Action For Better Healthcare

Thursday, August 26th, 2010

By Ed Howe
Former President and CEO, Aurora Health Care

Aligning Forces for Quality is the Robert Wood Johnson Foundation's signature effort to lift the overall quality of healthcare in targeted communities. The goal is to reduce racial and ethnic disparities and to provide models for national reform.

Dr. John Lumpkin, M.D., M.P.H., the Senior Vice President and Director of the Health Care Group at the Robert Wood Johnson Foundation says improving healthcare quality really needs to start in each community. Collaboration is critical to the success of Aligning Forces for Quality. The program brings together patients, doctors, nurses and employers and teaches them to work together instead of competing against one another.

"This isn't just an issue of what happens in a single physician's office, or a nurse practitioner's office, or another care provider's office or in a hospital. What these collaborations have done is to bring all these interested parties together to have conversations that they haven't had before about how each of them can play a role," says Dr. Lumpkin.

Here are some of the initial results reported by the foundation:

1. In Cleveland, 26,000 diabetics are getting better diabetes care and are seeing their blood sugar under better control.
2. In Minnesota, at least 10,000 people with diabetes are getting better care.
3. In Detroit, thousands of individuals, are getting much better care in terms of screening for breast cancer, colorectal cancer, and asthma care.

A number of communities that are involved in the program are now displaying a public report that offers information about docotor's offices and hospitals.  This allows patients to see the quality of care being offered and allows physicians to see how they are performing compared to others.

Below, you can hear interviews with some of those involved with this program. Listen and then let us know what you think about the idea.

Categories: Community healthcare, Healthy communities, Not For Profit hospitals, Nursing issues, Primary Care, Quality, best practices, healthcare reform, hospitals, patient care, physicians, public health issues, robert wood johnson foundation
Comments: 0

Tuesday, August 24th, 2010

By Kester Freeman
Former CEO, Palmetto Health

There was a case several years ago that involves a mistake involving a feeding tube being coupled with a tube that entered a pregnant woman’s vein, instead of with the tube that entered her stomach. It is such a sad story that not only led to the woman’s death but also to the death of her unborn child. This story and others like it, highlight the urgent need for stricter federal oversight.

For years patient safety experts have been pushing for changes, but the medical device industry has been resisting change and others have been dragging their feet. In some cases, manufacturers have turned to color-coded tubing, but some say that has just made the situation more confusing.

In a recent story by The New York Times, healthcare leaders talk about their concern:

“Nurses should not have to work in an environment where it is even possible to make that kind of mistake,” said Nancy Pratt, a senior vice president at Sharp HealthCare in San Diego who is a vocal advocate for changing the system. “The nuclear power and airline industries would never tolerate a situation where a simple misconnection could lead to a death.”

“This is a deadly design failure in health care,” said Debora Simmons, a registered nurse at the University of Texas Health Science Center who studies medical errors. “Everybody has put out alerts about this, but nothing has happened from a regulatory standpoint.”

Advocates in California got legislation passed in 2008 that would have mandated that feeding tubes no longer be compatible with tubes that go into the skin or veins by 2011. But in 2009, AdvaMed, the manufacturers’ trade association, successfully pushed legislation to delay the bill’s effects until 2013 and 2014 or until the international standards group reaches a decision.

AdvaMed should be pushing forward to make needed changes. It is of great concern that the association would drag its’ feet. Patients and healthcare industry leaders need to insist that changes be made. Be vocal and share your concerns in order to demand change.

Patient safety needs to come first. It is irresponsible to allow this safety flaw to continue after all these years.

Categories: FDA, Medical Devices, Nursing issues, Safety, best practices, medical errors, patient care, patient safety
Comments: 1

Wednesday, August 18th, 2010

By Kester Freeman
Former CEO, Palmetto Health 

There is a problem in this country that few are willing to talk about and it centers around caring for the mentally ill. This is a major public health issue and it cannot be ignored as we move forward with healthcare reform.

At a recent meeting with Palmetto Health Foundation board members, they announced they will continue with fundraising efforts for the construction of a new psychiatric emergency room that will be built on the campus of Palmetto Health Richland in Columbia, SC. It is expected to be complete in 2011 and will be staffed with mental health professionals who can meet the needs of these patients.

The crisis in mental health in South Carolina grows more serious all the time. Public funding has been cut to almost nothing in many states, and other means of care are strained as a result. Prisons, public hospitals and homeless shelters are all full of seriously ill patients who do not get the care they need.

I wonder what proponents of “competition” in healthcare would do about the thousands of mentally ill who are not accepted by for-profit psych hospitals or private hospitals.

The free market has no relevance for these people, because no one wants to deal with the problem. The capitalist economic model has made this country the most prosperous on earth, but it does not work to serve the needs of the mentally ill.

The disconnect is that we have said as a society that we will not refuse to care for patients. In a free market that would never be possible. People who say we need more free market in healthcare ignore the illnesses of patients who don’t meet the free market model.    

The Accountable Care Act will help in terms of attempting to insure some of these patients. Even so, states continue to close their public beds and that is a problem.

State governments need to get involved and reassess their commitment to the mentally ill. These patients and this problem are not going away.

Categories: Access, Community healthcare, Emergency Room (ER), Government, Healthy communities, healthcare advice, patient care, public health issues
Comments: 0