source:  The State Journal

Update 5/15/09

There are always two sides to a story, and it is important to note that Dr. Parihar strongly disputes the article I quoted this week from The State Journal.  I received this email from Dr. Parihar’s attorney this morning.

Dear Sir or Madam: 

I represent Hardev Parihar, M.D. was specifically named in the news story on your webpage in about a settlement by Weirton Medical Center.  Please be advised that the story os misleading as to my client and I demand a clarification and/or retraction.  A correction has already been posted on the webpage of the State Journal which is where you got the story.  I demand that you run the correction as the information about my client is defamatory.  The so-called news story was simply a self promoting press release from a law firm.  The correction can be found at http://www.wtrf.com/story.cfm?func=viewstory&storyid=58981.

Patrick S. Case
32 20th Street
Maxwell Centre, Suite 200
Wheeling, WV 26003
Email:  pscasey@bwhllc.com
Webpage:  www.bwhllc.com


Grand Rounds Sails in This Week from the Pacific Rim

Grand Rounds 5.33,the best of the medical blogosphere, is hosted this week at Nursing Handoff the blog of Ausmed, a company dedicated to producing high quality health care education in Australia and New Zealand. 

I live in the U.S. and have yet to travel to Australia, so I browsed the Ausmed education offerings. Hmm, a long way to go for a conference, but what a trip!  Here’s one all medical bloggers could consider:  Writing Your Way to the Top in Healthcare  or perhaps a session on Defusing Disruptive Staff Behaviours (ah, obviously an issue without borders).

Be sure to stop by Nursing Handoff this week for what our host refers to as a “medblog binge”

 Grand Rounds

Picking Off the Low-Hanging Fruit in Healthcare Regulatory Reform

They’re tired, frustrated, and verging dangerously close to hopeless.  They’re also bright, dedicated, and desperately needed.  

Who are they?  Physicians.  In particular primary care physicians, although their more specialized brethren aren’t lagging far behind.

It’s no longer news that many doctors want to leave the practice of medicine.  The ever-increasing complexity and volume of mandatory regulations, requirements, and expectations takes an enormous toll on body, mind, and spirit.  Healthcare reform is a much-discussed initiative, but will it bring relief to this sorely-distressed core group? 

Not long ago I read an article admonishing physicians that if they would just spend a little more time with each of their patients they would no doubt see a corresponding improvement in the all-important patient satisfaction score cards.  Seemed like a good plan – improving patient satisfaction is a worthwhile goal. I couldn’t help but notice, however, that the article never mentioned the enormous pressure this same group faces from administrators eager to increase volumes and reimbursement.  It’s got to be hard to make all those things happen at once, and as is so often the case in the world of metric-driven healthcare, no one is willing to establish a priority.  In order to be considered a team player every goal must be fervently sought and simultaneously attained.  No wonder doctors are tired.   

There’s something seriously wrong with this picture.

Dr. Scott Haig thinks so too, and addresses the issue in Time’s Health & Science section; How to Fix Healthcare: Four Weeds to Remove.Here are the “weeds” Dr. Haig would go after first:

Healthcare Regulation, including Credentialing  “Of course we need to know that doctors are healthy and competent. But the system is redundant and takes up way too much of our time…  A unified federal credentialing agency could pull those weeds right out and leave the country with 5% to 10% more doctoring at almost no cost.” (Many credentialers are surprised this process hasn’t yet been nationally centralized.)

Malpractice  There is little or no correlation between doing bad stuff and getting sued.” 

Medical Billing  The ultra-complex set of rules and regulations is a health-care expense that produces no health care.”

Computerization Aside from their costs to us, electronic records are time-consuming — a constant distraction from patient care.”  (I don’t entirely agree with Dr. Haig’s negativity about electronic medical records, and I’ve worked with both paper and computerized EMRs, but there is no denying that performing data entry while talking with a patient is distracting.)

In these difficult economic times it’s worthwhile to look seriously at the cost of healthcare regulation and policy; not all of it provides an acceptable return on investment.