Oct 9, 2013, 1:38 PM, Posted by
Gone are the days when the role of a designer was limited to boosting the aesthetic appeal of a product. Today, Design and design-thinking increasingly play integral roles in the research, development, and implementation of products, processes, services, and strategy. Design is becoming design thinking.
A quick Google search of the definition of design thinking states that “….it is a process for practical, creative resolution of problems or issues that looks for an improved future result. It is the essential ability to combine empathy, creativity and rationality to meet user needs and drive business success.”
That’s the kind of thinking that is needed to successfully tackle childhood obesity prevention—a fundamental issue for the Robert Wood Johnson Foundation. Our stated goal is to reverse the epidemic of childhood obesity in the U.S. by 2015, but we recognize that we can’t achieve this ambitious goal on our own. We need all hands on deck. As we explore potential partners in this effort, designers emerge as a key ally who have not been fully tapped.
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Oct 8, 2013, 10:00 AM, Posted by
It is increasingly clear that solutions for our most pressing and challenging public health issues will ultimately hinge on designing environments that encourage healthy behavior choices by making them more available, economical, and enjoyable.
Traditional public health approaches are not perfectly suited to this task. For example, epidemiological studies allow us to measure the association between environmental design features such as parks or sidewalks and walking behavior, but these experimental data are generally insufficient to be either actionable by decision-makers or effective in prompting behavior change. As Jeff Speck, urban planner and theorist, observes in his recent book Walkable City: How Downtown Can Save America, One Step at a Time:
The pedestrian is an extremely fragile species, the canary in the coal mine of urban livability. Under the right conditions, this creature thrives and multiplies. But creating those conditions requires attention to a broad range of criteria, some more easily satisfied than others.”
Public health must improve its ability to develop multi-dimensional interventions to more successfully provide environments and experiences that encourage positive health outcomes. Put another way, public health must develop its capacity for design thinking.
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Oct 4, 2013, 4:37 PM, Posted by
When the starting gun went off this week for the nation’s health insurance exchanges, millions of Americans began shopping for coverage. For those running the exchanges, or marketplaces, it was the start of a marathon.
That’s the conclusion that emerged from a Health Reporters’ Roundtable that the foundation sponsored in Washington recently. As top officials overseeing three of the state-based exchanges told reporters, signing people up for health insurance is just one of their tasks. Over time, the officials plan to use the power of their exchanges to help drive broader changes to improve the quality and value of U.S. health care.
The foundation-funded State Health Reform Assistance Network is providing technical support to 11 states. Two of those states, Maryland and Rhode Island, were represented at the roundtable—the former by its exchange director, Christine Ferguson, and the latter by Maryland’s secretary of health and hygiene, Joshua Sharfstein, who chairs that state exchange’s board. A third state, California, isn’t receiving help from the network, but was represented by Peter Lee, the director of its exchange, Covered California.
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Oct 4, 2013, 2:00 AM, Posted by
By Harvey V. Fineberg, MD, PhD, president of the Institute of Medicine, and Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. This commentary originally appeared on the Institute of Medicine website.
Three years ago, the Institute of Medicine (IOM) released its landmark report, The Future of Nursing: Leading Change, Advancing Health, made possible by the support of the Robert Wood Johnson Foundation (RWJF). In light of the tremendous need for nurses in health care today and in the future—due to the growing numbers of people with chronic diseases, an aging population, and the need for care coordination—the report provided a blueprint for how to transform the nursing profession.
Recommendations put forth by the report committee included removing barriers to practice and care, expanding opportunities for nurses to serve as leaders, and increasing the proportion of nurses with a baccalaureate degree to 80 percent by 2020.
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Sep 27, 2013, 11:21 AM, Posted by
RWJF President and CEO Risa Lavizzo-Mourey took part in a panel discussion at Tuesday's Clinton Global Initiative meeting in New York, and that was quite an honor. But, she writes in a recent blog post on the professional social networking site LinkedIn, the highlight of the day was what happened after the panel discussion: a presentation by presidents No. 42 and 44—Bill Clinton and Barack Obama. The two leaders delivered a clear explanation of the Affordable Care Act (ACA), and its implications for the future of the country.
And what they explained, Lavizzo-Mourey adds, was incredibly helpful, as the two presidents cut through all the background noise surrounding this clearly polarizing issue.
Health care spending is a drag on the economy, and the two presidents drove home that point. All of that spending has a measurable impact on everyday economic life, Lavizzo-Mourey says, affecting even the cost of a new car. For every new car built by America's iconic auto makers, Ford and General Motors, she writes, you can add to the price tag $2,000 in hidden health care costs. Lavizzo-Mourey concludes: "It is critical for our nation's future economic wellbeing that we fix health care."
The law in its current incarnation probably isn't perfect, Lavizzo-Mourey admits, but it's here, and we'll learn how to make it better. "The ACA is one of the most important pieces of legislation to come out of Congress in a generation," Lavizzo-Mourey writes, "and if history is a guide we know the law will be further refined and improved once its impact can be discerned."
That said, she adds: "I’m looking forward to going back to the Clinton Global Initiative a few years from now to talk about the good we can do for people with the money we once spent on health care."
PBS NewsHour videotaped the exchange. It's available below. Lavizzo-Mourey recommends you watch it. And you can read the transcript here on Politico.
Sep 6, 2013, 4:30 PM, Posted by
“Pay no attention to the man behind the curtain! The Great and Powerful Oz has spoken!”
In some ways, our health care system has traditionally functioned much like the fantastic land of Oz depicted in one of my favorite movies. Consumers and purchasers are expected to be passive consumers, doing what they are told and paying whatever price is levied based on a high degree of trust and limited information. This model seems increasingly ridiculous. We now face an urgent need to improve the quality and efficiency of our health care system.
But to do that, we need information, a lot of information. Health professionals, purchasers, consumers—basically anyone who comes in contact with health care—need timely, accurate, comprehensive information on cost and quality if they are to make smart decisions. Without such information, not even a wizard could do the trick. But right now, such information is usually unavailable, or, when it is accessible, too often indecipherable. In fact, the Institute of Medicine estimates that $105 billion is wasted every year in the U.S. because of a lack of competition and excessive price variations in health care, and a lack of information on the price of health care services plays a large role in this waste.
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Aug 20, 2013, 4:32 PM, Posted by
In my last post, I wrote about what would best motivate physicians to transform health care: carrots, sticks or something else. The case for “something else” was made in a series of innovation sessions presented at a recent American Board of Internal Medicine (ABIM) Foundation forum. They focused on evolving health care delivery models aimed at increasing quality, decreasing cost and enhancing patient-centered care.
Readers of Daniel Pink’s book Drive will be familiar with his thesis about “Type I” human behavior: the kind that is less concerned with “the external rewards to which an activity leads and more with the inherent satisfaction of the activity itself.” Many innovations presented at the forum echoed that theme—augmenting the satisfaction that doctors get from focusing most of their attention on helping patients.
Engaging doctors: At the forum, Craig Sammit, the CEO of Wisconsin-based Dean Health noted that “extrinsic” motivators, such as showing doctors how their relative performance data stacked up against their peers, had substantial impact in spurring improvement. But he observed that the measures that were most effective in transforming the way care is delivered at Dean were those that helped make the organization “the best place for a physician to work.”
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Aug 15, 2013, 5:17 PM, Posted by
Culture of Health Blog Team
When patients carry racist attitudes into the health care setting along with their illnesses and injuries, how should nurses and other providers of color respond?
While some patient attitudes can be insulting, to say the very least, Angela Amar, PhD, RN, FAAN, says such a patient encounter can also provide a learning opportunity.
In a post on RWJF's Human Capital blog, Amar recalls a particularly challenging incident when she was a new nurse. "I had just entered a patient’s room when he called out from the bathroom to ask his wife who was there," Amar writes. "She replied, 'it’s a lil’ colored girl to see you.'”
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Aug 14, 2013, 2:14 PM, Posted by
An old joke has it that the doctor’s pen is the costliest technology in medicine, since money typically flows where physicians’ prescriptions and other orders decide that it should go. As a result, influencing these decisions is key to achieving the Triple Aim of better health and health care at lower cost.
But what’s more likely to influence doctors: external factors, such as bonuses for improving the quality of care, or internal factors, such as appealing to their sense of altruism or satisfaction with their work? In other words, carrots, sticks, or something altogether different—what Daniel H. Pink, author of Drive, calls “our innate human need to direct our own lives, to learn and create new things, and to do better by ourselves and our world”?
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Aug 5, 2013, 9:43 AM, Posted by
As co-founder of ElationEMR, Kyna Fong and her brother Conan hope to revolutionize the way physicians use electronic medical records (EMRs). In this blog post, Fong, a former Robert Wood Johnson Foundation (RWJF) Scholar in Health Policy Research (2008-2010) and assistant professor of economics at Stanford University, explains how her new product helps physicians and nurses embrace the future of medicine. You can read more about how technology is being used in health care settings here.
Caring for patients is becoming increasingly complex. A whopping 68 percent of Medicare beneficiaries have multiple chronic conditions and, of those, 54 percent have four or more.
There is no doubt that innovations in information technology are essential to meeting this challenge and improving the quality and effectiveness of health care. New data streams are creating increasingly rich stories of our individual health—chronicling how we eat, sleep, exercise, and even what our genes predict.
New modes of delivering care are arising as new technologies offer more precise, more accessible vehicles to manage our health, including telemedicine, remote monitoring, connected messaging, and smart devices. What’s blatantly missing in these tools of the future, however, is a full understanding of how to connect with the key individuals who deliver care: physicians and nurses.
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