tag:blogger.com,1999:blog-32053362.post7465390847528944353..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: Whose fault is this?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-32053362.post-67861825530086915862012-09-27T16:45:16.333-04:002012-09-27T16:45:16.333-04:00nonlocal -
I think you're right inasmuch as ...nonlocal - <br /><br />I think you're right inasmuch as it applies to hospitals; my point was narrow and limited to the Mass. Dept. of Conservation and Recreation, which, as with its predecessor, the MDC, has had a legendary reputation for patronage and incompetence.<br /><br />The problem with hospitals is just that - they all exist as islands, reinventing wheels. If there were a Federal agency that, in conjunction with state agencies akin to state DOTs, regulated hospitals <b>directly</b> - not just creating transparency (though that's good), not just gathering data (though that's also good), but actually directly examining hospitals and enforcing specific best practices, treatments, and requirements, we would all be better off.<br /><br />Heavy regulation is the only way to make things work in a "free market" system. I can't for the life of me understand why 100,000 preventable hospital deaths doesn't make people up in arms the way 3,000 "distracted driving" deaths do. But it doesn't, and we sit on our hands and hope that people will take action rather than taking it ourselves.<br /><br />Of course, if you did this you've be accused of "death panels" and "government control of health care," so none of this will ever happen. But it should.massmotoristhttp://motorists.orgnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-61004179242241831652012-09-27T13:02:56.252-04:002012-09-27T13:02:56.252-04:00Massmotorist, I guess I have an issue with your pr...Massmotorist, I guess I have an issue with your proposed solution, in that if one follows your logic, all surgeries would be done in academic centers, all murders would be investigated by the FBI, etc. There should be a mechanism by which your local agencies can access the expertise or the standard procedure manuals of the larger agencies, so they may implement the solutions themselves. As you say, no need to reinvent the wheel.<br />There is a direct analogy to health care here, in which countless hospitals, academic or not, waste $$ and resources reinventing the wheel on many, many identical problems. <br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-11451438683285415842012-09-27T10:18:45.821-04:002012-09-27T10:18:45.821-04:00Just as a follow-up:
The problem is not that ther...Just as a follow-up:<br /><br />The problem is not that there have never been (or still aren't any) innovative or intelligent people at the DCR. I'm sure there have been. And I'm sure the people that are there do their best.<br /><br />But state DOTs are regulated and professionalized by Federal Highway Administration oversight, while the DCR is left to its own devices (federal law is designed to regulate only a single state Highway Department). In addition, economies of scale mean that in a state DOT, they have people that specialize in everything, such as low clearances, because they are dealt with regularly. At an agency such as DCR, they are dealt with once in a generation, and that's why the solutions are forgotten. And when a state DOT needs help with something they don't see often, they can rest assured that the FHWA will have someone that has dedicated their professional career and done extensive, multi-million dollar studies on exactly that issue - that's why we have an FHWA, and that's why state DOTs are regulated the way they are.<br /><br />If MassDOT were in charge, they would have checked out the FHWA's <a href="http://safety.fhwa.dot.gov/geometric/pubs/mitigationstrategies/" rel="nofollow">Mitigation Strategies for Design Exceptions</a> and found out the industry's best practices. There's no need to reinvent the wheel.<br /><br />This lack of use of best practices is endemic throughout the DCR. The FHWA invests enormous amounts of money in everything from <a href="http://safety.fhwa.dot.gov/intersection/resources/casestudies/" rel="nofollow">improving intersection safety</a> to <a href="http://safety.fhwa.dot.gov/roadway_dept/night_visib/sign_visib/" rel="nofollow">sign visibility</a> to <a href="http://www.fhwa.dot.gov/publications/publicroads/99julaug/signism.cfm" rel="nofollow">the most effective design for signs</a>. The DCR follows none of their best practices - that's not their fault, they aren't a state DOT and don't have the experienced engineers and close working relationship with FHWA, and the managers there are not traffic engineers. And there's nothing there like the "Towards Zero Deaths" safety culture at MassDOT (courtesy of FHWA). But it does mean we'd all be much better off if all parkways and significant DCR roadways were transferred to MassDOT.massmotoristhttp://motorists.orgnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-21957491660062382222012-09-27T08:42:11.628-04:002012-09-27T08:42:11.628-04:00Nonlocal,
Several are missing.Nonlocal,<br /><br />Several are missing.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-65199816179439396822012-09-27T07:58:30.925-04:002012-09-27T07:58:30.925-04:00Makes me think of hospital monitors beeping incess...Makes me think of hospital monitors beeping incessantly for attention and being ignored...maybe installing a series of changing sounds - like ringtones for your phone....for those really, really important warning signs would work - then change it every 3 months...simplify....Nancy Thomasnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-64591444298602754472012-09-27T06:30:56.377-04:002012-09-27T06:30:56.377-04:00Are the signs and cowbells no longer there?
nonlo...Are the signs and cowbells no longer there?<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-71747850872081232642012-09-27T00:56:56.585-04:002012-09-27T00:56:56.585-04:00I would suggest that, in this case, the problem is...I would suggest that, in this case, the problem is that the DCR remains a substandard agency with too many diverse tasks on its hands, and it should not be in charge of any roadways. <br /><br />The Highway Department knows how to run and maintain roads, is highly competent and professional, and would have come up with a solution to this problem that would have worked and would not have been lost through staff turnover. I'm not normally a huge Jeff Jacoby fan, but <a href="http://www.jeffjacoby.com/4105/the-one-thing-the-mdc-excels-at-protecting" rel="nofollow">this article</a> really hits the nail on the head. The MDC (now DCR) seems to exist in its current form simply out of inertia and politics, and not because it is the best agency to run the multitude of functions that it runs.massmotoristhttp://motorists.orgnoreply@blogger.com