Dr. 鲍勃韦希特尔, 加州大学旧金山分校的医疗服务主任, is credited with helping create a new specialty in medicine: hospitalists, doctors charged both with caring for hospitalized patients and making hospitals work better. In 内出血2004年,他与另一位十大赌博平台排行榜医师Dr. Kaveh Shojania, 韦希特尔 pulled back the curtain on the world of medical errors and discussed the latest thinking on how to prevent them. 他还 博客 关于十大赌博平台排行榜、病人安全和护理质量.
十大赌博平台排行榜问&A:鲍勃·沃赫特
I'm curious what you think of the health care reform debate. Do you see any major opportunities for improving patient 安全, or any major potential pitfalls?
我觉得这场辩论令人沮丧, mainly because there are so many important issues to be addressed but the politics tends to overwhelm, 和caricaturize, 一切. 也就是说, I do think that some of the changes in health care reform — specifically the ones that create real incentives for quality, 安全 and value — have the potential to transform the health care system in a positive way.
It is clear that the great hospital of the future will need to truly demonstrate that it achieves better outcomes for patients, 这需要新的思维方式, 教学, 团队合作与技术. That's really exciting, and I think we're well positioned at UCSF to thrive in this new world.
What drove you to help found this new specialty of hospitalists?
I was a political science major in college and have always tried to think about organizational models to improve care. In 1995, I became chief of the medical service at UCSF Medical Center and my boss charged me to "come up with a new way of delivering inpatient care.“十大赌博平台排行榜十大赌博平台排行榜的想法刚刚开始出现, and so I articulated a vision for this new way of organizing hospital care in an article in the New England Journal of Medicine, which coined the term "hospitalist" and is generally credited with launching the field.
为什么这道特色菜发展得这么快?
It became the fastest growing specialty in modern medical history because it filled so many needs: to provide high quality and well-coordinated inpatient care, 提高效率, 帮助培养新一代的学员, to be leaders in quality and 安全 improvement activities, to care for patients in the face of housestaff duty hour limits.
When new needs arise, it seems like the first question always is: "Can the hospitalists do that?“我喜欢这样。.
What are the main ways hospitalists have helped change health care at UCSF?
I see our contribution on two levels: what our folks do in caring for individual patients, 以及他们在改变医疗体系方面的作用. 每一天, our hospitalists participate in the care of about 200 patients — nearly half of the adult census at UCSF — in myriad ways: direct care, 监督各类学员, 咨询保健, co-management of patients on several specialized services, 姑息治疗, 执行和监督复杂的程序等等.
但可能更独特, 我们是改善十大赌博平台排行榜系统的领导者, and many of our faculty have assumed leadership roles in areas related to quality, 安全, medical education and information technology because of this. It would be hard to fathom what UCSF would look like today without hospitalists.
What changes would you like to see made in the future, both at UCSF and other hospitals?
简单的. I would like a system that is organized to reliably deliver high quality, 安全, 为每一位病人提供高效满意的护理, to educate the next generation in the competencies needed to do that, 并进行创新, both in the traditional scientific realm as well as the newer domain of improving the delivery of health care. 这应该不会太难,你不觉得吗?
What can patients and their families do to help prevent medical errors?
我希望有一个简单的答案. 我相信保持警惕是个好主意, 确保护理人员清洁了手, 给你药之前先问你的名字, 诸如此类的事情. 但我也知道,当我上了飞机, I need to trust that the system has done all it can to ensure my 安全. 在医疗保健方面,我们需要有同样的目标.
加州大学旧金山分校, 我们还没到那一步, but I think we're as good as any place in the world and I am completely comfortable being a patient there myself or recommending it to a family member or close friend.
You're on sabbatical in London, but it's a working sabbatical - you're on a Fulbright grant. 你在忙什么?
我正专注于几件事. I'm based at Imperial College with the top patient 安全 group in Europe, 所以我在探索他们是如何看待病人安全的. I've also become intrigued by the way they organize hospital care, which has some similarities to and some major differences with our hospitalist model.
I've just finished the second edition of my patient 安全 book, and am blogging away. 但我也花了很多时间去享受生活, 保持体形, 去欧洲其他地方旅行,享受一下休闲时光. I've been meeting lots of wonderful people — what a joy when they ask, “你们下周一能聚一聚吗??“我的日历完全是空白的. 在家里,我得等两个月的时间.
If you weren't a doctor, what would be your dream alternate career?
也许是电视上的新闻分析师. I thought about trying to be a golf pro for a while — I'm not bad (I'm a 5 handicap), 但是三英尺高的人压力太大了. 我窒息.
你的病人会对你的哪些方面感到惊讶?
I am the answer to a trivia question: Who was the school mascot for the last Ivy League college basketball team to reach the Final Four? 答案是:1979年的我, 作为佩恩贵格会教徒(是的, 我戴了一顶三角帽, 双光眼镜, 褶边衬衫和短裤).
我们是灰姑娘队, 命运之队, and we all felt like we were going to go all the way after we beat some mighty teams, 包括北卡罗来纳大学和锡拉丘兹大学, 在四强的准备阶段. Then we ran into a team that had this guy named Magic Johnson, and that was that. 但是很有趣.
有没有个人英雄?? 他们是谁??
确定. 已故的约翰·艾森伯格, who showed me that one could combine a career as a physician with one as a health policy leader, 两者都要擅长. 阿图尔·加万德——我发现他的写作简直令人震惊. 布鲁斯·斯普林斯汀,因为他的诚实正直. 还有我的孩子们, 谁已经成长为了不起的年轻人, each their own person without a hint of arrogance or artifice. 他们是伟大的.