Posts Tagged ‘Boston’

US News Names New Hospital as Best

Monday, July 23rd, 2012

Massachusetts General Hospital or Mass General is No. 1 for the first time, according to the US News & World Report Best Hospitals rankings. It marks the end of a 21-year run for Johns Hopkins that started in 1991, the year after U.S. News began publishing Best Hospitals.

When Mass General was founded, James Madison was President, Napoleon was Emperor of France and the Juliana, the first ever steam-powered ferryboat, began operation.   Only Pennsylvania Hospital (1751) and New York–Presbyterian Hospital (1771) are older. The fact that Mass General hasn’t taken the top spot before may come as a surprise to some, given its pedigree: It was the original teaching affiliate and flagship of Harvard Medical School; it remains the largest hospital-based research program in the United States, with an annual research budget of more than $400 million; and is renowned in such specialties as diabetes & Endocrinology, Ear, Nose & Throat, Neurology & Neurosurgery, Ophthalmology, Orthopedics, and Psychiatry.

The 950-bed medical center each year admits about 48,000 inpatients and handles nearly 1.5 million visits in its outpatient programs at the main campus and satellite facilities. It also delivers more than 3,600 babies annually. It is now the largest non-government employer in the city of Boston, with more than 19,000 employees, including a nursing staff of 2,900. In addition, its 3,600-member medical staff includes physicians, dentists, psychologists, podiatrists, residents and fellows.

MGH is owned by Partners HealthCare, which was formed by MGH and Brigham and Women’s Hospital in 1994. MGH is also a member of the consortium which operates Boston MedFlight.

“Positive Deviants” Will Revitalize the Healthcare System

Tuesday, June 30th, 2009

The solution to America’s healthcare crisis might just lie in deviant thinking.  This is the message of Dr. Atul Gawande, this year’s commencement speaker at the University of Chicago’s Pritzker School of Medicine.  Gawande is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, an associate director of their Center for Surgery and Public Health, an associate professor at the Harvard School of Public Health and at Harvard Medical School.

050102_Gawande_Atul_3.jpgHis concept of positive deviants identifies those communities and physicians who discover innovative ways to reduce costs and improve care  to deliver better outcomes.

Gawande cites a nutritionist who spent his career attempting to reduce hunger in Vietnamese villages.  This man asked villagers to identify which families had the best-nourished children to determine a “positive deviance” from the norm.  The answer was that those children’s mothers did not act in accordance with accepted village wisdom had the best outcomes.  Rather, they fed their children even when they had diarrhea; fed them several small meals daily rather than one or two large ones; and fed their children foods that others considered low class but were nutritious such as sweet potato greens.

In the American healthcare system, the positive deviants resist the tendency to view patients primarily as revenue streams – but as human beings.  Rather, these physicians deliver high-value healthcare without focusing too strongly on their practices’ bottom lines; they neither over-treat nor under-treat their patients with extraneous but profitable tests and procedures.

To quote Gawande, “Look for those in your community who are making healthcare better, safer and less costly.  Pay attention to them.  Learn how they do it.  And join with them.”

The WHO Raise the Alert on Swine Flu

Tuesday, May 5th, 2009

In a 24/7 media world, virtually everyone has now heard of the H1N1 – or swine – flu that is popping up in countries as distant as Peru and Switzerland. If they haven’t, they now surely will. World Health Organization (WHO) Director General Margaret Chan has declared a phase 5 alert – which raises the warning to the level of advising nations to prepare for a pandemic — after consulting with international flu experts.swine-flu

This alert might strike some people as alarmist, given that “regular” flu kills 36,000 Americans every year – compared with the single death so far we’ve seen in the United States and the 13 confirmed deaths worldwide so far in the current outbreak. But looking at it more closely, the WHO’s preemptive strike may be motivated more by historical fact than today’s news. The Spanish Influenza of 1918 – 1920, which arrived in a similar time frame, infected 28 percent of all Americans; an estimated 675,000 Americans died of the disease and about 50 million across the globe.  Clearly, this was a different order of pandemic at a time when the global health system was recovering from WWI and ill-equipped to deal with the emergency. But where it bears some resemblance to swine flu is that the first wave of flu appeared early in the spring of 1918. It disappeared over the summer, with the second wave arriving in Boston in September of 1918. With the number of cases expected to grow into the thousands, according to the chief at Mexico City’s National Institute of Respiratory Diseases’ Center for the Investigation of Infectious Diseases in Mexico City, the WHO’s response is understandable and responsible.

The one concern is on behalf of our already burdened health system.  Raising the alert level puts pressure on our emergency rooms especially as people are likely to interpret any flu-like symptoms as signs of H1N1 flu. This is when communication with the public is critical. Representatives of the CDC should be using the copious air time they’re being given not only to report on the level of the contagion but to educate the public about its symptoms and to calm fears.