Fantastic piece - the Ambulatory Care Transformation Network initiative seems very innovative yet long overdue. Care closer to home, clinician behaviour change and pt voice central to deliver this. @rcgp @Modality_MCP
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'Hospitals that had relatively more operating rooms and relatively fewer labor rooms tended to do more surgery'
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Yes, but are those hospitals the one's with NICUs? Are the seeing higher risk patients? Are we comparing hospitals in the same tier? I looked at the report, the analysis is not sophisticated.
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I am very, very, skeptical that the way to control unnecessary c-sections is to make it more difficult for facilities to perform a potentially life-saving procedure, or that is what they even measured in the first place.
End of conversation
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These sound like interventions that should be studied in a prospective fashion rather than implemented based on idealism or poor understanding of our tiered systems. Perverse outcomes abound in such unstructered experimentation.
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Completely agree and I often tell patients that putting a bed in the middle of the room sends entirely the wrong message about what is good for their health. I tell my patients to go to bed at night like at home.
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Great challenges ahead! Of course prospective plans are ideal but the vast majority of hospitals is already built around the old model. How is it best to approach design changing in this setting?
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The abuse of rules limiting residency work hours is like the abuses committed by Harvey Weinstein— nobody talked about them! Shame on the ACGME!
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