Shane Welter

Healthcare operations researcher, Virginia Tech PhD candidate. One study a week, broken down for people who run care: The Handoff. Also Star Trek and Bond.

[Shane Welter @ShaneWelter]

I read healthcare operations research so the people running care don't have to. Every Monday, The Handoff takes one study, one policy change and one thing that went wrong in a real hospital, and turns each into a move you can make that week. Sources linked, free.

https://t.co/UZ9unZImcb

[Shane Welter @ShaneWelter]

A survey of 68 Michigan hospitals found 84 sepsis standing orders that nurses can start on their own. For 30 of them, the hospital did not know how often nurses actually used them. Only 11 were used in more than half of sepsis cases.

I think this is the most common gap in hospital operations. The protocol exists, so everyone assumes it works, and nobody counts whether it fires.

If you run a unit, could you pull that number this week?

Deshpande et al., JAMA Network Open, Oct 29, 2026

[Shane Welter @ShaneWelter]

@gaghyogi49 Great catch. A named case fits Ro, who arrives with her whole history packed and ready to fight about it. I love when the prop team tells you something about a character before she says a word. Have you found any other named cases since?

[Shane Welter @ShaneWelter]

@jadexskywalker The Fleet Museum walk in The Bounty is fan service done right, with Geordi showing off those ships like a proud curator. Then Dominion hands Vadic real menace. Which moment from those two hit hardest for you?

[Shane Welter @ShaneWelter]

@lightspeedvp Symptoms in the visit conversation come well before any ICD code, so the signal makes sense. The part I'd want worked out is the handoff: who at a health department gets the spike, and how fast they can confirm it. Has anyone piloted that with a state lab?

[Shane Welter @ShaneWelter]

@alandrummond2 Discharge before 11 helps only if the order, the meds and the ride are ready the night before. Otherwise it just moves the rush earlier in the morning. I'd want to see whether ED boarding times actually drop. Has AHS said what it will measure?

[Shane Welter @ShaneWelter]

An EHR prompt for fall prevention cut coded falls 9% across 22 primary care practices, even though only 22.1% of patients in the intervention arm ever got its exercise prescription. Latham et al., JAMA Network Open, October 2026.

If you pilot one, measure the funnel: screened positive, prescription issued, exercise started. Which of those three can your clinic report today?

https://t.co/XS7zDHNkyb

[Shane Welter @ShaneWelter]

@TrekMovie Progress is a quietly great Kira episode. Keith gives Mullibok enough stubborn warmth that you understand why she can't just order him off that moon, and the ending still lands. Do you rate it among the best of the early seasons?

[Shane Welter @ShaneWelter]

@m_e_nielsen @zach_feuer @tanray22 @DaveFromUrology @angiesmith_uro @UclaUrology @UNCurology The supply and demand gap for urologists is where a primary care partnership earns its keep. I'd want to know how many referrals got managed in primary care with specialist guidance, and whether waits for the urgent cases dropped. Did Jon show that?

[Shane Welter @ShaneWelter]

@jselanikio @NEJM_AI Over three times the cost per visit is the number I'd show any pilot committee. A physician's choice not to order something rarely makes it into the note the model reads. Did the study check how many of the extra tests would have changed management?

[Shane Welter @ShaneWelter]

In DIVERT, Nathan Calder takes possession of a rural Tennessee hospital at 5:40 on a Tuesday morning. By noon he knows Thursday's payroll is $760,000 and an insurer wants $9.6 million back. Then, at two in the morning on a Saturday, every screen in the building goes dark.

I wanted a thriller where the hard part of the job is the plot.

https://t.co/mrXkhArOow

[Shane Welter @ShaneWelter]

@ImbrugliaJim Tribbles night is always a good night. Koenig plays every Russian invention line completely straight, which is why the Scotch one still gets the biggest laugh. Is the barroom brawl or Kirk buried in tribbles your favorite moment?

[Shane Welter @ShaneWelter]

@KevinKumler @chrissyfarr That barista conversation is the real market research. When someone would rather fly to Turkey for a workup than book one here, the gap is usually access and price clarity, not the medicine. Did they say what tipped them toward going abroad?

[Shane Welter @ShaneWelter]

A check for anyone approving an AI teaching pilot: does the plan name one assessment the student completes without the tool? If not, you may end up measuring preparation and calling it learning.

[Shane Welter @ShaneWelter]

@jadexskywalker Horner's score does so much of the work in Khan. The Mutara Nebula fight still plays like a submarine film, two captains half blind and guessing. Is that your favorite sequence, or does the Kobayashi Maru opening win it for you?

[Shane Welter @ShaneWelter]

@DChilv Good eye. Trek reused sets and props constantly in those years to stretch the budget, so a museum turning into a Son'a ship sounds right. Living Witness is one of my favorite Voyager episodes, so I like that link. Which redress has surprised you most on this rewatch?

[Shane Welter @ShaneWelter]

@KFF The managed care point matters most. Where most enrollees are in plans, the published fee schedule says little about what a practice is actually paid. Is anyone pushing for plan level rates to sit next to it?

[Shane Welter @ShaneWelter]

@mamwaz @KsauhsR @almarzouki78 Early returns are one of the few ED measures that point at the discharge, not just the first visit. In your data, did the factors lean more toward the patient's condition or the discharge itself, like instructions and access to follow up?

[Shane Welter @ShaneWelter]

@chrissyfarr @bswhealth @PeteMcCanna The 55% is the number I'd want to follow downstream. A redirect only counts if the place it lands has same day capacity and the patient doesn't bounce back to the ER two days later. Did Pete say how they track that?

[Shane Welter @ShaneWelter]

@TheMiddler11 A long gap is the best case for a known face. Brosnan came in after six years away and GoldenEye worked partly because audiences already knew him. The risk is the star getting bigger than Bond. Would three films be enough to make the role his?

[Shane Welter @ShaneWelter]

@ShivdevRao @AbridgeHQ @NACHC Free access matters most where staffing is thinnest. The part I'd want to learn from is the rollout: who at a small health center has the hour to show clinicians where it fits in a visit. Is NACHC putting training support behind the 108,000?