National hospital safety expert Robert M. Wachter, MD, UCSF professor and associate chair of the Department of Medicine, has published a book and launched a blog dedicated to promoting quality and safety in patient care.
Wachter, chief of the Division of Hospital Medicine and Lynne and Marc Benioff Endowed Chair in Hospital Medicine at UCSF, is widely seen as the foremost authority on ways to achieve hospital quality and prevent medical mistakes, the subject of his best-selling book, titled
Internal Bleeding, now in its fourth printing.
Wachter's new book, published by McGraw-Hill's Professional, focuses on patient safety, a topic he is well-versed on since he also serves as chief of the Medical Service of UCSF Medical Center and editor of the federal government's two leading safety websites:
AHRQ WebM&M and
Patient Safety Network.
The new health care blog, "Wachter's World: Lively and Iconoclastic Ruminations on Hospitals, Hospitalists, Quality, Safety and More" can be found at
www.wachtersworld.org.
Wachter is also a member of the UCSF Medical Center's Clinical Events Oversight Committee. The committee, which is composed of medical center leaders, meets weekly to review and evaluate errors and adverse events. Lessons learned from these reviews are then communicated in a variety of ways, including the medical center's Patient Safety and Quality Bulletins.
UCSF Today caught up with the busy health care leader to find out more about his new venture in the virtual "Wachter's World."
Robert Wachter
Why a blog?
A: As I trolled around the worldwide blogosphere, I found several excellent health care blogs, but none that focused on the policy and practice issues that affect real doctors, nurses and patients in real hospitals and clinics. I thought I might be able to help people better understand the issues of the day, and that it would be a fun thing to do. I also hoped it would impress my kids, but my 16-year-old, on hearing the title "Wachter's World," snorted, "Why don't you subtitle it: 'Just like Wayne's World…Only Nerdier?'"
Q: Will you cover political health care issues, such as the need for universal health care in the United States or the 2008 presidential election?
A: This will not be the place to go to analyze the details of the latest Clinton health care plan, though I may have a thing or two to say about matters inside the Beltway. Rather, I'll cover topics like medical errors, quality measurement, transparency, pay for performance, outsourcing, specialty turf wars, the malpractice system and interesting new, key clinical studies. I'll try hard to make it fun, interesting to read, and a bit contrarian and controversial.
Q: Who is sponsoring your blog?
A: The blog is being hosted by the Society of Hospital Medicine, but the views expressed are mine alone.
Q: Why does being a hospitalist, indeed one who first coined the term in 1996, make your blog unique?
A: Hospital medicine provides a unique vantage point for many of the key issues of the day in health care. We are in the center of the action and interact daily with the Emergency Department, Intensive Care Unit, hospital administration, trainees and more. Also, since there are now more than 20,000 hospitalists in the US, there is a potentially large audience.
Q: What is the main message in your new book,
Understanding Patient Safety?
A: I wrote the book because I didn't see a resource for physicians, nurses, pharmacists, other health care providers, quality and safety professionals, risk managers, hospital administrators, and others struggling to learn the key principles of patient safety. The main message is improving safety is a pretty messy business; it isn't just computers or regulations or teamwork or culture or reporting. It's all of these things and more, and each of them has to be thoughtfully applied, being careful to look for areas of overlap and to watch out for unforeseen consequences.
Q: As of July 1, 2007, a new California law (SB 1301) mandates that hospitals report within five days to the California Department of Health Services when one of 27 adverse events occurs. How has this law changed health care oversight?
A: Up until last year, hospitals had a general obligation to analyze the really terrible things that happened, like if a patient died from a medication error or if they operated on the wrong body part. The law has lowered the bar on mistakes - pressure ulcers and infections caused by a catheter are now on the list.
Q: Will the law improve patient care?
A: I think it's healthy because it really focuses attention on the patients by humanizing the problem and making it real. It also sends a message out to everybody how important patient safety is. Ernie [Ring, MD, chief medical officer at UCSF Medical Center] has been a tremendous leader in safety and it's very clear that this is No. 1 on his agenda. Ernie and the medical center leadership have seen the law as an opportunity to really turbo-charge our efforts to identify the systems that don't work as well as they should, and to fix them. I've been very impressed.
Related Links:
Wachter's World: Lively and Iconoclastic Ruminations on Hospitals, Hospitalists, Quality, Safety and More
Medical Errors Expert Ranks Among Top 50 Most Influential DoctorsUCSF Today, July 25, 2005
UCSF Blogs
