Best and Brightest Forum on Medical Innovation

I was honored to be a panelist earlier this week at the Best and Brightest Forum on Medical Innovation at the Franklin Institute Science Museum here in Philadelphia. The forum focused on the serious challenges facing the United States in maintaining its global leadership position in medical innovation. The speakers, including Gov. Edward Rendell, former U.S. Rep. Richard Gephardt, U.S. Rep. Joe Sestak, and Wyeth senior vice president Joseph Mahady, offered insights on how the U.S. can maintain its position as the leader in medical care and how we can compete with scientists in other countries. As always, I am interested in your views on this very important topic and hope you will engage in the dialogue. DAVID NASH

The ACHE COO Boot Camp

The American College of Healthcare Executives sponsors a special COO Boot Camp where national healthcare leaders come together for a spirited exchange of ideas and to share best practices in our business. I just had the privilege of participating in the COO Bootcamp, as part of a special evening program sponsored by one of the key corporate partners of the ACHE, namely the ARAMARK corporation. ARAMARK is headquartered in Philadelphia so I have a special affinity for them too!! My topic focused on the quality and safety of medical care with a special emphasis on CMS Non Payment Events. My take home message was this---you haven't seen anything yet!! The CMS Non Payment events represent the veritable tip of the iceberg, the beginning of the transformation of CMS from a passive payer to a savvy shopper for health care. I shared data from my ten year experience as a board member of Catholic Healthcare Partners in Cincinnati OH. I drew connections between these CMS activities and other P4P trends across the nation. The elite group of COOs asked great questions and we had a very stimulating conversation. I believe strongly that one of the key attributes of a good leader is to prepare the leaders of tomorrow!!! ARAMARK and ACHE are a great team and they sure do practice what they preach. What do you think about training future leaders?? How can we do a better job?? Hats off to ARAMARK for their sponsorship and good corporate citizenship too. DAVID NASH

The John Fisher Lecture in Muncie IN

I had the privilege this past week of delivering the 10th annual John Fisher Lecture at Ball Memorial Hospital in Muncie, IN. Ball is part of the newly merged Clarian and Cardinal Health Systems---which include the University of Indiana School of Medicine and Methodist Hospital. The lecture was focused on the need for health system reform and what advice I would give to President Elect Obama. However, the experience was highlighted by two events---one was the lovely dinner the night before with Mr Fisher and his wife Janice. They are both in their 90's and totally sharp in every respect. Mr Fisher questioned me about all kinds of issues and was clearly on top of current events. The second event was an opportunity I had to meet all the house officers and young faculty at Ball Memorial. We engaged in a comprehensive dialogue about the need for better teaching regarding the tenets of quality and safety in residency training. Safety is not an elective!!! I always learn a good deal from my experiences at institutions like Ball Memorial and I gain a better appreciation for the challenges that we all face each and every day. How should we improve the training of our residents in quality and safety?? How can we encourage young physicians to embrace the concept of self evaluation and improvement?? I am looking for good ideas all the time here and hope you'll engage in the dialogue. DAVID NASH

No Silver Bullet Letter

I wanted to give our readers an opportunity to review the open letter I recently submitted to President-elect Barack Obama. Hopefully the President-elect finds this helpful in navigating the healthcare crisis he is about to inherit. As always, I am interested in your views, as well.

Click here to view the letter

The ACPE in Tucson AZ, November 2008

I am in Tucson AZ teaching my favorite course for the American College of Physician Executives at the Fall Institute. The course is called the Three Faces of Quality, and I have profiled this previously. This week represents the 15th anniversary since the debut of the course and it has evolved along with the field of quality and safety. I am grateful to the ACPE for giving me the opportunity to meet colleagues from around the country, and each class, numbering nearly 100, presents a different pedagogic challenge. This week we are tackling virtually every topic under the quality and safety umbrella---issues like cultural barriers to improvement, public accountability for outcomes, unexplained variation in the quality of care, and much more. If you are interested to learn more about the ACPE go to www.acpe.org and be sure to check out both the Three Faces and our Advanced Applications course too. How can we do more to get the tenets of quality and safety into the medical curriculum?? How can we create incentives that will influence providers to pay more attention to these issues?? I am interested in your views here. The ACPE is clearly part of the answer to these complex questions!! DAVID NASH

Recent Travels

A few days ago in Boston, the Lucian Leape Institute of the National Patient Safety Foundation hosted an amazing meeting. This invitation only affair brought together most of the key stakeholders with a deep interest in changing how undergraduate medical education approaches the key topics of quality and safety. Among the guests were the leaders from AHRQ, NPSF, ABMS, ACGME, ABIM, and a host of others. I was proud to be one of the authors of the three submitted position papers that helped to guide and stimulate the discussion. As you might imagine, this group had a raucous conversation and a professional facilitator kept it very well on track. The bottom line, there is a lot of work to do in an attempt to really change some of the tightest cultural beliefs in medical education. We must get to students as early as possible in the spectrum of training, even years one and two in medical school. We need a curriculum and we need better informed faculty on these issues too. I am hopeful that our new Jefferson School of Health Policy and Population Health will be a key step in the right direction here. I am confident that we could help to produce just the sort of leaders that the stakeholders at this meeting called for. I really admire Lucian Leape, Dennis O'Leary and Don Berwick----the three nationally prominent hosts of this meeting as they attempt to transform medical education. What do you think we need to do in order to transform medical education for the future?? Clearly a key question!!! Thanks for your continued support, DAVID NASH

The Jefferson School of Health Policy and Population Health

I wanted to give our readers an update on the progress of the new Jefferson School of Health Policy and Population Health. I am happy to report that we have successfully brought on board a great leader for the Masters Program in Health Care Quality and Safety, namely Dr Susan DesHarnais from Penn State Medical School at Hershey. Susan is an accomplished scholar and teacher who will be responsible for this program in the new school. We have finished our new school bylaws which we hope will be approved by the Board of the University at their winter meeting. We have begun to sculpt the content and sequence of the key courses across several of the Masters Programs and they are coming together nicely. We have accessed additional space on our campus to house many of our new recruits. Our new book on healthcare governance will be out very shortly and we will add this book to our other faculty edited texts, currently in use in the program.We are about to confirm a new communications director and very shortly, we will be publishing our first of many new brochures. For now, please visit our expanding web site at www.jefferson.edu/jshpph/. Thanks again for your support and I sure would like to hear from you. What do you think of our efforts to date?? Where do you think our initial class roster will come from?? What would YOU put in a Masters program in quality and safety?? Thanks for our support, DAVID NASH

Preventing Line Sepsis

I recently had the opportunity to chair an important expert panel in Washington DC concerned with reducing the occurence of line sepsis. The COOK corporation gave an unrestricted educational grant to our department to organize and facilitate this panel. There were representatives from many major national organizations, hospitals, and policy groups. We explored all the issues and were treated to two spectacular summaries by former Secretary of the Treasury Paul O'Neill and the key ABC News Flight Safety correspondent, John Nance. The bottom line---it's the culture of the organization!!! You can lead a doc to water but you can't, apparently, make him follow agreed upon, evidence based guideline of care, without paying sufficient attention to the culture. We have to give docs, and others, good reasons to follow the guidelines and give them good information about how they might do a better job. Slogans, exhortations, and the like, will not work. Culture beats technology every time. The day after the panel we held a press conference at the National Press Club and we got some outstanding attention from both the lay and medical press. Be on the lookout for our materials, especially at US NEWS and WORLD REPORT. See the links posted here too. As always, I am interested in your views. How are you preventing line sepsis today?? DAVID NASH

The Meaning of Mission

I just returned from ROME, Italy, following a spiritual retreat for the Board of Trustees of Catholic Healthcare Partners (CHP) a large not for profit system headquartered in Cincinnati OH. I have been on the CHP Board for ten years and this retreat was the culmination of our visits to the "mother houses" of the orders of sisters who have come together to help form the system. For me, this was a journey to learn more about the mission of CHP and to see it in action in real time!! We visited various key Vatican dicasteries, or Papal Offices, concerned with health care world wide. We had a chance to meet with key leaders within the dicasteries and to further our understanding of the role of the Catholic Church in global health issues. Among the highlights of the trip was our participation in the weekly Papal audience with our special seats just a few feet away from the Holy Father.CHP is a mission driven organization with a core goal of taking care of the poor and underserved. In these challenging times, seeing the mission in real life and almost being able to actually "touch" it made me better appreciate its meaning. As always, I am interested in your views here too. Thanks for your support, DAVID NASH

Launching a New School

As our regular readers know, Thomas Jefferson University has enthusiastically embraced the creation of a new school on our campus called the Jefferson School of Health Policy and Population Health----unanimously approved by the Board back on July 28 of this past summer. Our team has been hard at work building the new school and I want to share aspects of this challenge with our readers. We are in the process of searching for some key new leaders to help us build the Masters Degree in Health Care Quality and Safety. This is a tall order as we are looking for persons who can teach, do research, and instill enthusiasm for this nascent field. We are also creating a new curriculum from scratch along with bylaws, a faculty committee structure and the like. Of course, we are also preparing the marketing plan and any day now, we will launch our first national press release. Our work is guided by a New School Task Force that meets every other week and reviews all of the key decisions. We also recently held our second New School Advisory Committee and received all kinds of input from across our own campus. Finally, we have had fruitful meetings with our colleagues at the University of Delaware and at Dickinson College. I will be providing our readers with regular updates now that the summer is over and we are in full swing with the operational blocking and tackling. Buckle your seat belts and hold on tight for this exciting ride!! I look forward to hearing from all of our readers. DAVID NASH

Jefferson Board Approves a NEW SCHOOL !!!!

On July 28th, the Jefferson University Board of Trustees unanimously approved the creation of a unique new school called the JEFFERSON SCHOOL OF HEALTH POLICY and POPULATION HEALTH after carefully reviewing a proposal created by a task force from our Department of Health Policy. This Task Force met regularly for nearly nine months and presented its finding to an on campus Advisory Committee, and to two subcommittees of the Board as well. After gathering input from many stakeholders I am so proud to report that the new school will be created by some key organizational shifts on our campus---namely, moving our Dept of Health Policy out of the Medical College, where it has been since its inception 19 years ago, and combining it with the already successful MPH Program currently housed in the Graduate School of the University. Hence, these two entities, our Dept and the MPH Program, will serve as the nidus of the new school. In a nutshell, our school will offer a series of Masters Degrees including the MPH, a Masters in Health Policy and two innovative degrees---a Masters in Health Care Quality and Safety AND finally, a Masters in Chronic Care Coordination. Shortly, we will be creating a new website exclusively focused on the new school but I was anxious to get this very exciting news out to our consituents around the nation.I will begin a series of postings as we make progress on the new school and will strive to keep you posted as to the challenges and accomplishments as we move forward with the vision. Remember, if you are not a part of the solution for fixing the broken health care system, you are automatically a part of the problem!! Let me know what you think and thanks for your support, DAVID NASH

Eighth Annual DM Colloquium

The Eighth Annual DM Colloquium was held last week in Philadelphia. Nearly 300 persons from all over the country, and overseas, joined us at the Hyatt at Penn's Landing for three days of presentations, workshops, brainstorming sessions, and some fun too. We heard from leaders in the public and private sectors that there is convergence of Disease Management, Prevention and Wellness. These themes are also connecting to work site wellness, productivity improvement and employee satisfaction. The entire field appears to me to be in flux and our conference highlighted all of these changes. Specific issues included a discussion of the controversy surrounding the Medicare Health Support program, measuring ROI in DM, the impact of health reform on DM and physician leadership for DM, among many other topics. Please view the video from my opening address to the assembled crowd from Monday May 19th where I reviewed the entire chronic care waterfront. I am interested in views of the meeting and you can download the presentations from www.dmcolloquium.com. Thanks again and I look forward to your comments. DAVID NASH

Catholic Healthcare Partners Board are on board with Quality & Patient Safety

What a week for Health Policy at Jefferson!!

First, thanks to all those persons who have been viewing our new videos and for your comments. Now I would like to review several key events on our campus here at Jefferson last week. The Chief Health Policy Advisor for the Clinton Campaign was our featured lunch speaker last Monday and Andrea Palm did a great job outlining the candidate's position and taking questions from the nearly standing room only crowd of medical students. Remember, the big PA Primary is tomorrow!! On Wednesday of last week we featured a campus wide AOA Forum on the Future of Primary Care with representatives from our faculty as well as experts from Independence Blue Cross and Take Care Health. We had a spirited discussion and concluded that reform of the payment system is critical if primary care is to survive. Finally, we capped off the week with a special visit from Dr Richard Carmona, the 17th Surgeon General of the United States who discussed the need for our nation to focus on better coordination of persons with chronic illness. He was adamant that our single biggest contribution toward better health for the nation would be to get our patients to stop smoking. Dr. Carmona also reviewed briefly our plans to launch the Jefferson School of Health Policy and Population Health and he applauded our efforts and voiced a sincere desire to get personally involved. What a week for health policy on our campus!! DAVID B. NASH

Quality & Safety: Beyond the Joint Commission

SEC HHS Leavitt visit to Jefferson

On Wednesday morning, March 19th, Sec of HHS Mike Leavitt spent nearly three hours on our campus at Jefferson in Philadelphia. He came to outline the new CMS national EHR demonstration project. Our department, with help from TJUH and others, put together a group of nearly 40 key stakeholders from across the region to sit at a table and work with the Sec on key issues concerning the adoption and dissemination of EHRs in small practice sites. SEC Leavitt did a great job outlining his plan and taking questions from the stakeholders. We hope to post a video of the meeting soon. Now, we will be the convener group responsible for submitting the demonstration project request in just the next few weeks!! I hope to keep you in the loop as we develop the proposal. Thanks for your support, DAVID NASH


Information in this video regarding the CMS EHR Demonstration Project was current as of March 19, 2008. CMS has made changes based on questions and input at this and other public meetings around the country.

For the most current and complete information, along with answers to frequently asked questions, please visit the CMS website.

Sec of HHS Mike Leavitt and JEFFERSON

I am happy to report that Sec of HHS Mike Leavitt will be our guest, on the campus of Thomas Jefferson University, on Wednesday March 19th and I will have the honor of serving as the convener for a regional meeting on the power of the EHR to improve the quality and safety of medical care. This is after all National Patient Safety Week and Sec Leavitt will be discussing the CMS EMR Regional Initiative---whereby CMS will be giving regional grants to docs in small primary care practices to stimulate the adoption of EMRs. CMS hopes to award one dozen regional grants after conducting nearly 40 visits around the nation.Our Department of Health Policy is once again being recognized for our leading edge work in this field and for our ability to bring together all the key stakeholders for a working session with the Secretary. More news to follow and we will surely post any video that comes from that meeting. Thanks for your support, DAVID NASH

Health & Human Capital Congress in Washington, DC

David Nash, M.D., chairman of health policy for Thomas Jefferson University's Jefferson Medical College, discusses the prospects for growth and success of employee health and wellness programs. From the Health & Human Capital Congress in Washington, DC.

Original Link:
Corporate Research Group (CRG)

The Catholic Healthcare West Annual Quality meeting

Watch this video or listen to it

The American College of Physician Executives

I am in Weston FL, just outside of Ft. Lauderdale teaching for the American College of Physician Executives, the ACPE----this is the premier group for senior physician executives interested in the quality and safety agenda. This year is the 15th anniversary on the launch of my course entitled, THE THREE FACES OF QUALITY and my colleagues and I have taught more than 5,000 ACPE members in this four day overview course since 1993. We are also teaching the ADVANCED APPLICATIONS IN QUALITY course at this same hotel so I am going to be running back and forth between two big conference rooms at the Bonaventure Hotel!! If you would like to learn more about these courses I invite you to visit the ACPE at www.acpe.org and also be sure to check out my on line version of the THREE FACES at the site marked INTERACT. I am looking forward to another exciting session with so many docs from around the country.

New Video

Interclerkship Day number FIVE

Happy New Year and let's make it a great 08!!On January 7th our Department will sponsor the Fifth Annual Jefferson Medical College Interclerkship Day on Patient Safety. This is a unique program in the nation where we bring the entire Third Year Medical College Class, all 255 students, to an offsite hotel and spend the day talking and learning about their role in improving patient safety. With the help of famous speakers like John Nance from ABC news and other faculty, we review the recent literature on patient safety and we give specific examples as to how Third Year Students can participate in the hard work of improving medical care. We have previously published our experience with this program in the American Journal of Medical Quality. Most Third Year Students, even with just six months of clinical experience, have seen a medical error occur or at least a near miss.They have seen obusive behaviours by their more senior colleagues, and they have been reluctant to speak up. Our program, focusing on the tenets of Crew Resource Management, helps them to overcome their fears and to make a difference for patients. I am proud of our entire Department and hope that these kinds of programs will make a difference in the future. What do you all think??? DAVID NASH