Why hospital performance cannot be understood without population, capacity, and context. Aurelian’s Casebook Casebook #3 The dashboard was green. Surgical backlog: 0%. No patients were waiting beyond the hospital’s defined backlog threshold. Then the hospital director received a question from regional leadership: Why is your operating room performing so few surgeries? It was a reasonable … Read more
Aurelian’s Casebook Casebook #2 A performance indicator can tell us something about a system. That does not make improving the indicator the purpose of the system. Healthcare organizations measure utilization for good reasons. Admissions, bed-days, occupancy, outpatient activity, and referrals help leaders understand demand, capacity, access, and how healthcare resources are being used. But an … Read more
Aurelian’s Surveillance Files Field Note #8 The case definition asks whether the patient belongs in the surveillance net. Clinical reasoning asks whether the disease actually explains the patient. Imagine a clinician working in a region where dengue is endemic. A patient arrives with fever, thrombocytopenia, and other compatible clinical findings. The surveillance criteria are reviewed. … Read more