Category: Hospitals

Toyota enters the health care provider market

published date
November 8th, 2006 by

Toyota enters the health care provider market

The Detroit News has an article about Toyota’s pickup truck factory in San Antonio, TX, which will soon have the company’s first medical clinic. The ironically named Ford Brewer, Toyota’s executive in charge of health and wellness, says Toyota is taking the same approach to health care as to cars: lower costs by improving quality.

The Institute for Healthcare Improvement has been modeling its hospital quality efforts on the Toyota production system, and I’m encouraged that Toyota is picking up the ball itself. The clinic will focus on primary, outpatient care. What would really be great would be for Toyota to get big enough in San Antonio to build an inpatient hospital. That way we could see what’s really possible from a cost and quality standpoint.

For now, though, Toyota has enough on its hands, like trouncing the Big 3, so I’m not holding my breath for bolder moves.

Hooray for hospitalists

published date
October 30th, 2006 by

Hooray for hospitalists

Hospitalists, physicians who practice internal medicine solely within the inpatient setting, are profiled in today’s Boston Globe. One of the weirder things about hospitals is there usually aren’t many doctors around. Primary care physicians tend to round in the early hours of the day, and then patients are left with nursing and administrative staff the rest of the time. Hospitalists address that deficiency by actually being in the hospital most of the day.

The article profiles Dr. Faisal Hamada, who runs the hospitalist program at Brockton’s Caritas Good Samaritan Medical Center. He’s actually employed by Cogent Healthcare, an Irvine, CA –not Philadelphia as the article states– based provider of turnkey hospitalist programs. Cogent provides the hospitalists, support staff, protocols and IT systems. The company generates a return on investment for its clients by improving the quality and efficiency of the hospital. Because hospitalists are around they can make adjustments in a patient’s schedule during the course of a day, something a primary care is unlikely to do after rounds . That kind of intervention tends to improve length of stay.

Good hospitalists develop a rapport with community physicians, which is essential so that those physicians don’t feel like the hospitalists are stealing their patients. I’m not surprised that Dr. Hamada is complimentary to the community physicians, but it’s also a fact that hospitalists tend to be more competent working in the hospital than their community-based colleagues. Hospitalized patients tend to be very sick –sicker than office-based physicians are used to seeing. Hospitals also have their policies, procedures, and informal ways of getting things done. It’s easier for a hospitalist to be good at this part of the job than someone who is only in the hospital occasionally.

One of the common complaints about hospitalists, also echoed in this article, is that there is a gap in communication between the hospitalist and the primary care physician, so that patients can get in trouble in between the time they are discharged and the time they see their community doc again. But that actually shouldn’t be such a problem in Brockton. Unlike most hospitalist programs, Cogent has its own call center to follow up with discharged patients, and has specific protocols for communicating with community physicians. In addition, Brockton is one of the three Massachusetts communities that is being wired up with a health information exchange as part of the Massachusetts eHealth Collaborative. That should make it much more straightforward for hospital-based and community-based physicians to stay in touch. Patients will benefit.

Children’s Hospital switches on the boob tube

published date
October 17th, 2006 by

Children’s Hospital switches on the boob tube

From the Boston Globe (Pediatricians criticize use of TVs in hospital)

Children’s Hospital Boston, which runs a center that is an authority on the effects of television on children, has TVs throughout the building, some of which show programs to infants.Cartoons, educational programs, and other shows are shown to children as young as 2 months old; the Globe observed two babies on their backs with screens playing cartoons a foot from their faces.

At a minimum it should help the little ones acclimate to US airports, where it can be impossible to get away from CNN.

No more Winstons or Salems in some NC hospitals

published date
October 4th, 2006 by

No more Winstons or Salems in some NC hospitals

Growing up I hated cigarette smoke, but my mom told me I’d have to get used to smoke-filled rooms, because that’s where the important decisions were made. Luckily times have changed, even in North Carolina. Hospitals in the Research Triangle Park area have gotten together to ban smoking on hospital grounds. That’s progress.

Looks like you can still smoke in designated smoking areas at Winston-Salem’s Wake Forest University Baptist Medical Center.