Michael Calderwood
@calderwoodmd.bsky.social
Infectious Diseases Physician, Chief Quality Officer at Dartmouth Hitchcock Medical Center, Associate Professor at Dartmouth’s Geisel School of Medicine
Your intestinal microbiome predicts your risk of SSI following abdominal surgery. So, can probiotics prevent SSI? academic.oup.com/ofid/advance...
Preoperative Enterosignatures Predict Surgical Site Infections After Abdominal Surgery
AbstractBackground. The relationship between preoperative intestinal microbiota composition and the development of surgical site infections (SSIs) followin
academic.oup.com
September 7, 2025 at 3:23 AM
Your intestinal microbiome predicts your risk of SSI following abdominal surgery. So, can probiotics prevent SSI? academic.oup.com/ofid/advance...
Next time you think to yourself, I miss paper charting, tell me if you read: 1. Frequent vs. Pregnant, 2. Positive vs. Routine, 3. Heparin 1000 units vs. 10000, 4. Hypertension vs. Hypotension, 5. Negative vs. Hepatitis
May 2, 2025 at 2:55 PM
Next time you think to yourself, I miss paper charting, tell me if you read: 1. Frequent vs. Pregnant, 2. Positive vs. Routine, 3. Heparin 1000 units vs. 10000, 4. Hypertension vs. Hypotension, 5. Negative vs. Hepatitis
Bonding capital is what you do within a community to create more affinity between people. Bridging capital is when you reach across communities to groups that are not part of your own. We need both to create stronger organizations and stronger societies. www.ihi.org/insights/how...
How Better Use of Technology Can Free Up Time for Better Care
“We need to make technology work harder so that we can work smarter in health care.”
www.ihi.org
May 2, 2025 at 11:53 AM
Bonding capital is what you do within a community to create more affinity between people. Bridging capital is when you reach across communities to groups that are not part of your own. We need both to create stronger organizations and stronger societies. www.ihi.org/insights/how...
What about patient care will AI not replace:
1. Human connection at the bedside
2. Someone who truly cares and is worried about the outcome
AI will challenge us to define what it means to be a human being.
1. Human connection at the bedside
2. Someone who truly cares and is worried about the outcome
AI will challenge us to define what it means to be a human being.
May 2, 2025 at 11:49 AM
What about patient care will AI not replace:
1. Human connection at the bedside
2. Someone who truly cares and is worried about the outcome
AI will challenge us to define what it means to be a human being.
1. Human connection at the bedside
2. Someone who truly cares and is worried about the outcome
AI will challenge us to define what it means to be a human being.
Heard @theihi.bsky.social Leadership Alliance:
1. “Safety is a process of proactive risk mitigation”
2. “We need to understand work as it happens every day, not just when an event occurs”
3. “Let’s not buy new technology for a year and spend that money on optimizing technology that we have”
1. “Safety is a process of proactive risk mitigation”
2. “We need to understand work as it happens every day, not just when an event occurs”
3. “Let’s not buy new technology for a year and spend that money on optimizing technology that we have”
May 2, 2025 at 11:28 AM
Heard @theihi.bsky.social Leadership Alliance:
1. “Safety is a process of proactive risk mitigation”
2. “We need to understand work as it happens every day, not just when an event occurs”
3. “Let’s not buy new technology for a year and spend that money on optimizing technology that we have”
1. “Safety is a process of proactive risk mitigation”
2. “We need to understand work as it happens every day, not just when an event occurs”
3. “Let’s not buy new technology for a year and spend that money on optimizing technology that we have”
1/4 At the end of 2025, several tax provisions from the 2017 Tax Cuts and Jobs Act (TCJA) expire. Extending TCJA will add >$4 trillion to U.S. deficit over 10 years. TCJA disproportionately advantages those with more wealth. bipartisanpolicy.org/blog/the-new..., taxpolicycenter.org/taxvox/unpac...
May 2, 2025 at 4:41 AM
1/4 At the end of 2025, several tax provisions from the 2017 Tax Cuts and Jobs Act (TCJA) expire. Extending TCJA will add >$4 trillion to U.S. deficit over 10 years. TCJA disproportionately advantages those with more wealth. bipartisanpolicy.org/blog/the-new..., taxpolicycenter.org/taxvox/unpac...
We have an exciting opportunity to join @dartmouthhealth.bsky.social as the Chief of Infectious Diseases. Please message me if you have questions. This is a wonderful opportunity to lead an incredible team in a beautiful part of the country. dhcareers.org/job/section-...
Section Chief of Infectious Diseases and International Health - Healthcare Careers at Dartmouth Hitchcock Medical Center and Clinics
OverviewSection Chief of Infectious Diseases and International Health– Department of MedicineDartmouth-Hitchcock Medical CenterLebanon, NHDartmouth-Hitchcock Medical Center (DHMC), located in the Uppe...
dhcareers.org
April 29, 2025 at 2:25 PM
We have an exciting opportunity to join @dartmouthhealth.bsky.social as the Chief of Infectious Diseases. Please message me if you have questions. This is a wonderful opportunity to lead an incredible team in a beautiful part of the country. dhcareers.org/job/section-...
“Leaders move along a continuum from inspiring to infuriating, and where they land at any given time depends on how well they play 3 key roles. … Visionaries give us meaning & purpose; exemplars provide us with passion & protection; and mentors bring us belonging & status.” hbr.org/2025/03/what...
What Sets Inspirational Leaders Apart
When people around the world are asked to reflect on both inspiring leaders and infuriating leaders, they point to three factors that distinguish the former from the latter. Inspiring leaders are visi...
hbr.org
March 29, 2025 at 7:09 PM
“Leaders move along a continuum from inspiring to infuriating, and where they land at any given time depends on how well they play 3 key roles. … Visionaries give us meaning & purpose; exemplars provide us with passion & protection; and mentors bring us belonging & status.” hbr.org/2025/03/what...
When trying to diagnose Jamestown Canyon virus disease, it is worth noting the high seroprevalence (prior exposure) in endemic states such as Massachusetts, Minnesota, and Wisconsin. I suspect that this is also true in Northern New England. academic.oup.com/cid/advance-...
Jamestown Canyon Virus Seroprevalence in Endemic Regions and Implications for Diagnostic Testing
Estimated population seroprevalence for Jamestown Canyon virus infection is high in endemic areas. Interpreting diagnostic testing is challenging and requi
academic.oup.com
March 29, 2025 at 7:01 PM
When trying to diagnose Jamestown Canyon virus disease, it is worth noting the high seroprevalence (prior exposure) in endemic states such as Massachusetts, Minnesota, and Wisconsin. I suspect that this is also true in Northern New England. academic.oup.com/cid/advance-...
Routine use of rifampin in not recommended for staphylococcal native valve endocarditis. But what if patient undergoes valvular surgical intervention? The answer is still no. Not only does rifampin combination therapy not help, it may cause harm. academic.oup.com/ofid/advance...
Post-Operative Treatment Regimens in Patients with Native Valve Endocarditis due to Staphylococcus aureus who Undergo Valve Replacement or Repair
S. aureus NVE patients may have better outcomes (adverse events and drug-drug interactions, six-month infective endocarditis relapse and one-year mortality
academic.oup.com
March 29, 2025 at 6:56 PM
Routine use of rifampin in not recommended for staphylococcal native valve endocarditis. But what if patient undergoes valvular surgical intervention? The answer is still no. Not only does rifampin combination therapy not help, it may cause harm. academic.oup.com/ofid/advance...
Sharing two quotes from Edgar Schein’s “Humble Inquiry” that I finished this weekend; they seem even more relevant in our current era.
March 10, 2025 at 4:05 PM
Sharing two quotes from Edgar Schein’s “Humble Inquiry” that I finished this weekend; they seem even more relevant in our current era.
1/4 Vit A supplementation for treating measles: This is based on studies showing an association between prevalence of Vit A deficiency and measles mortality; however, evidence in support of Vit A supplementation has not reached statistical significance. pmc.ncbi.nlm.nih.gov/articles/PMC...
Population-Level Risk Factors Related to Measles Case Fatality: A Conceptual Framework Based on Expert Consultation and Literature Review
A better understanding of population-level factors related to measles case fatality is needed to estimate measles mortality burden and impact of interventions such as vaccination. This study aimed to ...
pmc.ncbi.nlm.nih.gov
March 7, 2025 at 3:02 PM
1/4 Vit A supplementation for treating measles: This is based on studies showing an association between prevalence of Vit A deficiency and measles mortality; however, evidence in support of Vit A supplementation has not reached statistical significance. pmc.ncbi.nlm.nih.gov/articles/PMC...
I am getting a lot of questions about measles. Here are some thoughts on measles vaccination, as a number of people are asking about boosters.
March 6, 2025 at 3:26 AM
I am getting a lot of questions about measles. Here are some thoughts on measles vaccination, as a number of people are asking about boosters.
Fascinating paper showing missed diagnoses identified on autopsy. Speaks to the need for better pleuropulmonary and CNS diagnostic testing. A fair bit of TB was missed, but this may not reflect US experience (paper from Iran). Regardless, message holds. academic.oup.com/ofid/advance...
Infectious Causes of Death: An Autopsy-Based Study of 546 cases
Among infectious disease-related deaths, autopsies revealed a 22.4% diagnostic discrepancy rate. Pleuropulmonary infections were the leading cause of death
academic.oup.com
February 8, 2025 at 3:18 PM
Fascinating paper showing missed diagnoses identified on autopsy. Speaks to the need for better pleuropulmonary and CNS diagnostic testing. A fair bit of TB was missed, but this may not reflect US experience (paper from Iran). Regardless, message holds. academic.oup.com/ofid/advance...
Nice discussion about “a more efficient and effective quality measurement enterprise that contributes to clinician well-being while enhancing the quality impact of performance measurement.” qualitysafety.bmj.com/content/earl...
The beast and the burden: will pruning performance measurement improve quality?
Programmes dedicated to driving improvement in healthcare quality have grown dramatically in the last two decades. Accreditation programmes along with performance measurement and reporting have been c...
qualitysafety.bmj.com
February 8, 2025 at 3:09 PM
Nice discussion about “a more efficient and effective quality measurement enterprise that contributes to clinician well-being while enhancing the quality impact of performance measurement.” qualitysafety.bmj.com/content/earl...
Thoughtful discussion on a path forward focussed on the following 4 tenets to “transform diversity backlash”: Fairness, Access, Inclusion, Representation. hbr.org/2025/01/what...
What Comes After DEI
While backlash to DEI has challenged how many companies and practitioners approach creating more equitable workplaces, fewer have considered whether DEI work itself has room to improve. A new framewor...
hbr.org
February 8, 2025 at 3:00 PM
Thoughtful discussion on a path forward focussed on the following 4 tenets to “transform diversity backlash”: Fairness, Access, Inclusion, Representation. hbr.org/2025/01/what...
Across ~750k inpatients in 928 U.S. hospitals, starting with empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics based on cultures was NOT associated with worse outcomes compared with empirically starting broad (done close to 90% of the time). academic.oup.com/cid/advance-...
Association between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right with Empiric Antibiotics Matter?
Empiric antibiotics are frequently unnecessarily broad-spectrum. This study compared clinical outcomes between matched patients who received early vs. dela
academic.oup.com
February 8, 2025 at 2:46 PM
Across ~750k inpatients in 928 U.S. hospitals, starting with empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics based on cultures was NOT associated with worse outcomes compared with empirically starting broad (done close to 90% of the time). academic.oup.com/cid/advance-...
Thoughtful challenge to 30 yrs of clinical practice. FQ ppx to prevent SBP in pts w/ cirrhosis based on low quality evidence and a/w ⬆️ resistant bacteria, longer hospitalizations, C diff, ⬆️ gut translocation due to microbiome disruption, and ⬆️ rates of recurrent SBP. academic.oup.com/cid/advance-...
Rethinking Antibiotic Prophylaxis for Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: First, Do No Harm
Abstract. Antibiotic prophylaxis for spontaneous bacterial peritonitis (SBPPr) in patients with cirrhosis has been considered standard of care since the 19
academic.oup.com
February 8, 2025 at 2:38 PM
Thoughtful challenge to 30 yrs of clinical practice. FQ ppx to prevent SBP in pts w/ cirrhosis based on low quality evidence and a/w ⬆️ resistant bacteria, longer hospitalizations, C diff, ⬆️ gut translocation due to microbiome disruption, and ⬆️ rates of recurrent SBP. academic.oup.com/cid/advance-...
Thoughts for a Wednesday.
February 5, 2025 at 11:15 PM
Thoughts for a Wednesday.
“QI is a humanistic response to solving problems. It is personal in both [how we] engage humans in change and the outcomes that matter to us enough to make these efforts.” “Leaders must be strong but humble, curious yet compassionate, inspiring and predictable.” qualitysafety.bmj.com/content/earl...
Art of leading quality improvement
In their article in this issue of BMJ Quality and Safety , ‘ We listened and depended on and supported each other’ , Ginsburg et al examine how leaders shaped the site-level experience in a quality im...
qualitysafety.bmj.com
January 18, 2025 at 5:20 PM
“QI is a humanistic response to solving problems. It is personal in both [how we] engage humans in change and the outcomes that matter to us enough to make these efforts.” “Leaders must be strong but humble, curious yet compassionate, inspiring and predictable.” qualitysafety.bmj.com/content/earl...
Urgent care centers have been reported to have higher rates of inappropriate antibiotic prescribing. Study demonstrated that active participation in 3 PDSA cycles successfully reduced inappropriate antibiotic prescribing, although some racial disparities persisted. www.cambridge.org/core/journal...
www.cambridge.org
January 18, 2025 at 5:12 PM
Urgent care centers have been reported to have higher rates of inappropriate antibiotic prescribing. Study demonstrated that active participation in 3 PDSA cycles successfully reduced inappropriate antibiotic prescribing, although some racial disparities persisted. www.cambridge.org/core/journal...
“When done right, team rituals provide certainty, connection, & space for employees to engage with each other & connect to the purpose of their work. In this way, rituals become a stabilizing force that helps unite & shepherd employees through whatever storms come their way.” hbr.org/2025/01/the-...
The Surprising Power of Team Rituals
Rituals — collective activities that team members regularly engage in and attribute meaning to — can make a big difference during times of change or transition. Research, which included a survey of 92...
hbr.org
January 18, 2025 at 4:59 PM
“When done right, team rituals provide certainty, connection, & space for employees to engage with each other & connect to the purpose of their work. In this way, rituals become a stabilizing force that helps unite & shepherd employees through whatever storms come their way.” hbr.org/2025/01/the-...
“Leaders of the 20th century were question answerers, setting the vision and strategy from above. … Leaders in the 21st century are question askers. They seek feedback and new perspectives, and they ask curious questions about themselves, their teams, and their environment.” hbr.org/2024/10/6-es...
6 Essential Leadership Skills — and How to Develop Them
The way we work has changed — and so has leadership. Leaders are under new pressures to perform at higher levels and adapt quickly to changing demands. In this article, the author shares advice from t...
hbr.org
January 18, 2025 at 4:56 PM
“Leaders of the 20th century were question answerers, setting the vision and strategy from above. … Leaders in the 21st century are question askers. They seek feedback and new perspectives, and they ask curious questions about themselves, their teams, and their environment.” hbr.org/2024/10/6-es...
A negative urinalysis (- LE, - nitrite, <10 WBCs/hpf) has a negative predictive value of 98% in urine collected from neutropenic patients. These patients don’t need to be excluded from lab reflex protocols. academic.oup.com/cid/advance-...
Improving UTI Diagnostics in Oncology: Reliability of Reflex Urine Culture in Immunosuppressed Neutropenic and Non-neutropenic Cancer Patients
This retrospective study assessed performance dynamics of urine screen methods to detect clinically significant bacteriuria in cancer patients. A dipstick
academic.oup.com
January 18, 2025 at 4:45 PM
A negative urinalysis (- LE, - nitrite, <10 WBCs/hpf) has a negative predictive value of 98% in urine collected from neutropenic patients. These patients don’t need to be excluded from lab reflex protocols. academic.oup.com/cid/advance-...
Interesting study showing that antibodies in saliva are a better correlate of protection than antibodies in serum when it comes to protection against symptomatic #COVID19. Highlights the importance of robust induction of mucosal immune responses. academic.oup.com/ofid/advance...
Correlates of protection against symptomatic COVID-19: the CORSER 5 case-control study
AbstractBackground. Establishing correlates of protection often requires large cohorts. A rapid and adaptable case-control study design can be used to iden
academic.oup.com
January 18, 2025 at 4:33 PM
Interesting study showing that antibodies in saliva are a better correlate of protection than antibodies in serum when it comes to protection against symptomatic #COVID19. Highlights the importance of robust induction of mucosal immune responses. academic.oup.com/ofid/advance...