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Letter from the Editor

From the December ACP Hospitalist, copyright © 2011 by the American College of Physicians

Admitting a mistake is difficult, and admitting that a mistake almost happened isn't easy, either. But that's precisely what some hospitals are encouraging through “good catch awards,” which honor clinicians who are willing to own up to near-blunders like botching a prescription or performing surgery on the wrong side of the body. In doing so, these facilities have an opportunity to improve systems of care and reduce the incidence of errors without harming a single patient. Near-miss analysis also is often less labor-intensive than sentinel events analysis, though getting physician buy-in can be just as challenging. Turn to our cover story to read more about how these award programs work.

Mistakes in judgment are common when it comes to assessing the ability of some patients to make decisions about their care. Research indicates that about one-quarter of all patients have an impaired ability to make such decisions, yet only 42% of those patients are recognized by physicians as impaired. Our feature story provides a primer on how to spot a patient with limited decision making capacity and when to call for expert help. Meanwhile, we address another area where physicians can fall short in their observational skills—predicting which patients are most at risk for readmission. Unfortunately, prediction algorithms don't do much better, as Nazima Allaudeen, MD, discusses in our Q&A.

Much better than predicting readmissions is preventing them from happening at all. To this end, more and more hospitalists are spending time in discharge clinics that aim to smooth the transition from hospital to outpatient care, and help prevent return visits to the hospital. Our story looks at several examples of these clinics, and the opportunities and challenges they afford both patients and hospitalists. Also in this issue, medical student Trahern Jones discusses his life-changing trip to a Rwanda hospital to help expand lab services, while hospitalist and ACP Member Andrew Kurklinsky, MD, talks about a life-altering experience he had during routine rounds on an oncology ward.

We'd love to hear your feedback on these or any other stories. E-mail us.

Sincerely,

Jessica Berthold

Editor, ACP Hospitalist

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ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated