Why 10 years of Quality Effort in Medicine Have So Little To Show…

My take on why quality and patient safety improvements in medicine have been so hard to demonstrate, and why. I also present my belief in how we can move more effectively in quality and patient safety if we give up on competition. Also Brian Hughley and I playing “James” by Pat Metheny from a few years ago. Thanks.

Hyperurgent hospital communications

Discussion of how to present patients when their lives are on the line. Thanks for listening. JY

Handoffs

Discussion of handoffs of patients, essential information, and strategies to avoid missed problems. Some jazz flute from me from a few years ago.

Thanks for listening.  JY

Making Logical Presentations in the ICU Part 2

Further discussion of presenting critical care patients. I go through each system and present an entire patient so you can hear the entire process. Thanks for listening. JY

Logical Patient Presentations in Critical Care

The beginning discussion of creating a new model for patient presentations in critical care that is safe and logical. Chameleon by myself and Brian Hughley from a few summers ago. Thanks for listening. JY

Newest Video from Orange County Fire EMS: EMS, Hospice, and Palliative Care

http://www.youtube.com/watch?v=zgLpexM27R4

Critical Care Airway and Breathing Emergencies

A discussion of hospital airway and breathing emergencies in the ICU environment. Thanks for listening. JY

The Future of EMS Hospital Integration

A discussion of where we should be headed in integrating EMS care and hospital care. Some of my flute playing on a Jeff Lorber tune. Thanks for listening. JY

FDNY Buff trip

Just got back from a great trip to the Big Apple with my friends from Albemarle County fire. The purpose was to buff FDNY firehouses and units and we saw a ton. The link goes to a video of the pictures I took.  FDNY trip pic video

Couple of thoughts about what goes on in NYC. FDNY is an amazing organization, incredible people, incredible equipment, and incredible training. The “Rock” their training school and simulation center is amazing and their devotion to training is astounding, especially since they think a great deal of themselves, and usually organizations like that rest on their laurels, the FDNY doesn’t do that.

But the disdain for EMS in NYC is really shocking. As many of you know FDNY EMS and FDNY are essentially separate organizations living under the same roof. The FDNY firefighters are trained in CFR (first responder) which is less training than EMT, and yet first respond to all major EMS incidents. What they do their other than comfort and help lift is hard to figure out. And that’s fine, I don’t like many EMS calls myself, but it does actually save lives occasionally, and in order to save the lives you should, you need to have a solid EMS system, which does not seem to exist in NYC. Also, as a former New Yorker, I know how hard it is for us to think anything done outside of NY is worth a sh*t, but I think if you took an unbiased person and had them watch the NYC EMS system in work during a complex call, and then watched the Virginia system in most jurisdictions, I think the differences would be striking.

I don’t know the solution for EMS in NYC but the first step in addressing any problem is realizing you have one.

Time Travel and Recognition Primed Decision Making

A discussion of how experts size up situations and how as an experienced person, you often look ahead in time to predict how your interventions will work. Thanks, JY