WIHI - A Podcast from the Institute for Healthcare Improvement

The Blogosphere's Hospital CEO

The Blogosphere's Hospital CEO

There are now published consensus guidelines for the diagnosis and treatment of acute rhinosinusitis. Acute viral rhinosinusitis and acute bacterial rhinosinusitis can be difficult to distinguish in the first 10 days of symptoms. Radiologic imaging is often ?positive? in both viral and bacterial etiologies of acute sinusitis and therefore cannot be used to distinguish the two. Oral antibiotics when prescribed appropriately confer a higher rate of partial or complete resolution of acute sinusitis symptoms compared to placebo. However, it should be noted that the spontaneous rate of resolution of acute bacterial rhinosinusitis may be as high as 40-60%. Adjunctive therapies such as topical and oral decongestants may offer symptomatic relief but have not been proven to shorten the duration of illness.

The Blogosphere's Hospital CEO

Wanted! An EMR That Works

Speaking Up When Things Go Wrong

Cardiovascular disease accounts for 35% of the excess mortality in African Americans, in large part because of hypertension. Racial disparities in physicians? clinical decision-making and in quality of care for cardiovascular disease have been documented extensively; studies also show racial differences in patient-physician communication, particularly when the patient and physician come from different racial backgrounds, and unconscious racial biases among physicians. A categorical approach that lumps patients of particular cultural backgrounds into groups and outlines their characteristics values, customs and beliefs may lead to over-simplication and stereotyping. Instead, an understanding of broad cultural concepts and skills that emphasize a patient-centered approach are preferred. This approach takes into account the individual patients? explanatory model, illness agenda and behaviors, and social context, and attitudes and skills with regard to negotiating treatment. It also includes participatory behaviors such as asking open-ended questions, using reflective listening, and avoiding arguments in which one tries to change the patient?s views.

Breaking the Cycle of Readmissions

Getting Quality Improvement into the Curriculum

Burnout and compassion fatigue are fundamentally different phenomena. Understanding the difference is helpful for effective intervention. Investments in self-awareness and self-care are sound business strategies that can be expected to reduce staff turnover and increase patient satisfaction. Mindfulness meditation and reflective writing have both been shown to increase self-awareness and self-care. They are among a number of strategies that can be built into clinical practice to prevent burnout and compassion fatigue.

Smoking is extremely common among persons with mental illness and exerts a huge toll in terms of morbidity and mortality. We are now in the midst of a culture change. Formerly smoking was an integral part of the mental health culture and smoking cessation was not deemed pertinent. Now it is evolving into an important component of mental health and wellness. Most smokers who have mental illness would like to quit. And many are able to do so, using the standard smoking cessation techniques used for the general population. There is still much more to know, but we know enough to encourage persons with mental illness to stop smoking and to provide them the tools to do so.

Leading from the Botton Up

Channeling Grief Into Action

Diamond Pass

How a Simple Checklist can Dramatically Reduce Medical Errors