Am I smarter than a fifth grader?
by Kathleen Rose
I didn't expect any red marks!
Nope. But hey, since I don't do the game show circuit for a living, the ability to respond to questions about obscure or not so obscure facts is not a top priority. But having the skills to ensure patient safety (especially when I am the patient or recipient of services) by preventing medical errors (more especially when you are the healthcare professional or provider of services), now that's a priority I can wrap my brain around. Health literacy, especially as it relates to patient safety, is a pretty hot topic. And whose literacy is always in question? Why, it's the patient's, of course. How refreshing to follow a tweet and find that in the UK, folks at the National Health Service (NHS) North West Strategic Health Authority think it's important to assess literacy/numeracy skills of aspiring healthcare professionals.
This very brief article Online assessment in numeracy set to improve patient safety in Nursing Times cites the results of a survey in which 87% of users thought the NHS assessment would improve patient safety. The article further pointed out that...
...despite the fact that the ability to make accurate calculations is an essential skill for all healthcare professionals to ensure patient safety, it is possible to attain a senior clinical role without ever taking a numeracy assessment.
So, even though I can't actually harm anyone (by accident) where I work, I thought I'd assess my own skills. Here are a few things I learned:
- I don't speak English; I speak American, and "realisation" is not misspelled
- My literacy skills are Level 2, and if the senate and congress continue to beg to differ on reforming healthcare, I can use other NHS resources to see how my skills match healthcare jobs in England, Scotland and other crown holdings
- It's probably a good thing that my computer froze during the numeracy test, as I have no idea if a penny is the same as a pence; I was only guessing that there might be 100 pence in a pound (the 'L' symbol with squiggly line through it)
- I might want to get my hearing checked, since my incorrect answers on the literacy portion involved listening/attending to an audio clip
But seriously, even though screening for literacy/numeracy skills seems like a good thing to do and people think it would improve patient safety, I know more than a few sticklers who'll want to see some evidence.
It was a little tricky finding the tool, so click on this handy dandy link if you'd like to try it out. C'mon what's one more assessment.
Patient involvement – Another public service announcement
by Kathleen Rose
Apparently this video has been out for some time, but someone asked me today if I'd seen the AHRQ commercial about asking your doctor questions. The video really needs no explanation; it's a great message. Share it with every patient you know!
Perfecting patient care
by Kathleen Rose
Since my last post referred to people who make healthcare better, a post on "Perfecting Patient Care" seemed appropriate. I recently made a short field trip across the great state of PA to Pittsburgh, where I learned you cannot hail a cab easily, but you can find the dedicated staff at the Jewish Healthcare Foundation (JHF) and Pittsburgh Regional Health Initiative (PRHI) doing their best to address patient safety and quality improvement, often in one patient care setting at a time.
In her dual role as president of JHS and co-founder of PRHI, our highly energetic colleague Karen Wolk Feinstein and a fine cast of PRHI staff eagerly introduced us to "Perfecting Patient Care (PPC)," which is based on the "lean" concept, using Toyota-based methods. PPC is an interdisciplinary fellowship program targeted at graduate students that runs for eight weeks during the summer. Twenty to 25 students from several local universities learn a different tool or philosophy each week. Paired with a local mentor, they meet weekly at a different healthcare institution and set to work on a problem, identified by the institution. By employing learned observation methods, students are able to identify issues and design an action/improvement plan. It's an overall win-win situation, the fellows learn a valuable team-based problem-solving methodology, and the institution is provided with valuable information and insight into their issue without having to sacrifice staff time.
Can't participate in the fellowship program? There's always PPC University, a 4-day program to train champions and healthcare professionals in practice. Open PPC runs five times a year in Pittsburgh; participants arrive with a goal in mind, e.g., reducing patient falls, eliminating infections, etc., and leave with the design and implementation tools needed to identify the issues, address the problems and attain their goals. Customized PPC focuses the 4-day program on the needs of an individual institution or care setting and is delivered on-site.
"PRHI offers healthcare leaders the necessary tools, expertise, education, models and networks to perfect patient care and safety in their organizations. Using the Toyota Production System as a model, PRHI developed a quality improvement method for clinical settings known as Perfecting Patient Caresm."
There's also something brewing called Tomorrow's Healthcare, but if I tell you about it, I'd have to kill you. Before taking my leave, I was eager to sign up for University, as I'm sure there is something I can work on fixing around here!
To learn more about PPC and other projects and PRHI programs, check out their website or stop in and say hey to Karen, Laura, Linda, Steve, Keith, Barb, Gerry, Colleen, Brian, et al...
20 people who make healthcare better
by Kathleen Rose
I followed a link in a tweet today to an article in Health Leaders Media that put the spotlight on 20 people who make healthcare better. I'm not sure if the profiles are in any particular order, but I was pleased to note that three of the first four on the list were familiar names--Atul Gawande, Dave deBronkart, and Daniel Sands, MD. Full of confidence in my ability to identify and pursue the right "people in motion," I scanned the remaining names on the list and did not recognize any of them. The good news is that there are 17 more interesting people I plan to learn about.
I first heard about Atul Gawande via a guest post on this blog entitled Moral Hazards 'r Us where the author references Gawande's New Yorker article The Cost Conundrum, "...a brilliant piece because it shines a light in so many directions." Give it a read, if you haven't already.
After stalking @epatientdave via Twitter and his blog, I finally had the pleasure of hearing him speak at a conference in Toronto--Medicine 2.0; I wrote about it in a previous post. The Health Leaders article describes Dave as "...the quintessential engaged patient consumer the likes of whom—depending on your viewpoint—is either an anomaly or an inevitability." After meeting Dave recently at a the ePatient Connections Conference here in Philly, I continue to stalk him to keep up with his efforts to enable others to partner with their healthcare providers. Get to know him, he's quite a guy!
As a biproduct of my stalking Dave, I learned about Danny Sands, engaging physician and one of the key reasons Dave is able to actively partner in his own medical care and promote participatory medicine. Danny is assistant clinical professor of medicine at Harvard Medical School and senior medical informatics director for Cisco Systems. Check out the Health Leaders Media article to learn more about Danny and the others.
Doctor knows best?
by Kathleen Rose
Does the doctor always know best?
Have I mentioned lately how grateful I am to have had my tweepiphany? Now that I have access to the collective wisdom of an entire community advocating patient-centered healthcare, I find myself with a steady stream of valuable tidbits that I can address in blog posts or use to poke at med ed colleagues. Such was the source of this article Power to the Patients by the authors of Innovator's Prescription, Clayton Christensen and Jason Hwang.
"...if more patients realized how much influence they could have in their own care, they would discard their roles as passive health care consumers, and would instead become its agents of change."
If you like the article, you ought to try the book...can't borrow ours though, I'm not finished yet.
Home safety taught in virtual world
by Kathleen Rose
Check it out! That's me again, in Second Life exploring a site designed to train healthcare professionals in conducting home safety assessments. I recently toured this Geriatrics Virtual World with Drs. Jorge Ruiz and Allen Andrade of the University of Miami Miller School of Medicine. The "homes" pictured here are full of hazards for seniors (e.g., bug infestations; stove burner left on; tripping hazards; etc.). When a trainee tours the home, they are able to address the hazards (i.e., turn off the burner; move obstructions; etc.), and their actions can be recorded and fed back for training or assessment purposes. The home safety assessment is one of several research interests of the GVW group--others include interdisciplinary team training; communication skills; patient self-management; and disaster management. To that end, some of their other SL experiments include "text to speech" where avatars play out a scenario of physical activity counseling for a diabetic patient and provide meditation advice. The video below shows an overview of some of their research around avatar animation--have a look!
These projects appear to be a collaborative effort, so please visit Geriatrics Virtual World for further information. Here you'll find additional videos highlighting their work and a teleport link to the Geriatrics Virtual World in Second Life.
Healthcare reform in primary colors
by Kathleen Rose
I loved this slide show for it's simplistic message about what's going on in Washington around healthcare insurance reform. I appreciated the plain language around the options being debated and how they affect the various stakeholders (namely me, the providers, and the payors).
NEJM Healthcare Reform 2009
by Kathleen Rose
Today I followed a lead from a tweet; a link to New England Journal of Medicine Healthcare Reform 2009 and a perspective piece entitled Doctors as the Key to Healthcare Reform by Arnold S. Redman, MD. It's a quick read and the message seems a no brainer.
"Successful examples of multispecialty group practices already exist in our current health care system: the Mayo Clinic, the Cleveland Clinic, the Permanente Medical Group, the Geisinger Health System, the Marshfield Clinic, the Scott and White Clinic, the Billings Clinic, Denver Health, and many others."
Didn't even know NEJM had a separate collection covering a range of topics related to healthcare reform. Check it out.
A public service announcement
by Kathleen Rose
Dr. John Clarke raps about swine flu (H1N1)
Medicine 2.0 – A truly engaging conference
by Kathleen Rose
When I scout “medical conferences,” I attend sessions, scribble notes, and retreat to my room in complete control of the television remote (a feat almost never achieved at home). The “take home” is usually an update on the latest techno-medical snippets for colleagues interested in the future of medical education and assessment.
Medicine 2.0 was a unique experience for me. Was it something about the size of the conference? The sense of community among participants and speakers? The constant buzz generated from the concurrent sessions? I’m not quite sure when it happened, but I became a participant rather than a spectator, and for the first time enjoyed a relationship with fellow conference attendees, even if it was via Twitter. I experienced first hand the impact of social media (see my previous post). I did stop short of fraternizing on the dinner cruise—not quite ready to relinquish the remote control.
During his opening statements, conference chair Gunther Eysenbach clarified the 1.0/2.0 thing.
- Medicine 1.0 – what a mess it is today
- Medicine 2.0 – what it could and should be
The keynote Gimme My Damn Data, given by cancer survivor and participatory medicine champion, Dave DeBronkart (aka e-Patient Dave), was thought provoking and quite moving at times. Take home points for me included
- Keep an eye on the movement toward decentralized medical care – how technology changes industry; the general hospital model is not sustainable
- It’s a human right to have your health data – your life may depend on it
- Peer controlled study data is not useful (woefully out of date) for the newly diagnosed
- Physicians and patients as partners, makes for optimal medical care
The first panel discussion (Jen McCabe, Saad Alaam, Chia Hwu, Robert Fraser) responded to the challenges of
- How to build confidence in social media
- How to affect institutions with power
- Vulnerability of putting yourself out there in online health care situations
Jen was as spunky as I expected, and during a later session had the audience shouting out micro choices we regretted and tweeting #getupandmove.
Reviewing the proceedings from the 2008 conference, it was obvious that there was a shift in the focus for 2009. The majority of the sessions last year seemed to focus on tools and technologies, with this year focusing on the trends and movements around the social and participatory nature of Medicine 2.0. I hope to follow up on connections with interesting “people in motion” and some of the resources I learned about that might facilitate medical education and/or the practice of medicine in the future.
I attended a number of interesting sessions and more detailed information about each session can be found on the Medicine 2.0 Official Blog.
- Learning in a Virtual World: Using Second Life for Medical Education
- What do residents really want? The Stanford Ether Project
- Social Healthcare Networks: Connecting Patients and Clinicians
- Enabling Semantic Health Apps: The MEDgle Clinical Decision Support Service API
- Apomediationand Women’s Choices of Birth Place and Attendants
- Improving Patient-Physician Communication about Internet Use
- Twitt-ER: Using Twitter in the ER for Dispatch, Order Communication, Patient Alerts, and Progress Reports
- Solas a Virtual Community for Children with Cancer
- Facebook: Awareness-raising, Fundraising and Support for People Affected by Breast Cancer
- ScanGrants: Reaching out to Researchers in the Health Sciences www.scangrants.com
- Bikmas 2.0: A Biomedical Knowledge Management Antenna System
- OrphanData.org: Enabling Transdisciplinary Scientific Collaboration Using Web 2.0
- Implementing Participatory Medicine Strategies and Exploring the Evolution of Choice/Control Aware Care
Scouting Themes
Research
- Content analysis of patient complaints
- Changing physicians' competence and performance: Finding the balance between the individual and the organization
- Individual Differences and the Development of Perceived Control
Bookmarks
- Pre-Grade Your Paper!
- Doctor Leads Quest for Safer Ways to Care for Patients - NYT Interview with Dr. Peter J. Pronovost
- Popular Science puts its archives online for free - awesome!
- amednews: National Practitioner Data Bank expanded beyond physicians to other healthcare professionals
- Bloggasm » New study shows some correlation between free ebooks and higher print sales