The Hospital Book

By Admin | June 13, 2012 at 3:52 am


Patients want and deserve safe and effective care. The Hospital Book: 100 Things You Need To Know To Make It Out Alive and Well will give readers the background knowledge and specific technical information (as opposed to general strategies) to help them recognize and avoid the clinical scenarios that lead to medical catastrophes. Written by two practicing physicians who have collaborated on three previous books on medical errors for professionals, The Hospital Book will explain clinical treatment protocols and “best practices” in simple, easy-to-understand language that patients can use to monitor their care and help avoid bad outcomes. It’s aim is to close the large information gap between medical providers and medical users.

In 1999, the Institute of Medicine, drawing on a large and well-known body of literature, issued a report estimating that the number of preventable hospital deaths in the United States at 100,000, with perhaps ten times the number of potentially life-altering preventable injuries. Subsequently over the last ten years, there was a burgeoning interest and intensive effort by insurers, hospitals, physicians, and patient advocates to reduce this shocking number by using a systems-based model to analyze the root causes of hospital errors. Modeled, in part, on the template provided by the safety science used in the airline industry, errors theory was discussed, errors types were categorized, and errors terminology was developed. Hospital safety officers were appointed, hospital safety campaigns intiated, and hospital safety systems developed.

None of it worked.

Distressingly, follow-up reports to the landmark 1999 study show that preventable death and serious injury occur with the same tragic frequency. There is now a growing realization that for all the discussion about the theory of medical errors and various root causes, there was very little attention given to what the actual specific errors were and how to avoid them. To remedy that, it is now understood that the key to reducing medical errors is to diagnose them in a specific and concrete way. To further that goal, patient safety guidelines have been developed by government health agencies and leading patient safety organizations that list specific, actionable items and recommendations to tell healthcare providers what the errors are and what exactly to do or not to do to avoid them.

Similar to these guidelines, the rationale behind The Hospital Book is the belief that reliable, safe, and error-free healthcare is an achievable goal if uniform and specific practices are adopted across the healthcare spectrum – and that knowledgable patients can and must contribute to this effort. After all, patients (and not doctors and nurses) have a personal stake in engaging in the outcomes. They must understand the stark reality that they are passengers on an airplane – but when and if it crashes, the pilot (doctor) never perishes.

To structure this information, this book will have 100 chapters grouped into seven sections. Each section will correspond to a care area of the hospital.

About the Authors

Market Analysis and Comparable Books

You: The Smart Patient: An Insider’s Handbook for Getting the Best Treatment, Michael F. Roizen and Mehmet C. Oz, Free Press, 2006, ISBN-10: 0743293010, ISBN-13: 978-0743293013, 432 pages, $14.95.

Wall of Silence: The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans, Rosemary Gibson and Janardan Prasad Singh, LifeLine Press, 2003, ISBN-10: 089526112X, ISBN-13: 978-0895261120, 256 pages, $24.95.

Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes, Robert M. Wachter, MD and Kaveh Shojania, MD, Rugged Land, 2005, ISBN-10: 1590710738, ISBN-13: 978-1590710739, 460 pages, $26.95.

Understanding Patient Safety (Lange Clinical Medicine), Robert M. Wachter, MD, McGraw-Hill Professional, 2007, ISBN-10: 0071482776, ISBN-13: 978-0071482776, 240 pages, $36.95.

Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive, Martine Ehrenclou, Lemon Grove Press, LLC, 2008, ISBN-10: 0981524001, ISBN-13: 978-0981524009, 248 pages, $19.95.

The Empowered Patient: Hundreds of Life-Saving Facts, Action Steps and Strategies You Need to Know, Julia A. Hallisy, Bold Spirit Press, 2007, ISBN-10: 0615177913, ISBN-13: 978-0615177915, 351 pages, $25.95.

Hospital Stay Handbook: A Guide to Becoming a Patient Advocate for Your Loved Ones, Jari Holland Buck, Llewellyn Publications, 2007, ISBN-10: 0738712248, ISBN-13: 978-0738712246, 264 pages, $17.95.

How to Get Out of the Hospital Alive: A Guide to Patient Power, Sheldon P Blau, Elaine Fantle Shimberg, Wiley, 1998, ISBN-10: 0028623630, ISBN-13: 978-0028623634, 256 pages, $14.95.

The Savy Patient: How to Get the Best Health Care, Mark Pettus, Capital Books, 2004, ISBN-10: 1931868808, ISBN-13: 978-1931868808, 288 pages, $19.95.

Table of Contents

Section 1: Before Being Admitted To The Hospital

Chapter xx: Finding the Best Doctor
Chapter xx: Getting Ready to be Admitted
Chapter xx: Trauma Injuries Go To Trauma Hospitals
Chapter xx: Emergency Problems Require Emergency Transport
Chapter xx: Think Hard About Being a DNR
Chapter xx: Tell Your Surgeon Every Drug and Supplement You Take and Follow Instructions Carefully
Chapter xx: Stop Smoking (and if you still are, don’t lie about it)
Chapter xx: Changes in the culture of care

Section 2: The Emergency Department

Chapter xx: Don’t be talked out of an MI
Chapter xx: Not all MI’s are the same: STEMI’s and NSTEMI’s

Section 3: The Operating Room and Post-Anesthesia Care Unit (PACU)

Chapter xx: Do Not Become a Marketing Prop
Chapter xx: Do Not Mark Your Surgical Site
Chapter xx: You Are Not the Coach (You Don’t Decide Who Plays)
Chapter xx: Ask For Two Intravenous Lines
Chapter xx: Remind Your Surgeon to Check for a Type and Screen or Type and Cross
Chapter xx: Know the correct Sequence for Using Sequential Compression Devices
Chapter xx: Music for Your Ears; Medicine for Your Health
Chapter xx: Ask about Sepra film in abdominal surgery
Chapter xx: Sleep apnea is serious

Section 4: The Intensive Care Unit

Chapter xx: The kidney is king!!
Chapter xx: Be skeptical about the use of paralytics
Chapter xx: Antibiotics need to be started within one hour
Chapter xx: Ask for Licox monitoring in brain trauma
Chapter xx: Sedation: The siren song of the units
Chapter xx: Ask about cardioversion for atrial fibrillation
Chapter xx: Beta blockers by morning
Chapter xx: Benzodiazepines must be restarted
Chapter xx: The Clinical Pharmacist: Your New Best Friend
Chapter xx: Head of the Bed at Thirty Degrees
Chapter xx: Hardnosed About Handwashing
Chapter xx: Creatinine is Critical
Chapter xx: Lactate Must Be Low
Chapter xx: No Blood Draws Through Central Lines
Chapter xx: Nutrition is Needed
Chapter xx: Pancreatitis is dangerous
Chapter xx: Fentanyl is fabulous
Chapter xx: Glucose control is good

Section 5: The Floors

Chapter xx: Get The Nurses on Your Side
Chapter xx: Two Sticks Max
Chapter xx: Get Out of Bed
Chapter xx: Don’t Take Your Collar Off
Chapter xx: When to Worry About Your Surgical Wound
Chapter xx: Incentives for Incentive Spirometry
Chapter xx: Stomach Contents Go Through A Nasogastric Tube (Not Around It!)
Chapter xx: Do not Lobby To Keep Your Foley Catheter
Chapter xx: Code Brown (Clostridium difficile)
Chapter xx: Orthopedic doctors are great with with bones but….

Section 6: Labor and Delivery


Chapter Summaries

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Greg Hardison – Playwright and Director of Museum Theatre (Part 2 of 2)

By Admin | August 7, 2010 at 2:49 am

Greg Hardison is the Director of Museum Theatre at the Kentucky Historical Society. We visited with him recently in Frankfurt, Kentucky and continues with his interview

When did you decide to become a playwright and what influenced your decision? I began writing plays when I owned my own company.

Do you develop your own ideas for your plays or do your directors suggest topics?

I develop my own ideas for the most part, but they are influenced by institutional goals and initiatives, new exhibitions, teachers needs, current trends and audience interests.

I have total confidence from my directors and supervisors. There is never a lack of ideas really, but I get to shape and mold it. We use a lot of market research, scholarly guidance, and gut feelings to make our final decisions.

Who is your favorite playwright?

Shakespeare wins hands down as the best of all time. His works stand the test of time. Always new interpretations, but the text remains as important as ever. There are many others that I like too, but usually on a play-by-play basis.

Which current playwright today is the most overrated?

None. I realize that is a calculated response, but everyone is entitled to their own voice. Some are just more appreciated, understood, and popular than others.

But art isn’t about being popular, it’s about saying what you think and feel. Just ask the guy who cut his ear off, or the fact that most artists die poor, and don’t become famous until after they die.

Other than your own works, how often do you attend the theatre?

Sad to say, I don’t attend as much as I would like to. My job and my family keep me terribly busy. I try to see about five to six pieces a year, mostly local productions with friends, and the occasional traveling piece. There is some great local theatre, if you know where to look. I love Balagula Theatre in Lexington, and Woodford County Theatre Association.

Are you working on any plays that are not for the Historical Society?

I have no interest in writing beyond my job. I get to experiment with all of my ideas there, and don’t have the time to develop beyond that.

Do you have any desire to try a screenplay?

I have ideas, but no immediate desire to do so. Maybe some day. We have the potential of grant money to develop a video series around the Civil War, that is as close as I will come for a while.

I write and produce so much in conjunction with my job, that I really don’t have much of a need to express myself beyond that. I have other hobbies. Playwrighting and production is my job, when I get home I want to do other things.

What overall mission have you been given by your directors?

Well, I helped to define the mission of the Kentucky Historical Society, of the Education Department, and wrote the mission of the Museum Theatre program.

In short, our goal is to connect with the past, provide perspective on the present, and inspire thought for the future. There are tons of objectives, strategies and outcomes that branch out from there.

We are in the process of institutional strategic planning now for the next three years. It’s all interconnected from there.

What is one little known fact about Kentucky that you would like to have readers know?

It probably doesn’t mean “Dark and Bloody Ground,” it is the home to the cheeseburger, two guys name Cassius Clay (not related, and 100 years apart), Hopkinsville may have been visited by aliens, and may have had a great swiss silver mine.

Oh, and middle eastern explorers may have written grafitti on a rock in Clay Co. hundreds of years before Dr. Walker. Ain’t the study of history great? Well, if you believe all of that, then I’ll tell you about the blue people from Troublesome creek. True story!!! Really.

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Greg Hardison – Playwright and Director of Museum Theatre (Part 1 of 2)

By Admin | August 5, 2010 at 1:04 am

Greg Hardison is a playwright and the Director of Museum Theatre at the Kentucky Historical Society in Frankfurt, Kentucky. We visited with him recently.

Where are you from?

I was born in Alabama, lived from 6 months to 16 years in rural eastern North Carolina, and then moved to Charlottesville, Virginia for last two years of high school.

I guess I consider myself from North Carolina and Virginia, as they both hit me at particular developmental times.

Where did you go to school and what was your academic major?

I attended Old Dominion University, first as an engineering student, but hated math.

I changed to Elementary Education in my third year, but life offered opportunities that seemed more compelling and I left less than a year from completing my degree.

I will forever regret that decision, and have intentions of going back when time permits. Alas, isn’t that always so, we never seem to have time to do the things we know we should.

What has been your career path from college to your current position?

While in college, I paid for my own expenses by working for a family entertainment company. I learned to walk on stilts, juggle, perform magic, and I honed my performance and storytelling skills before a huge number of audience sizes and types.

Towards the end of my time at college, I was offered the opportunity to buy the business. It seemed like a good idea, and I did. I ran the business for about 5 years, learned alot about business, and that it wasn’t my favorite thing.

I sold the business and took a management position for a large indoor amusement park in northern Delaware. Worked there for several years, got married, and moved to Kentucky to be near my wife’s extended family, because we wanted kids.

The museum I now work for advertised in the paper the next week. I applied for a job as an actor/docent and got the job.

From there, I helped to define the concept of Museum Theatre for the Kentucky Historical Society and eventually even defined the goals and duties of my position here at KHS, as the Director of Museum Theatre.

When did you decide to become a playwright and what influenced your decision?

I began writing plays when I owned my own company. They were horrible, but it was the only way. I couldn’t afford to pay a playwright, and we needed material.

When I started here at KHS 10 years ago, the concept of Museum Theatre was still new. My director at the time didn’t really know what it was either, but he knew good theatre, and together we kept trying things, and we defined it for our institution.

I learned alot about what it took to both entertain and educate museum audiences. I am still learning how to develop and work within clear educational goals.

I still don’t think I am a great playwright, but I do understand Museum Theatre and how it is different from other types of plays. I think I am now producing programs that are defining new thought in the field.

We are challenging our audiences, actors, our institution and the field. Evaluations and audience feedback tell me that what we are doing is working, but I will never settle.

I will always work to better define what I do, and how I do it. I have found the career of a lifetime. I love what I do!

How many plays are you required to write a year for the Historical Society?

I am not required to write any number of plays really.

In the beginning we wrote about five a year, but we have learned alot, and what we do now is far more complex than what we used to do.

Now, we really try to develop pieces that work really hard to achieve our educational and institutional goals. We produce plays that require more research, and that seek to provide new insight on our topics.

It takes longer to produce the pieces now. I am in no rush these days. We have created over sixty pieces, and we just seek to add to our repetoire now. I pick these new pieces carefully to fill holes in our timeline, or missing themes, or upcoming inititives.

I now create about three plays a year, but I also develop video conference programs, assist with the creation of other education programs, and am working on a proposal for a new literary series, with actors doing dramatic readings of deceased Kentucky authors, and other proposals for summer art camps, evening programming, and day care programs.

We present several hundred school shows both in house and as outreach each year, and keep a steady schedule of weekly performances on our campus. I stay pretty busy.

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Terry Wilder – Park Ranger, White Sands National Monument

By Admin | October 24, 2009 at 2:55 am

Where are you from?

Originally, I am from Covington Kentucky up until age 17. Then
over 20 years in the United States Air Force, which led me to Alamogordo area (adjacent to the White Sands Monument)

Where did you go to college and what was your academic major?

New Mexico State University and it was Occupational Business.

What has been your career path from college to your current position at White Sands?

Well, since I did not start college till I retired from the Air Force I was finishing up my degree when I was offered a position at
White Sands as a seasonal employee.

What are your typical duties day-to-day at the White Sands?

Along with being a visitor use assistant – fee collector – I am in charge of the Special Use Program. Permits for weddings, group use area applications, and special events that includes our Annual Hot Air Balloon Festival, Early Easter Sunrise Service, etc.

If you weren’t a national park ranger, what would you be doing?

I would probably be working on the Air Force Base for the government as an aircraft inspector overseeing a civilian contractor working on Air Force airplanes.

How does having an Air Force base right next door to the monument impact it?

Pretty good for us actually, whenever they have some type of event such as Airshow, Octoberfest, Base Open House we get over flow to the Park and our visitation goes up a bit. Although, we have had aircraft crash on our property and it makes for quite a red tape mess.

What is one little known fact about the park that you want visitors and readers to know?

That 3 to 4 inches down in the sand the temperature stays at a pretty constant 57 degrees, no matter how hot or cold it is. You get lost in the cold of the winter at night, then just bury yourself in the sand and you will stay warm till morning. In the summer if it is
115 degrees just bury yourself and you will stay cool till the sun goes down.

Here is a bonus. Eighteen inches down from anywhere on the hardpacked sand or at the bottom of a dune you will reach water. Very salty water but water none the less.

How did the white sands actually form? Are they still forming?

The real short version is that the gypsum is in the mountains and the wind and rain carry it to Lake Lucero twnty miles down the road. When when the lake bed dries up the gypsum chunks break apart and are carried by the wind and replenish the dunes.There is a seventeen minute film on the whole process in our Visitors Centers.

What is your favorite part of the monument?

Two or three miles out from the heart of the dunes on top of a big dune with a cool summer breeze blowing across you as the sun goes down in the fiery sky of southwestern New Mexico.

What are the two biggest challenges that the White Sands monument faces?

Education of a new generation to the enjoyment of all for the National Parks and to the protection of this precious resource we have been entrusted with. Such programs as the Junior Ranger Program and on-site visits to the schools to talk to the kids who will soon enough be responsible for taking care of the Park System.

Is the White Sands featured at all in the new Ken Burns” documentary?

Honestly, I do not know if we are and I have not been following the Ken Burn’s specials.

How many people visit the monument every year?

We get anywhere from 450,000 to 600,000 a year give or take the economy

Has anyone ever got lost and stranded in the monument or died from exposure?

We have numerous people get lost and found every year and we have had one fatality since this place
became a National Monument.

Copyright 2009

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