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JTepperJoshua Tepper is a family physician and the President and Chief Executive Officer of Health Quality Ontario

 

Often when we talk about improving health care, we turn to the Triple Aim. Developed in 2007 by the Institute for Healthcare Improvement (IHI) in the United States, the Triple Aim captures three objectives for a better quality health system: Improving a patient’s experience of care, improving population health and doing this at a reasonable cost. It has become a way of thinking embraced by many health care systems around the world.

The Triple Aim takes a big-picture, system-wide approach that can be applied to any part of the health care system, as well as across all levels of an organization. The ultimate endgame is a sustainable health care system that patients trust and that contributes to healthier populations.

All great ideas get improved upon over time. ...continue reading

This week's author interviews:

Interview with Dr. Christopher Parshuram, critical care specialist with the Hospital for Sick Children in Toronto. He is the lead author of a randomized trial published in CMAJ looking at patient safety, resident well-being and continuity of care for three resident duty schedules in the ICU. Work schedules incorporating shorter periods of continuous duty affected neither doctors' daytime sleepiness nor adverse outcomes in patients.

Interview with Dr. Thomas Maniatis, internal medicine training program director and clinical ethicist at McGill. Dr. Maniatis is the author of a commentary published in CMAJ. He argues that resident duty-hour reform must be further evaluated in order to design systems that provide maximal benefit and minimal harms for all involved.

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Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

“It was the loneliest I’ve ever felt,” said my consultant surgeon colleague as he described lying in his hospital bed the night before cardiac surgery. Even with all his surgical experience, familiarity of the surroundings, knowledge of his own hospital, and utmost confidence in his cardiac surgical colleagues and anaesthetist, he was scared. Despite what our patients might think, being a doctor is no defence against illness and doesn’t make coping with illness any easier.

But, we are our own worst enemies. We put immense pressure on ourselves and don’t want to let our medical colleagues or patients down. I once listened to a single-handed rural GP who had recent chest pain and was awaiting an angiogram. His greatest worry was that he could not get a locum to cover his patients ...continue reading