tag:blogger.com,1999:blog-32053362.post3121231508128097867..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: This is what dominance looks likePaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-32053362.post-17986451692144109352011-12-24T00:05:26.287-05:002011-12-24T00:05:26.287-05:00It would be interesting to see these numbers compa...It would be interesting to see these numbers compared to several denominators - Academic medical center beds, total beds, total number of physicians / primary care physicians to see if the numbers are disproportionately high for any system or hospital.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-60870271301024752132011-12-11T13:27:36.404-05:002011-12-11T13:27:36.404-05:00My personal experience with Kaiser is over 10 year...My personal experience with Kaiser is over 10 years old and on the east coast, but I believe Paul has characterized it well. During the time I dealt with them as a non-affiliated hospital-based physician, they struggled with continuity of care due to their staff model, although much of medicine has since moved in the same direction. A more recent vignette described below is disturbing - although not named in this post, the organization cited was confirmed to be Kaiser. I believe it illustrates their struggle with the rigidity Paul describes:<br /><br />http://e-patients.net/archives/2010/05/through-the-land-of-smoke-and-mirrors-an-e-patients-odyssey.html<br /><br />Not to say that the other organizations cited do not also have the same anecdotal experiences.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-20794095846121458612011-12-11T12:28:35.306-05:002011-12-11T12:28:35.306-05:00Where is the medical school to provide them with a...Where is the medical school to provide them with appropriately skilled labor? The first Mayo Clinic grew more slowly than others. There was personal contact with the philosophy of leadership, day-to-day sculpting of a culture of quality, growth led by learning rather than the capital campaigns and NIH funding that followed.<br /><br />How many quality and safety leaders does Harvard Medical School produce? We might be hard pressed to fill a lecture hall, let alone a hospital.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-28621387021845053252011-12-11T05:58:20.704-05:002011-12-11T05:58:20.704-05:00Others may know better and may want to comment. I...Others may know better and may want to comment. I hear excellent things about KP's commitment to quality and safety, on the one hand, and a somewhat rigid process for how the company manages care within its system on the other. I have heard, too, that both it and Mayo have had problems replicating their success outside of their home territory. Does anybody want to pitch in?Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-16457037259403573722011-12-10T23:13:17.719-05:002011-12-10T23:13:17.719-05:00I'd really like to hear your opinions on the K...I'd really like to hear your opinions on the Kasier Permanente model, and how it compares and contrasts (in terms of cost, quality) with some of the other touted systems (Mayo, Geisinger, Intermountain) and top hospitals (e.g. BIDMC) out there.<br /><br />Kaiser really did well on the new Leapfrog list: http://www.leapfroggroup.org/news/leapfrog_news/4810593<br /><br />Why does KP not seem to have the same visibility at the national level, as a potential model to replicate?<br /><br />Thanks a lot,<br />-an interested med studentMedstudent2014noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-45762238523629054312011-12-10T18:23:01.183-05:002011-12-10T18:23:01.183-05:00I wanna see an Edward-Tufte-style multi-variate gr...I wanna see an Edward-Tufte-style multi-variate graphic here - not just the height of the bar for market share, but let's add in the quality data and the prices they charge.<br /><br />btw, I for one would be empowered by (and thus wouldn't mind) if you started using the names. Blue Cross, instead of "the state's largest insurer."<br /><br />Heck, I'd like to know the name of the executive in charge of those pricing decisions, and what kind of car s/he drives, while the rest of us hear that Occupy Boston should get out of the streets and stop causing trouble.e-Patient Davehttps://www.blogger.com/profile/16381434866099596466noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-88115943005049949002011-12-09T12:57:22.053-05:002011-12-09T12:57:22.053-05:00Given (1) well-documented (and under-reported) rat...Given (1) well-documented (and under-reported) rates of patient harm in tertiary hospitals (even among the few with highly transparent and aggressive patient safety efforts - which do not exist in Boston, by the way) (e.g. Landrigan et al., N Engl J Med 2010; 363:2124-2134), and (2) successfully deployed tools for internal discovery of adverse events (e.g. IHI Global Triggers Tool) - what is the estimated number of patients harmed in this graph? How many preventable deaths occurred in Boston in 2010 because we do not hold this industry accountable?Anonymousnoreply@blogger.com