The Science of Health Care Improvement: Overcoming Unintended Variation

By Ted James
November 29, 2018

“Uncontrolled variation is the enemy of quality.”
– Edwards Deming

Widespread variations in clinical practice that cannot be explained by differences in medical condition or patient preference are routinely observed across multiple specialties and clinical settings. The problem with unexplained variation in health care is that it negatively impacts clinical outcomes, increases the cost of care, and diminishes value for our patients. Continue reading “The Science of Health Care Improvement: Overcoming Unintended Variation”

Is “Meaningful Use” Contributing to Physician Burnout?

Aligning quality incentive measures with physician wellness: When “Meaningful Use” leads to less meaning in a physician’s practice

By Ami Bhatt, MD, FACC
July 5, 2018

Lately, I have been struck by how often the phrases physician burnout and meaningful use are used in any given day, leading both to suffer the same fate: neither one is well defined. While speaking with colleagues across the country, I’ve asked the question, “What does meaningful use mean to you?” The answers I’ve received vary from expletives, to “waste of time,” “hoop to jump through,” and “garbage in, garbage out.” Those in leadership or quality improvement positions have a different insight: “My physicians call any task asked of them ‘meaningful use’,” or “The institution has many governing bodies, each with their own expectations, but they all call their needs ‘meaningful use’ which frustrates my physicians.” The logistics of meaningful use in the electronic health record (EHR) are also often noted: “I forget more than I remember it, but now there are prompts,” and “The extra 45 seconds per note adds up with a busy clinic.” Continue reading “Is “Meaningful Use” Contributing to Physician Burnout?”

Improving Physician Wellness by Addressing Decision Fatigue

By Ami B. Bhatt, MD, FACC
April 12, 2018

Physician burnout continues to be a significant concern for the medical workforce. Importantly, it can also affect patient experience (encompassing both quality and safety of care). Over half of United States physicians report at least one symptom of burnout including a decrease in empathy, decreased self-worth, and emotional exhaustion. Whereas the original research from several years ago suggested that front-line physicians in the primary care and emergency medicine space are at greatest risk, we now know that burnout is seen in many medical specialties. Not only do half of US physicians report being “burned out,” an equal percentage would not recommend a career in medicine to their children.1, 2 Continue reading “Improving Physician Wellness by Addressing Decision Fatigue”