Research Topics
| R M WachterSummaryAffiliation: University of California Country: USA Publications
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Publications
Medicare's decision to withhold payment for hospital errors: the devil is in the detRobert M Wachter
Department of Medicine, University of California, San Francisco, USA
Jt Comm J Qual Patient Saf 34:116-23. 2008..This initial implementation should be considered a bold experiment, whose consequences are carefully monitored. Additional research will be needed to help identify preventable adverse events and evidence-based strategies to prevent them...
Personal accountability in healthcare: searching for the right balanceRobert M Wachter
Department of Medicine, University of California, San Francisco, Room M 994, 505 Parnassus Avenue, San Francisco, CA 94143 0120, USA
BMJ Qual Saf 22:176-80. 2013..Ultimately, a robust approach to patient safety will balance 'no blame' with accountability, and will also parse the correct target for accountability in a way that maximises fairness and effectiveness...- Why diagnostic errors don't get any respect--and what can be done about themRobert M Wachter
Department of Medicine, University of California, San Francisco, CA, USA
Health Aff (Millwood) 29:1605-10. 2010..As approaches to measuring, preventing, and mitigating harm from diagnostic errors are proven to work, it will be important to integrate these approaches into policy initiatives to improve patient safety... - The faces of errors: a case-based approach to educating providers, policymakers, and the public about patient safetyRobert M Wachter
Department of Medicine, University of California at San Francisco, USA
Jt Comm J Qual Saf 30:665-70. 2004..The Web-based Agency for Healthcare Research and Quality (AHRQ) WebM&M was then developed as a forum that was part-reporting system and part-journal. Finally, we then applied this approach to writing a book for a popular audience... - Expected and unanticipated consequences of the quality and information technology revolutionsRobert M Wachter
Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0120, USA
JAMA 295:2780-3. 2006 - What will board certification be-and mean-for hospitalists?Robert M Wachter
Department of Medicine, University of California, San Francisco, San Francisco, California, USA
J Hosp Med 2:102-4. 2007 - The 100,000 Lives Campaign: A scientific and policy reviewRobert M Wachter
Department of Medicine, University of California, San Francisco, USA
Jt Comm J Qual Patient Saf 32:621-7. 2006..quot; The actual mortality data were supplied without audit by the more than 3,000 participating hospitals, and 14% of the hospitals submitted no data at all... - Reflections: the hospitalist movement a decade laterRobert M Wachter
Department of Medicine, University of California, San Francisco, California 94143 0120, USA
J Hosp Med 1:248-52. 2006..These individuals have given life to our theoretical notion a decade ago that a new model for inpatient care would improve the American health care system and the care of inpatients... - The state of hospital medicine in 2008Robert M Wachter
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco 94143 0120, USA
Med Clin North Am 92:265-73, vii. 2008..In this article, I briefly trace the reasons for the field's remarkable growth, describe some of hospital medicine's key issues and concerns, and speculate about the future shape of the field... - Public reporting of antibiotic timing in patients with pneumonia: lessons from a flawed performance measureRobert M Wachter
University of California, San Francisco, San Francisco, California 94143 0120, USA
Ann Intern Med 149:29-32. 2008..These steps will increase the probability that future quality measures will improve care without creating negative unintended consequences... - Patient safety at ten: unmistakable progress, troubling gapsRobert M Wachter
Department of Medicine, University of California, San Francisco, California, USA
Health Aff (Millwood) 29:165-73. 2010..The research pipeline is maturing, but funding remains inadequate. Our limited ability to measure progress in safety is a substantial impediment. Overall, I give our safety efforts a grade of B-, a modest improvement since 2004... - The end of the beginning: patient safety five years after 'to err is human'Robert M Wachter
University of California, San Francisco, UCSF Medical Center, USA
Health Aff (Millwood) . 2004..Error-reporting systems have had little impact, and scant progress has been made in improving accountability. Five years after the report's publication, we appear to be at "the end of the beginning"... - The hospitalist movement 5 years laterRobert M Wachter
Department of Medicine, University of California, San Francisco, Box 0120, San Francisco, CA 94143 0120, USA
JAMA 287:487-94. 2002..We originally described the hospitalist model of inpatient care in 1996; since then, the model has experienced tremendous growth. This growth has important clinical, financial, educational, and policy implications... - The evolution of the hospitalist model in the United StatesRobert M Wachter
Department of Medicine, University of California Medical Center, Box 0120, Room M 994, 505 Parnassus Avenue, San Francisco, CA 94143 0120, USA
Med Clin North Am 86:687-706. 2002..With these goals in mind, it is likely that hospitalists will play an increasingly important and visible role in many institutions across the country... - The benefits of using hospitalistsR M Wachter
Department of Medicine, University of California, San Francisco, USA
Health Forum J 44:34-6, 1. 2001..Moreover, the program can often attract primary care physicians who prefer to use the service of a hospitalist... - Reorganizing an academic medical service: impact on cost, quality, patient satisfaction, and educationR M Wachter
Department of Medicine, University of California, San Francisco 94143 0120, USA
JAMA 279:1560-5. 1998..Academic medical centers are under enormous pressure to improve quality and cut costs while preserving education... - The "continuity visit" and the hospitalist model of careR M Wachter
Department of Medicine, University of California, San Francisco, USA
Am J Med 111:40S-42S. 2001..quot; Moreover, we encourage research on the value of continuity visits and recommend compensation if research establishes that these visits improve the efficiency and quality of inpatient care or patient satisfaction and comfort... - The surgical hospitalist: a new solution for emergency surgical care?John Maa
Department of Surgery, University of California, San Francisco, USA
Bull Am Coll Surg 92:8-17. 2007 - Caregiver perceptions of the reasons for delayed hospital dischargeT M Minichiello
Department of Medicine, University of California, San Francisco 94115, USA
Eff Clin Pract 4:250-5. 2001..Financial pressures have increased the emphasis on expeditious hospital discharge. Identification of barriers to timely discharge may help direct efforts to decrease unnecessary hospital days... - Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS ProjectM A Blegen
Community Health Systems Department, School of Nursing, University of California, San Francisco, 2 Koret Way, Box 0608, San Francisco, CA 94143, USA
Qual Saf Health Care 19:346-50. 2010..The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention... - A new doctor in the house: ethical issues in hospitalist systemsS Z Pantilat
Department of Medicine, University of California, San Francisco 94143 0903, USA
JAMA 282:171-4. 1999..An approach that keeps the patient's best interests foremost, defines a clear role for the PCP, and takes advantage of the expertise and availability of hospitalists will best serve patients and physicians... - Republished paper: Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS ProjectM A Blegen
Community Health Systems Department, School of Nursing, University of California, San Francisco, 2 Koret Way, Box 0608, San Francisco, CA 94143, USA
Postgrad Med J 86:729-33. 2010..The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention... - A pneumonia practice guideline and a hospitalist-based reorganization lead to equivalent efficiency gainsJ C Reddy
Department of Medicine, University of California San Francisco Medical Center, USA
Am J Manag Care 7:1142-8. 2001..For common diagnoses amenable to practice guidelines, successful implementation of and compliance with guidelines may be an alternative to major organizational change... - The evolution of the hospitalist movement in the USAThomas E Baudendistel
University of California, San Francisco, USA
Clin Med 2:327-30. 2002.... - Assessment of prognosis in patients with community-acquired pneumonia who require mechanical ventilationF E Pascual
Cardiovascular Research Institute, Department of Medicine, University of California, San Francisco, USA
Chest 117:503-12. 2000..We formulated a prediction model to quantitate the risk of hospital mortality in this population of patients... - Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-outArpana R Vidyarthi
Department of Medicine, University of California, San Francisco, CA, USA
J Hosp Med 1:257-66. 2006..Although studies show that discontinuity may be harmful to patients, this is little data to assist residency programs in redesigning systems to improve sign-out and manage the discontinuity... 
The impact of duty hours on resident self reports of errorsArpana R Vidyarthi
Department of Medicine, University of California, San Francisco, California 94143 0131, USA
J Gen Intern Med 22:205-9. 2007..Resident duty hour limitations aim, in part, to reduce medical errors. Residents' perceptions of the impact of duty hours on errors are unknown...- Identification of inpatient DNR status: a safety hazard begging for standardizationNiraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, California 94143, USA
J Hosp Med 2:366-71. 2007..However, hospitals vary widely in their methods of making these preferences (including do-not-resuscitate [DNR] status) available to frontline providers, increasing the potential for errors... - Color-coded wristbands: promoting safety or confusion?Niraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, CA 94143, USA
J Hosp Med 2:445. 2007 - Neurohospitalists: an emerging model for inpatient neurological careS Andrew Josephson
Department of Neurology, University of California San Francisco, San Francisco, CA 94143 0114, USA
Ann Neurol 63:135-40. 2008..A neurohospitalist model of care is an emerging idea in neurology that would overcome many regulatory, educational, and economic challenges facing neurologists; further research is needed to gauge the effects of this innovative approach... - Critical conversations: a call for a nonprocedural "time out"Niraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California 94143, USA
J Hosp Med 6:225-30. 2011..Nonprocedural settings generate equal risks for communication failure, yet lack a similar communication tool or practice that can be applied, particularly with a patient-driven focus... - Investing in the future: building an academic hospitalist faculty development programNiraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California 94143, USA
J Hosp Med 6:161-6. 2011.... - Comanagement of surgical patients between neurosurgeons and hospitalistsAndrew D Auerbach
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA 94143 0131, USA
Arch Intern Med 170:2004-10. 2010..Shared management of surgical patients between surgeons and hospitalists (comanagement) is increasingly common, yet few studies have described its effects... 
Potential unintended consequences due to Medicare's "no pay for errors" rule? A randomized controlled trial of an educational intervention with internal medicine residentsSomnath Mookherjee
Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, CA 94143, USA
J Gen Intern Med 25:1097-101. 2010..quot; This "no pay for errors" rule may have a profound effect on the clinical practice of physicians...- Patient whiteboards as a communication tool in the hospital setting: a survey of practices and recommendationsNiraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California 94143, USA
J Hosp Med 5:234-9. 2010..Patient whiteboards can serve as a communication tool between hospital providers and as a mechanism to engage patients in their care, but little is known about their current use or best practices... - Impact of duty-hour restriction on resident inpatient teachingLindsay A Mazotti
Department of Medicine, University of California, San Francisco, San Francisco, California 94143 0131, USA
J Hosp Med 4:476-80. 2009..The Accreditation Council for Graduate Medical Education (ACGME) duty-hour restrictions (DHR) likely impacted aspects of resident teaching, well-being, and patient care practices that affect the duties of academic hospitalists... - Applying Toyota Production System principles to a psychiatric hospital: making transfers safer and more timelyJohn Q Young
Adult Psychiatry Clinic, Langley Porter Psychiatric Hospital and Clinics, San Francisco, CA, USA
Jt Comm J Qual Patient Saf 35:439-48. 2009..However, the use of such methods in psychiatric hospitals has been limited... - Refocusing the lens: patient safety in ambulatory chronic disease careUrmimala Sarkar
Division of General Internal Medicine, University of California, San Fransisco, USA
Jt Comm J Qual Patient Saf 35:377-83, 341. 2009..A framework, provided in the context of the Chronic Care Model, outlines the multifaceted approach needed for ambulatory care... - A multidisciplinary teamwork training program: the Triad for Optimal Patient Safety (TOPS) experienceNiraj L Sehgal
Division of Hospital Medicine, University of California, San Francisco, CA 94143, USA
J Gen Intern Med 23:2053-7. 2008..Communication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based practice, are particularly challenged to address these important skills... - The expanding role of hospitalists in the United StatesNiraj L Sehgal
Department of Medicine, University of California, San Francisco, CA, USA
Swiss Med Wkly 136:591-6. 2006..As their skills sets and unique competencies become more clearly outlined, the next step will likely be the development of an independent specialty with its own board certification... - Implementation of a voluntary hospitalist service at a community teaching hospital: improved clinical efficiency and patient outcomesAndrew D Auerbach
Department of Medicine, Box 0120, 505 Parnassus Avenue, University of California, San Francisco, San Francisco, CA 94143 0936, USA
Ann Intern Med 137:859-65. 2002..Previous investigations of the effect of the hospitalist model on resource use and patient outcomes have focused on academic medical centers or have used short follow-up periods... - Effects of hospitalist attending physicians on trainee satisfaction with teaching and with internal medicine rotationsKaren E Hauer
Department of Medicine, University of California, San Francisco 94143 1031, USA
Arch Intern Med 164:1866-71. 2004..The educational impact of this new model is unclear. We evaluated the relationship between type of attending (hospitalist vs traditional) and trainees' ratings of attending teaching and the overall ward rotation... - Trends in market demand for internal medicine 1999 to 2004: an analysis of physician job advertisementsAndrew D Auerbach
Department of Medicine, University of California San Francisco, San Francisco, CA, USA
J Gen Intern Med 21:1079-85. 2006..The health care marketplace has changed substantially since the last assessment of demand for internal medicine physicians in 1996... - Effect of the inpatient general medicine rotation on student pursuit of a generalist careerVineet Arora
Department of Medicine, University of Chicago, Chicago, IL, USA
J Gen Intern Med 21:471-5. 2006..Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain... - Impact of reduced duty hours on residents' educational satisfaction at the University of California, San FranciscoArpana R Vidyarthi
University of California, San Francisco, CA 94143 0131, USA
Acad Med 81:76-81. 2006..To assess the impact of the Accreditation Council for Graduate Medical Education duty-hour limitations on residents' educational satisfaction... - Primary care physician attitudes regarding communication with hospitalistsS Z Pantilat
Department of Medicine, University of California, San Francisco 94143-0903, USA
Am J Med 111:15S-20S. 2001..It may be possible to tailor communication to individual PCPs. Further research could assess the impact of such communication on patient satisfaction and outcomes... - Implications of the hospitalist model for medical students' educationK E Hauer
Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143 0320, USA
Acad Med 76:324-30. 2001.... - Cross-sectional analysis of hospitalist prevalence and quality of care in CaliforniaEduard E Vasilevskis
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
J Hosp Med 5:200-7. 2010..Whether the presence of hospitalists is associated with differences in hospital-level performance is unknown... - Safe but sound: patient safety meets evidence-based medicineKaveh G Shojania
Department of Medicine, University of California, San Francisco, USA
JAMA 288:508-13. 2002 - Quality of primary care and hospital admissions for diabetes mellitus in EnglandAlex Bottle
School of Medicine, University of California, San Francisco, CA, USA
J Ambul Care Manage 31:226-38. 2008..However, low neighborhood socioeconomic status is more strongly associated with hospital admission rates for diabetes... - Response to David Meltzer's paper "Hospitalists and the doctor-patient relationship"R M Wachter
Department of Medicine, University of California, San Francisco, CA, USA
J Legal Stud 30:615-23. 2001..The hospitalist--unlike most traditional medical specialists--is actually a generalist by nature whose specialty is defined by the the site of the care rather than by organ, disease, patient population, or procedure... - California hospital leaders' views of hospitalists: meeting needs of the present and futureEduard E Vasilevskis
Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA
J Hosp Med 4:528-34. 2009..Hospital medicine has grown rapidly, but hospital leaders' perceptions of current and future drivers of hospitalist growth are unknown... - Hospitalists in the United States--mission accomplished or work in progress?Robert M Wachter
University of California, San Francisco, USA
N Engl J Med 350:1935-6. 2004 - The "dis-location" of U.S. medicine--the implications of medical outsourcingRobert M Wachter
Department of Medicine, University of California, San Francisco, USA
N Engl J Med 354:661-5. 2006 - Effect of evaluator and resident gender on the American Board of Internal Medicine evaluation scoresV E Rand
Division of General Internal Medicine, University of California, San Francisco 94143, USA
J Gen Intern Med 13:670-4. 1998..This study raises the possibility that subtle aspects of gender bias may exist in medical training programs... - Perspectives on medical outsourcing and telemedicine--rough edges in a flat world?Sanjiv N Singh
University of California, San Francisco, School of Medicine, San Francisco, USA
N Engl J Med 358:1622-7. 2008 - Improved survival with highly active antiretroviral therapy in HIV-infected patients with severe Pneumocystis carinii pneumoniaAlison Morris
Department of Medicine, San Francisco General Hospital, San Francisco, California, USA
AIDS 17:73-80. 2003..Highly active antiretroviral therapy (HAART) might alter the course of PCP either via effects on the immune system or through anti- actions; however, HAART has not been studied in patients acutely ill with PCP... - Intensive care of human immunodeficiency virus-infected patients during the era of highly active antiretroviral therapyAlison Morris
Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA
Am J Respir Crit Care Med 166:262-7. 2002..These patients may have an improved survival because of effects of therapy on variables such as likelihood of non-AIDS-associated admission diagnoses and serum albumin levels... - International teleradiologyRobert M Wachter
Department of Medicine, University of California, San Francisco, USA
N Engl J Med 354:662-3. 2006 - Clinical problem-solving. One surprise after anotherNicholas J Leeper
Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143-0120, USA
N Engl J Med 352:1474-9. 2005 - Intensivist consultation and outcomes in critically ill patientsRobert M Wachter
JAMA 289:986; author reply 986-7. 2003 - Learning from our mistakes: quality grand rounds, a new case-based series on medical errors and patient safetyRobert M Wachter
Ann Intern Med 136:850-2. 2002 - Medical and surgical comanagement after elective hip and knee arthroplasty: a randomized, controlled trialJeanne M Huddleston
Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
Ann Intern Med 141:28-38. 2004..Hospitalists are assuming an increasing role in the care of surgical patients, but the impact of this model of care on postoperative outcomes is unknown... - Tracking progress in patient safety: an elusive targetPeter J Pronovost
Department of Anesthesiology and Critical Care, Johns Hopkins University, Baltimore, MD 21231, USA
JAMA 296:696-9. 2006 - The future of general surgeryJohn Maa
JAMA 299:1015; author reply 1015-6. 2008 - The wisdom and justice of not paying for "preventable complications"Peter J Pronovost
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
JAMA 299:2197-9. 2008 - Quality grand rounds: the case for patient safetyRobert M Wachter
Ann Intern Med 145:629-30. 2006 - The patient provider relationship and the hospitalist movement. IntroductionSteven Z Pantilat
Dis Mon 48:189-90. 2002 - Drug withdrawals in the United States: a systematic review of the evidence and analysis of trendsAmalia M Issa
Program in Personalized Medicine and Targeted Therapeutics, University of Houston, 300 Technology Building, Houston, TX 77204 4021, USA
Curr Drug Saf 2:177-85. 2007..A comprehensive approach will be needed to address the improvement of drug safety. We propose improvements to the evidence base to increase drug safety and assess how new scientific evidence can be incorporated into drug safety efforts... - The patient safety movement will help, not harm, qualityRobert M Wachter
Ann Intern Med 141:326-7. 2004 - Could computerization harm patient safety?Robert M Wachter
MedGenMed 8:84. 2006 - The hospitalist movement 10 years later: life as a Swiss army knifeRobert M Wachter
MedGenMed 8:30. 2006 - The "continuity visit" and the hospitalist model of careRobert M Wachter
Dis Mon 48:267-72. 2002..quot; Moreover, we encourage research on the value of continuity visits and recommend compensation if research establishes that these visits improve the efficiency and quality of inpatient care or patient satisfaction and comfort... - Is ambulatory patient safety just like hospital safety, only without the "stat"?Robert M Wachter
Ann Intern Med 145:547-9. 2006 - Primary care physician attitudes regarding communication with hospitalistsSteven Z Pantilat
Dis Mon 48:218-29. 2002..It may be possible to tailor communication to individual PCPs. Further research could assess the impact of such communication on patient satisfaction and outcomes...