Mapping Healthcare : Healthcare improvement lessons from around the world

Dr. Ulfat Shaikh
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Mapping Healthcare is a radio show and podcast where a medic with a map explores ways in which people around the globe improve the world of healthcare and what we can learn from them. The host is a physician, medical educator, and researcher who leads programs that help health systems deliver high-quality healthcare. About your host: Dr. Ulfat Shaikh is a pediatrician and professor at the University of California Davis. She is the Chair of the American Academy of Pediatrics' Council on Quality Improvement and Patient Safety and is on the board of directors of the International Society for Quality in Healthcare. Dr. Shaikh has been a practicing pediatrician for over 25 years and has a Doctor of Medicine, master’s in public health, master’s in clinical research, and is a fellow of the American Academy of Pediatrics.

  1. 33. The Rural Community Pharmacy: A Lifeline on Catalina Island

    6D AGO

    33. The Rural Community Pharmacy: A Lifeline on Catalina Island

    In rural counties most pharmacies are independently owned. When these rural pharmacies close, they don’t just leave a gap in healthcare, they affect a region's economy. Because who wants to move to a town where you can’t get a prescription filled for 40 miles? Hear the audio story that I created at the Transom Story Workshop on Catalina Island about Sue Ponce, the sole pharmacist on Catalina Island’s only drug store for three decades. When I arrived at the workshop I thought I was there to learn some audio technical skills. What I didn’t expect was to also rethink how stories work and their place in healthcare. References: Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: A nationwide geographic information systems cross-sectional analysis.J Am Pharm Assoc. 2022;62(6):1816-1822.e2.Catalano G, Khan MMM, Chatzipanagiotou OP, Pawlik TM. Pharmacy Accessibility and Social Vulnerability.JAMA Netw Open. 2024;7(8):e2429755. doi:10.1001/jamanetworkopen.2024.29755.DiStefano MJ, Chen NC, Asche CV, Anderson KE, Mattingly II TJ.“The crux of the community”: A qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah.J Am Pharm Assoc. 2026;66:102940. doi:10.1016/j.japh.2025.102940.Gravlee E, Ramachandran S, Qato D.Critical Access Pharmacy Designations Could Strengthen Access. Health Affairs Forefront. December 19, 2025. doi:10.1377/forefront.20251216.325474.Kono M, Deller S. Rural Pharmacies an Overlooked Piece of the Rural Health Care Milieu.Choices. 2023;34(4).Luchen GG, Hall KK, Hough KR. The Role of Community Pharmacists in Patient Safety.PSNet. October 25, 2021. Accessed May 7, 2026. https://psnet.ahrq.gov/perspective/role-community-pharmacists-patient-safety.Moodley S. Rethinking Community Pharmacy: A Path To A Sustainable Model.Health Affairs Forefront. July 28, 2025. doi:10.1377/forefront.20250724.565622.

    28 min
  2. 32. What Matters to You: A Simple Question That Transforms Care in Switzerland

    APR 25

    32. What Matters to You: A Simple Question That Transforms Care in Switzerland

    In healthcare, we’re trained to move fast, to diagnose, treat, and fix. But what happens when we slow down just enough to ask a different question: What matters to you? In this episode, we reflect on how one simple question can transform not just clinical decisions, but relationships, trust, and meaning for patients, families, and clinicians. Christian von Plessen shares what happens when we stop asking “What’s the matter?” and start asking “What matters to you?”. Whether you're wearing a stethoscope or the hospital gown, this seemingly simple question is a reminder of why connection matters. References: von Plessen C, Vasserot K, Bonnevie L, Coelho V, Dell'Eva E, Piazza V, Staines A. “What matters to you ?” From campaign to daily practice. Rev Med Suisse. 2025 Jun 4;21(921):1192-1196. French. doi: 10.53738/REVMED.2025.21.921.47318.Barry MJ, Edgman-Levitan S. Shared decision making — the pinnacle of patient-centered care. N Engl J Med. 2012;366(9):780-781. doi:10.1056/NEJMp1109283.Staines A, Laroussi-Libeault L, Coelho V, Pomey MP. “What matters to you?”: a powerful question to unlocking partnership in care. Int J Qual Health Care. 2025;37(1):mzaf007. doi:10.1093/intqhc/mzaf007.Barry M. Ask “what matters to you?” when it matters most. Institute for Healthcare Improvement Blog. September 17, 2019. Accessed April 11, 2026.Janerka C, Hooper AR, Sanders B, Gallagher O. How has ‘what matters to you’ been used for patient care? A scoping review. Health Expect. 2025;28:e14300. doi:10.1111/hex.14300.Kebede S. Ask patients “what matters to you?” rather than “what’s the matter?”. BMJ. 2016;354:i4045. doi:10.1136/bmj.i4045.

    29 min
  3. 31. A Voice from the Village: Primary Care in Rural Ireland

    APR 11

    31. A Voice from the Village: Primary Care in Rural Ireland

    Today we’re in a place where everybody knows your name, but also where the nearest specialist may be a three hour drive away. In a city, your physician is someone you may see a couple of times a year. In a rural area you see them in the grocery store or at the Friday night football game. This creates a whole new level of social connection. John Brennan tells us about his experience providing primary care to people in County Kilkenny, Ireland. Join us as we explore the rugged landscape of rural healthcare and hear why this lifeline that depends heavily on committed primary care physicians, is becoming increasingly fragile. References: Arredondo K, Bay K, Witte L, et al. Rural practice made attractive: a scoping review of rural primary care physician recruitment and retention incentives. J Gen Intern Med. Published online January 26, 2026. doi:10.1007/s11606-026-10218-8.Kaboli P, Blaine A, Mares J, Fortney J, Ono S, O’Shea AMJ. Health care access from the rural perspective: a narrative review. J Rural Health. 2026;42:e70119. doi:10.1111/jrh.70119.Maganty A, Byrnes ME, Hamm M, et al. Barriers to rural health care from the provider perspective. Rural Remote Health. 2023;23(2):7769. doi:10.22605/RRH7769.Huffstetler AN, Greiner A, Kempski A, Park J, Filippi MK, Langa M. Closing the Distance in Rural Primary Care: Primary Care Collaborative 2025 Evidence Report. Washington, DC: Primary Care Collaborative/Robert Graham Center; 2025.Serchen J, Johnson D, Cline K, et al. Improving health and health care in rural communities: a position paper from the American College of Physicians. Ann Intern Med. 2025;178:701-704. doi:10.7326/ANNALS-24-03577.

    28 min
  4. 30. Smart Risks in High-Stakes Health Systems from the Netherlands

    APR 1

    30. Smart Risks in High-Stakes Health Systems from the Netherlands

    Healthcare faces urgent challenges. Rising complexity, widening inequities, burned-out clinical teams, and health systems stretched to their limits. But what if the biggest risk is playing it safe? Behind every breakthrough in healthcare, there is a moment when someone chose to take a thoughtful, informed risk. Ellen Joan van Vliet tells us how to question the status quo, experiment responsibly, and push forward when it matters most. Hear what it really takes to make smart bets that improve patient care, strengthen communities, and accelerate meaningful change – one intelligent risk at a time. References: Edmondson AC. Learning from failure in health care: frequent opportunities, pervasive barriers. BMJ Qual Saf. 2004;13(Suppl 2):ii3‑ii9. doi:10.1136/qshc.2003.009597Macrae C, Vincent C. Learning from failure: the need for independent safety investigation in healthcare. J R Soc Med. 2014;107(11):439‑443. doi:10.1177/0141076814555939Hibbert PD, Stewart S, Wiles LK, et al. Improving patient safety governance and systems through learning from successes and failures: qualitative surveys and interviews with international experts. Int J Qual Health Care. 2023;35(4):mzad088. doi:10.1093/intqhc/mzad088Bates DW, Singh H. Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety. Health Aff (Millwood). 2018;37(11):1736‑1743. doi:10.1377/hlthaff.2018.0738Ramar K, Oxentenko AS, Dowdy SC. Transforming health care through quality and safety. Mayo Clin Proc. 2025;100(8):1385‑1401. doi:10.1016/j.mayocp.2025.03.021

    30 min
  5. 29. Improving Clinical Environments for Nurses from South Africa

    MAR 14

    29. Improving Clinical Environments for Nurses from South Africa

    About 40% of nurses say they plan to leave nursing in the next five years because of unmanageable stress, workload, and understaffing. There are scales to measure the health of a workplace that look at staffing, leadership support, nurse-physician relationships, participation in hospital affairs, and the quality of care delivered. Sabelile Tenza tells us about her research on the relationship between nurses' practice environments and the quality and safety of healthcare. Hear how we can create clinical environments where nurses don’t just survive their 12-hour shifts, but where they are empowered to thrive. References: Leary KB, Lee M, Mossburg S. Patient Safety Amid Nursing Workforce Challenges. PSNet. April 24, 2024.Chiminelli-Tomás V, Tutte-Vallarino V, Ferreira-Umpiérrez A, Hernández-Morante JJ, Reche-García C. Impact of Nursing Practice Environments in Work Engagement and Burnout: A Systematic Review. Healthcare. 2025;13(7):779.Leone S, Rosato I, Poli E, Canova C, Danielis M. Factors Related to Turnover Intention Among OR Nurses: A Systematic Review. AORN J. 2025;121(5)Mabona JF, Van Rooyen DRM, Ten Ham-Baloyi W. Best practice recommendations for healthy work environments for nurses: An integrative literature review. Health SA Gesondheid. 2022;27:a1788.Martinez E, Cartwright T, McKenzie L, Faulkner B. Cultivating Healthy Work Environments Through the Lens of Nursing’s Code of Ethics. Nursing Administration Quarterly. 2026;50:25–30.

    28 min
  6. 28. Pharmacists Preventing Medication Mix‑Ups from Melbourne

    FEB 28

    28. Pharmacists Preventing Medication Mix‑Ups from Melbourne

    Transitions of care from hospital to home are some of the riskiest moments in a person’s healthcare journey. Medication lists change, high‑risk medications require careful monitoring, and patients often deal with overwhelming amounts of instructions. Linda Graudins tells us how pharmacists play crucial roles in helping people on complex medication regimens navigate these challenges safely. We’ll look at a process called medication reconciliation which is a bit like medication detective work and helps pharmacists keep those potentially dangerous transitions from home to hospital, and back to your home, smooth and safe. References: Agency for Healthcare Research and Quality. Medication Reconciliation. Patient Safety Network (PSNet). Published September 2019. Updated December 15, 2024.McNab D, Bowie P, Ross A, MacWalter G, Ryan M, Morrison J. Systematic review and meta-analysis of the effectiveness of pharmacist-led medication reconciliation in the community after hospital discharge. BMJ Qual Saf. 2018;27(4):308–320. doi:10.1136/bmjqs-2017-007087.International Pharmaceutical Federation (FIP). Medicines reconciliation: A toolkit for pharmacists. The Hague: International Pharmaceutical Federation; 2021.Cheema E, Alhomoud FK, Kinsara ASAL-D, et al. The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE. 2018;13(3):e0193510. doi:10.1371/journal.pone.0193510.Patel E, Pevnick JM, Kennelty KA. Pharmacists and medication reconciliation: a review of recent literature. Integr Pharm Res Pract. 2019;8:39–45. doi:10.2147/IPRP.S154388.Schnipper JL. Medication reconciliation—too much or not enough? JAMA Netw Open. 2021;4(9):e2125272. doi:10.1001/jamanetworkopen.2021.25272.

    29 min
  7. 27. Bringing the Hospital to Your Home in Australia

    FEB 14

    27. Bringing the Hospital to Your Home in Australia

    Ever wish you could skip noisy hospitals and heal in your own bed? We explore Hospital at Home, a game-changing model that brings acute care—from IV meds to 24/7 monitoring—directly to your living room. We trace how this 1990s pilot became a global trend, accelerated by the COVID-19 pandemic and new government payment models. Michael Montalto shares how Hospital at Home prevents unnecessary hospital admissions and emergency department visits and reduces healthcare costs in Australia. We also weigh the downsides, including caregiver stress and lack of integration with primary care. References: Levine DM, Souza J, Schnipper JL, et al. Acute Hospital Care at Home in the United States: The Early National Experience. Ann Intern Med. 2024;177(2):238-241. doi:10.7326/M23-2264Edgar K, Iliffe S, Doll HA, et al. Admission avoidance hospital at home. Cochrane Database Syst Rev. 2024;(3):CD007491. doi:10.1002/14651858.CD007491.pub3Patient Safety Network. Hospital at Home? Care Reduces Costs, Readmissions, and Complications and Enhances Satisfaction for Elderly Patients. PSNet. April 7, 2021.Montalto M, McElduff P, Hardy K. Home ward bound: features of hospital in the home use by major Australian hospitals, 2011–2017. Med J Aust. 2020;213(1):22-27. doi:10.5694/mja2.50599Pandit JA, Pawelek JB, Leff B, Topol EJ. The hospital at home in the USA: current status and future prospects. NPJ Digit Med. 2024;7:49. doi:10.1038/s41746-024-01040-9Patel HY, West DJ Jr. Hospital at Home: An Evolving Model for Comprehensive Healthcare. Glob J Qual Saf Healthc. 2021;4(4):141-146. doi:10.36401/JQSH-21-4Wallis JA, Shepperd S, Makela P, et al. Factors influencing the implementation of early discharge hospital at home and admission avoidance hospital at home: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2024;(3):CD014765. doi:10.1002/14651858.CD014765.pub2Truong TT, Siu AL. The Evolving Practice of Hospital at Home in the United States. Annu Rev Med. 2024;75:391-399. doi:10.1146/annurev-med-051022-042210Arsenault-Lapierre G, Henein M, Gaid D, et al. Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(6):e2111568. doi:10.1001/jamanetworkopen.2021.11568

    30 min
  8. 26. Spelling Out Who's Who in the Hospital from South Carolina

    JAN 31

    26. Spelling Out Who's Who in the Hospital from South Carolina

    You're in a hospital. There’s a whirlwind of people in scrubs and white coats. It can be confusing trying to figure out who's who. Is that person a nurse, a respiratory therapist, a resident physician, a senior doctor? Who's actually in charge? It sounds simple but can be quite complicated – knowing who is actually treating you in a hospital. It is a real problem because while those in the medical field understand the hierarchy, for patients these roles are often totally opaque. This is not just an identity crisis. Helen Haskell tells us why this is a serious patient safety concern and what we can do about it. References: Turner DA, Rehder KJ, Nagler A, Aucoin J, Edwards P, Kuhn C. What’s in a name? Role clarity goes well beyond a simple title. J Patient Exp. 2019;6(4):325-328. doi:10.1177/2374373518803615. Wray A, Feldman M, Toohey S, et al. Patient perception of providers: do patients understand who their doctor is? J Patient Exp. 2020;7(5):788-795. doi:10.1177/2374373519892780. Solomon HV, Kim BS, Rajagopalan AK, Funk MC. “Doctor” badge promotes accurate role identification and reduces gender-based aggressions in female resident physicians. Acad Psychiatry. 2022;46(5):611-615. doi:10.1007/s40596-022-01641-0.Olson EM, Dines VA, Ryan SM, et al. Physician identification badges: a multispecialty quality improvement study to address professional misidentification and bias. Mayo Clin Proc. 2022;97(4):658-667. doi:10.1016/j.mayocp.2022.01.007.Tsai J. Who is my doctor? Some hospital patients never know. Scientific American. Published online December 4, 2020. Foote MB, Jain N, Rome BN, DeFilippis EM, Powe CE, Yialamas MA.Association of perceived role misidentification with use of role identity badges among resident physicians. JAMA Netw Open. 2022;5(7):e2224236. doi:10.1001/jamanetworkopen.2022.24236.

    28 min
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About

Mapping Healthcare is a radio show and podcast where a medic with a map explores ways in which people around the globe improve the world of healthcare and what we can learn from them. The host is a physician, medical educator, and researcher who leads programs that help health systems deliver high-quality healthcare. About your host: Dr. Ulfat Shaikh is a pediatrician and professor at the University of California Davis. She is the Chair of the American Academy of Pediatrics' Council on Quality Improvement and Patient Safety and is on the board of directors of the International Society for Quality in Healthcare. Dr. Shaikh has been a practicing pediatrician for over 25 years and has a Doctor of Medicine, master’s in public health, master’s in clinical research, and is a fellow of the American Academy of Pediatrics.

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