Differences in Ambulatory EHR Use Patterns for Male vs. Female Physicians

NEJM Catalyst | November 13, 2019

Kiran Gupta, MD, MPH, Sara G. Murray, MD, MAS, Urmimala Sarkar, MD, MPH, Michelle Mourad, MD & Julia Adler-Milstein, PhD

UCSF Health found that women providers spent more time in the EHR and documented longer notes on a per-wRVU basis, possibly contributing to greater burnout.

Decisions and repercussions of second victim experiences for mothers in medicine (SAVE DR MoM)

BMJ Quality and Safety | February 4, 2019

By Kiran Gupta, Sarah Lisker, Natalie A Rivadeneira, Christina Mangurian, Eleni Linos, and Urmimala Sarkar

The second victim effect is defined as emotional distress experienced by providers involved in mistakes. This study characterizes events contributing to the second victim effect among a diverse sample of physician-mothers, describes the impact on both provider and patient and seeks to determine the association between experiencing a mistake and burnout. The paper concludes that physician mothers involved in errors experience negative outcomes and may be at increased risk for burnout. Additional research should focus on strategies to mitigate burnout associated with the second victim effect, particularly among women physicians and those with family responsibilities.

Understanding Patient Safety, Third Edition

McGraw Hill | November 2017

By Robert Wachter and Kiran Gupta

Understanding Patient Safety, Third Edition is the essential book for anyone seeking to learn the core clinical, organizational, and systems issues of patient safety. Written in an engaging and accessible style by national experts on patient safety and quality, this full-color text is filled with valuable cases and analyses, as well as table, graphics, references, and tools.

Financial incentives and mortality: taking pay for performance a step too far

BMJ Quality and Safety | February 18, 2016

By Kiran Gupta, Robert Wachter, and Allen Kachalia

In the USA, hospitals are increasingly evaluated and paid, based on a burgeoning list of publicly reported quality and safety metrics. Performance measurement is undoubtedly essential for improving healthcare quality, but developing the ‘right’ metrics has remained a formidable challenge. As stakes for physicians and hospitals continue to rise, several of the measures used in performance programmes have come under greater scrutiny. One measure increasingly tied to financial incentives in the USA is hospital mortality. We believe its use, while well-intentioned and with some value, is too problematic to merit inclusion in pay-for-performance programmes.

Interhospital Transfers: The Need for Standards

Journal of Hospital Medicine | January 28, 2015

By Kiran Gupta and Stephanie K. Mueller

Today, the process of interhospital transfers varies tremendously across US hospitals, differences that may have significant implications for both cost and patient safety outcomes Standardization of interhospital transfers, including patient selection and information exchange between transferring and accepting providers/institutions, is imperative to improve the quality and safety of this process.