15 episodes

From the JAMA Network, this is JAMA Performance Improvement: Do No Harm, the podcast about performance improvement and medicine that aims to elevate the quality of care, one patient at a time, with host Ed Livingston, MD.

JAMA Performance Improvement: Do No Harm JAMA Network

    • Medicine
    • 4.4 • 22 Ratings

From the JAMA Network, this is JAMA Performance Improvement: Do No Harm, the podcast about performance improvement and medicine that aims to elevate the quality of care, one patient at a time, with host Ed Livingston, MD.

    A Better Way to Manage Chronic Medical Conditions in Homeless Emergency Department Patients

    A Better Way to Manage Chronic Medical Conditions in Homeless Emergency Department Patients

    Homeless patients with chronic medical conditions who need long-term care often repeatedly present to emergency departments to receive treatment. Following a performance improvement analysis, clinicians at UCSF developed an emergency department–based team who work with the community to provide care for this challenging population. Hemal Kanzaria, MD, and Jack Chase, MD, discuss how UCSF has addressed this clinical problem.
    Related Article(s) available here

    • 35 min
    Improving Management of Elevated Liver Function Tests in Post Liver Transplant Patients

    Improving Management of Elevated Liver Function Tests in Post Liver Transplant Patients

    There are hundreds of thousands of liver transplant patients, all of whom will be seen in general clinical practices. It is common for them to develop elevated liver enzymes—a potentially serious problem that may be a sign that the transplanted liver is failing. Traditionally, patients with these findings are sent to a liver transplant center for an inpatient workup. A new protocol facilitating management of most of these patients in routine outpatient clinics has been developed, greatly improving the efficiency of managing patients with this clinical problem. Fady Kaldas, MD, director of the Dumont-UCLA transplant center, discusses how to manage elevated liver function results in liver transplant patients on an outpatient basis.
    Related Article(s):
    Outpatient Management of Liver Function Test Abnormalities in Patients With a Liver Transplant

    • 17 min
    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 2

    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 2

    As physicians age, they experience the inevitable decline of cognitive and physical function. It is not clear how that affects clinical practice. Jeffrey Saver, MD, vice chair of neurology at UCLA and a JAMA Associate Editor, discusses how to best assess the clinical performance of aging physicians.
    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 1
    Read the article:
    Cognitive Testing of Older Clinicians Prior to Recredentialing

    • 9 min
    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 1

    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 1

    More than a third of the physician workforce is older than 60 years, and 10% are older than 70 years. Cognitive abilities may decline with age but how cognition affects clinical practice is unknown. It is also not clear how clinicians’ cognitive ability can be measured and acted upon when diminished without committing age discrimination. Two major academic hospitals launched programs to test cognitive abilities in older physicians applying for renewal of their medical staff privileges. It went well for one and not well for the other hospital. Yet, in the hospital where the testing program was carried out, several clinicians who were not suspected of having any problems had profoundly affected cognition. Leo Cooney, MD, from Yale-New Haven Medical Center, and Anne Weinacker, MD, from Stanford Health Care, discuss their experiences in dealing with these difficult issues.
    The Aging Clinician: When Should Older Clinicians' Cognitive Abilities Be Evaluated?, Part 2
    Read the article: Cognitive Testing of Older Clinicians Prior to Recredentialing

    • 32 min
    How to Reduce Emergency Department Dwell Time

    How to Reduce Emergency Department Dwell Time

    Chaos in the emergency department is common. How to fix it is not always clear. Mary P. Mercer, MD, MPH, from the University of California, San Francisco, discusses how they successfully fixed their long dwell times at the emergency department at San Francisco General Hospital. Their solution was to create a fast-track unit that managed low-acuity patients separately from the rest of the emergency department cases. The most important aspect of this quality improvement effort was the ongoing and regular engagement of executives from the medical center with frontline staff.
    Read the article: Reducing Emergency Department Length of Stay
     

    • 24 min
    Poof – It’s Gone – The Disappearing Order That Led to a Patient Getting an Unnecessary Procedure

    Poof – It’s Gone – The Disappearing Order That Led to a Patient Getting an Unnecessary Procedure

    Electronic health records are the bane of most clinicians’ existence. They were supposed to help us but not only have they made life more difficult for clinicians, they are the cause of medical errors. Described here is a case of the patient receiving an unnecessary procedure because an order was not canceled in an EHR where it had disappeared from the clinicians’ view. A second theme in this case that is consistent in nearly all of the JAMA Performance Improvement articles to date is inadequate communication among clinicians.

    • 20 min

Customer Reviews

4.4 out of 5
22 Ratings

22 Ratings

Atieh ,

Valuable information

This is the only podcast that I enthusiastically wait for the next episode. Every health care professional should be familiar with the situations that they discuss and the best way to approach and manage them. I am a pre-med student working as a medical assistant and this podcast helped me personally to be more cautious and aware of my workplace ethical concerns. Thanks for all your valuable work.

PathMax ,

I took their advice on

being exposed to dishonest superior physicians and got counseling. I think it's helping.

Fromthestage ,

Engaging and interesting presentation

I really enjoyed the first episode of this podcast, so much so that I just subscribed. Ed is a terrific host and moderator. In fact, all of the recent JAMA podcasts have been interesting, informative and fun to listen to during my commute. Looking forward to the next episode.

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