54th Annual Employee Benefits Conference

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Interclerkship Day number SIX

Happy New Year and welcome to 2009---it is going to be the year of changes in healthcare!! Speaking of changes, the Jefferson School of Population Health just hosted the Sixth Annual Interclerkship Day for the entire third year class of medical students on our campus. Nearly 265 students jammed into our brand new Hamilton Building auditorium to listen to outstanding national experts like John Nance talk to them about their role in promoting a safer environment for patients, and for themselves. Nearly every student admitted to witnessing an incident or behavior that could be construed as "unsafe", even in their first six months of clinical practice!! Nance explained what lessons we could learn from the aviation industry and how we might improve communication and teamwork---key ingredients to improving patient safety. The students participated in role playing exercises and they also heard from local health care lawyers as to how to more effectively engage with patients following a medical error.Pretty powerful stuff for students and the evaluations of the day were outstanding. WHAT is your medical school doing to teach students about patient safety?? How can we connect this work to the IHI and their new program on the Open School?? We are interested in your views and thanks again, DAVID NASH

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