Monday, June 8, 2009

Daschle and Gingrich discuss healthcare

Former Senate Majority Leader Tom Daschle and former House Speaker Newt Gingrich discussed healthcare reform during a panel discussion at the National Press Club sponsored by Volunteers of America. A video from an interview with the two men is below. It is nice to see both sides willing to have a reasonable discussion.

If President Barack Obama wants healthcare reform this year, he’s going to have to be flexible and accept “half a loaf” on certain issues Newt Gingrich, founder of the for-profit consultancy Center for Health Transformation, said. Congress and the administration “will get nothing” if they approach reform with an all-or-nothing attitude, he added. Gingrich acknowledged that the reform effort could get “locked up” by various demands, and possible push back from hospitals and doctors. Any healthcare-reform effort should emphasize wellness and best practices to eliminate waste from the system, Gingrich said, adding that he was in favor of 100% coverage—but not a single-payer system.

Tom Daschle, who had been nominated for HHS secretary, was not as optimistic about the chances of getting a bill through Congress. Cost, quality and access issues remain, “and so little attention has been given to long-term care” in this debate, said Daschle, who gave legislation a 50-50 chance of getting approved. He stressed the need for a priority for Health IT and stated that we need to "change the paradigm from illness to wellness" by addressing chronic care management.

Neither man thought Medicare was doomed, however, even though the trust fund is predicted to dry up in 2017. Congress will find a way to fix the problem, Gingrich said. “I don’t think it will run out of money.”

Thursday, June 4, 2009

Hospitals cutting off social media access

A disturbing trend in healthcare facilities is blocking social media sites for staff. I would be very interested in knowing how you are all dealing with this and what methods work best for allwoing access, yet controlling it so that it is appropriate and effective.
Some helpful resources are:





Wednesday, June 3, 2009

Faith and Healthcare

Many people claim that spirituality within the context of healthcare is mumbo jumbo and does not deserve to be part of the conversation. I think it is arrogant to assume that we have enough knowledge to discount the obvious benefits of including faith and spirituality in the healthcare dialogue. Reading through American Family Physician a peer reviewed journal of the American Academy of Family Physicians, along with other journals and research results, can give some insight into this thorny issue.

Attending to the spiritual dimension of the patient provides the physician with a deeper understanding of the patient and his or her needs. The provider might use a variety of spiritually informed therapeutic tools that could greatly facilitate the patient's coping ability, thus enhancing well being. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process.

Barbara Apgar, M.D., M.S. in an article in American Family Physician discusses research on the significance of intercessory prayer for the sick, referencing the study by Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. The authors conclude that supplementary, remote, blinded, intercessory prayer produced a measurable improvement in the medical outcomes of critically ill patients in the CCU. Clinical trials on the Effects of Meditation on Mechanism of Coronary Heart Disease seem to bear out the same conclusion. Prayer and meditation are very effective tools in the fight against disease and valuable to promote healing and wellness.

Walter L. Larimore, M.D., reports that 99% of surveyed family physicians believe that religious beliefs can heal, 75% believe other people’s prayers (i.e., intercessory prayer) can promote healing. Based on his own clinical practice and dialogue with other family physicians Larimore suggests that “infrequent religious attendance or “poverty of personal faith” should be regarded as a risk factor that is nearly equivalent to tobacco and alcohol abuse.

The impact of spiritual practices and disciplines such as prayer are obvious.  While issues of faith and beliefs and how to implement those in medical care, such as through prayer, are controversial they should not be ignored. In light of some of the research on spirituality in healthcare we can not dismiss prayer as a possible viable intervention. And since the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), requires the administration of a spiritual assessment then it will be good to include standard templates for these assessments in an Electronic Health Record to be used for quality reporting. A good template for spiritual assessment and review of the JCAHO requirements and guidelines for implementation by Hodge can help social workers being called on to conduct spiritual assessments.

I am firm believer in technology enabled healthcare - but I also am absolutely certain that we should not try to push God out of the healthcare arena.

Tuesday, June 2, 2009

Courage to be first


Since the early 90s, numerous newspapers, magazines and radio and TV broadcasts have told the story of Mid-Columbia Medical Center’s efforts to change for the better the way patients experience hospitals.

MCMC appeared in a Bill Moyer’s PBS series called “Healing and the Mind” and was even featured in a book highlighting American companies noted for their outstanding customer service.

But now the hospital that many say has written the book on how to create a true patient-centered healing environment has had an entire book written about it. Courage to be First:  The Journey of Mid-Columbia Medical Center Becoming the First Planetree Hospital in America was released in March by Second River Healthcare Press.

The book tells the story of MCMC’s dramatic transformation over the last two decades, beginning with the hospital’s implementation of the Planetree model of care in the early 90s.  MCMC’s story was written by Dick Baltus, as told by former CEO Mark Scott, current CEO Duane Francis and many hospital employees, with Leland Kaiser, Ph.D., offering commentary after each chapter.

Baltus is a consultant and writer, who served as the MCMC’s part-time public relations director during the Planetree implementation and continues to work with the hospital today.  Kaiser is a renowned healthcare futurist, motivational speaker and authority on America’s healthcare system.  He was introduced to Scott after hearing about MCMC’s transformative work. 

Kaiser visited the hospital several times and, when Scott retired from MCMC in 2002, Kaiser proposed they collaborate on a book about the process of changing so profoundly their manner in which hospitals treated their patients.

Courage to be First is targeted at readers in the healthcare management industry, as well as any business committed to improving customer service.  Like the hospital itself, the book has received enthusiastic reviews. 

B. Joseph Pine, co-author of The Experience Economy (named one of The Best 100 Business Books of All Time) wrote:  “There is not a hospital in the world – or any company in the healthcare field, for that matter – that could not benefit from this enlightening book.  Read how Mid-Columbia Medical Center has transformed itself into a shining light so you, too, can inspire your employees, enhance your patient experience and improve your outcomes.”

And from John Nance, the author of Why Hospitals Should Fly:  “The very concept of a true patient-centered hospital – the vision of patients actually being partners in their own care – should have never been a radical idea.  But somehow along the evolution of healthcare, it became just that.  ‘Courage to be First’ is the story of how a visionary hospital CEO made it live again in the form of a Planetree Hospital.  What the concepts of St. Michael’s (Hospital) do for patient safety and quality, ‘Courage to be First’ does for the long-dormant soul of American Healthcare.”

President/CEO Francis says the book will serve as a lasting tribute to Scott, the hospital board and management team, and all the physicians, nurses and employees who over the years have remained committed to a vision that began as a bold experiment and has turned into a way of life at MCMC.

“It took a lot of vision, and frankly a lot of guts, to attempt something that was considered so revolutionary at the time,” Francis says.  “This was an industry that was not very comfortable with change in the early 90s, and to attempt to change the status quo, at least in this small corner of the world, really required a leap of faith.

“I think it’s very appropriate that the story of how that happened successfully at MCMC be chronicled. Courage to be First will serve as a lasting tribute to all the people who ensured this hospital became a true place of healing that was worth writing, and reading, about.”Courage to be First is available for purchase on-line at www.couragetobefirst.com.